Spinal Screening Program

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    The Texas Department of State Health Services (DSHS) Spinal Screening Program was established by the Texas Legislature to detect abnormal spinal curvature in students. The program is required to adopt rules as mandated by the statute

    School-based spinal screening helps to identify adolescents with abnormal spinal curves and refer them for appropriate follow-up with their doctor. Screening can detect scoliosis at an early stage when the curve is mild and may go unnoticed. Early detection is key to controlling spinal deformities.  


    Provisional Certificate Holders  

    This is a reminder that your vision, hearing and spinal screening certification will expire this year on December 31st 2022. Please contact your vision, hearing and spinal screening regional coordinators to schedule an in-person recertification class before the expiration date. Thank you for your cooperation. If you have questions please contact your regional coordinator or contact our customer service line at 512-776-7420, 1-800-252-8023 extension 7420, or vhssprogram@dshs.texas.gov

    Regarding Screening Rules During 2021-2022 School Year  

    Health and Safety Code, Chapter 36 and 25 Texas Administrative Code Chapter 37 require Public, Private, Parochial, and Denominational Schools (Schools) and Department of Family and Protective Services (DFPS) Licensed Child Care Centers and Licensed Child Care Homes (Child Cares) to screen children for vision, hearing and spinal problems.

    The Health Screening Group understands the challenges that schools and school districts are facing due to the COVID-19 pandemic.  Although screening is still required for this school year, DSHS understands the need for flexibility and advises schools and school districts to assess their capacity to safely conduct screenings.  Schools and child cares with the capacity to screen should notify parents and follow best practices previous developed by the department.  Parents who choose not to participate at this time may decline screenings.

    DSHS recommends schools notify the parents of children who have missed or will miss a screening. This notification should inform parents of the missed screening and encourage them to ask for screenings at their child’s next well-child appointment with their medical provider. If a parent suspects their child has a vision, hearing, or spinal problem they should notify the school nurse or school administration for assistance in obtaining a screening. The Health Screening Group has developed sample letters for parents for vision and hearing screening  and spinal screening that schools may use. The letters are also available in Spanish: vision and hearing screening - Spanish, spinal screening - Spanish.

    In Person/Online Instructions

    Schools should follow these guidelines for students to obtain visionhearing and spinal screenings that are receiving in person or online instructions.  

    • Send a letter to parents notifying them in advance that screenings will be conducted on designated dates
    • Request parent to please bring student receiving online instructions to the school so screenings may be performed in accordance with the statutes
    • In lieu of the screening(s) provided by the school:
      a.      parents or guardians may provide screening record signed by a licensed professional
      b.      parents or guardians may provide signed statement that the vision, hearing or spinal screening conflicts with the tenets and practices of a church or religious denomination of which the affiant is an adherent or member

    Vision, Hearing and Spinal Screening Updates  

    Schools who are screening students, please refer to this best practices document for guidance on safely screening children this school year.    

    Vision, Hearing and Spinal Screening Reporting Period Begins January 15

    The reporting period for vision, hearing and spinal screening (VHSS) begins on January 15, 2022. Results are required to be submitted to the Department of State Health Services online at the Child Health Reporting System (CHRS) by June 30 of each year. View the vision, hearing and spinal screening annual reports flyer.

    The last day to submit your report for this school year is June 30, 2022. After June 30, the reporting system shuts down and late reporting cannot be submitted.

    Updated Spinal Screening Policy Effective 2018-2019 School Year

    Due to feedback from stakeholders, the Spinal Screening Policy has been reviewed and updated regarding ages and grades to be screened for the 2018-2019 school year. In September 2015, the Scoliosis Research Society (SRS) published a joint position statement paper with the American Academy of Orthopedic Surgeons (AAOS), the Pediatric Orthopedic Society of North America (POSNA), and the American Academy of Pediatrics (AAP) and have the following recommendation: “AAOS, SRS, POSNA, and AAP believe that screening examinations for spine deformity should be part of the medical home preventative services visit for females at age 10 and 12 years, and males once at age 13 or 14 years.”

    Grade-based screening is considered an acceptable alternative to age-based screening in a school setting. The grades, however, must align with the professionally recommended ages so that most children are screened at the appropriate age, or as close to it as reasonably possible.

    In compliance with Health and Safety Code, Chapter 37, all children shall undergo screening for abnormal spinal curvature in accordance with the following schedule:

    • Girls will be screened two times, once at age 10 (or fall semester of grade 5) and again at age 12 (or fall semester of grade 7).
    • Boys will be screened one time at age 13 or 14 (or fall semester of grade 8).

    It is necessary for schools to identify outliers (i.e., children promoted to higher grades or held back) and ensure their screenings align with appropriate ages rather than grades. 

    Updated Program Guidelines and Spinal Screening Report (M-51)

    The Spinal Screening Program Guidelines is the teaching manual for DSHS-approved spinal screening certification workshops. It has been updated to reflect the changes effective the 2018-2019 school year.

    School districts, private school systems, and charter schools use Form M-51 to report cumulative totals of the spinal screenings conducted at each campus.

    Contact Us

    Texas Department of State Health Services 
    Spinal Screening Program - Mail Code 1818
    PO Box 149347 | Austin, Texas 78714-9347
    1100 West 49th Street | Austin, Texas 78756-3199
    Phone: 512-776-7420 | Toll Free 1-800-252-8023, extension 7420 
    Fax: 512-776-7256 
    Email: vhssprogram@dshs.texas.gov


    Last updated July 1, 2022