The Hearing Screening Program supports local health department screening of children at least once between the ages of three and five years and every other year between the ages of five and 12 years to prevent permanent repercussions of hearing impairment by the application of appropriate treatments. A few local health departments also screen children who are younger than age three using behavioral techniques which are sensitive only to identify a severe-profound loss.
The program includes two stages of screening (preliminary and threshold). About 5% of all children screened require a medical referral. Children who are referred are assisted by local health department staff to obtain a medical evaluation either from a private provider or a Michigan Department of Community Health (MDCH), Medical Services Administration, Children's Special Health Care Services (CSHCS) sponsored otology clinic. Local health departments provide initial screening, retesting, and referral of children who do not pass the threshold testing.
Local health department staff are trained as technicians as either an EPSDT screener or school screener. They attend a two-day training for preliminary screening to provide them with knowledge and skills for EPSDT Program screening. Technicians doing school screenings attend an intensive three-week didactic and clinical practicum training which prepares them for all stages of the screening process for pre-school and school age children.
Quality assurance is provided for the approximately 150 local health department threshold technicians by the MDCH audiology consultants through field visits and required biennial skills update workshops. In local health departments, the Hearing Program Coordinator also provides quality assurance.
Serous otitis media is the most commonly identified and treated problem.
Follow-up is required to assure that service was received or to facilitate the child receiving service from a CSHCS otology clinic. Local health departments also provide community education on hearing conservation.
The Hearing Program screens in excess of 650,000 children per year in pre-school and school programs.
Vision screening of pre-school children is conducted by local health department staff at least once between the ages of three and five years, and school-age children are screened in grades 1, 3, 5, 7, 9, or in grades 1, 3, 5, 7, and in conjunction with driver training classes.
Many children enter school with vision problems. Children usually do not know that they see differently. Early identification of an eye problem is important. Conditions like amblyopia, or lazy eye, can be prevented if detected and treated during pre-school years.
Vision screening of pre-school and school-age children includes tests for clearness of vision, eye muscle balance, farsightedness, and symptoms of eyesight problems. All vision screening and testing procedures are approved by the Michigan Department of Community Health (MDCH). The tests used to screen pre-school and school-age children are not diagnostic, but identify children who may have vision problems that require additional evaluation and follow-up. A referral is made to an eye care professional after a child has failed one or more of the battery of vision screening tests. Five to ten percent of the children screened in Michigan are referred to an eye care professional.
The battery of vision screening tests is administered by local health department staff who have been trained by the Vision Consultant in the Division of Family and Community at MDCH. Technicians who perform EPSDT screening complete a two-day training course including practicum with both pre-school and school-age children. Technicians who perform pre-school and school-age screens complete a two-week training course, including practicums with all ages of children.
Quality assurance is provided for approximately 200 local health department school screening technicians by the MDCH Vision Consultant and a cadre of specially trained individuals, through field visits and skills update workshops provided yearly in at least two regional sites. Consultation is also provided to Vision Program Coordinators in all local health departments.
All county or district health departments have a Vision Screening Program which includes initial screening, retesting, and referral of children. In addition, follow-up for all screening is required which assures that care is received. When follow-up is completed, counties report those findings to MDCH. Local health departments also provide community-based education on vision conservation.
Screening is available to all children in Michigan without cost, and screenings are conducted in public, private, and charter schools as well as in health department based clinics.
The Vision Screening Program screens more than 850,000 pre-school and school-age children in Michigan each year.
More than 70,000 referrals are made to eye doctors annually.