The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise.

1. (1) American Academy of Pediatrics (AAP)--A professional organization that makes health recommendations for children.
2. (2) American Association for Pediatric Ophthalmology and Strabismus (AAPOS)--A professional organization that, along with the AAP, sets recommended vision screening standards. AAPOS works to improve children's eye care, supports the training of pediatric eye doctors, supports pediatric eye research, and helps adults with alignment issues.
3. (3) American National Standards Institute, Inc. (ANSI)--A national organization that provides information about standards used in the United States and around the world.
4. (4) Audiometer--A device used to evaluate hearing sensitivity. For the purposes of this subchapter, the term refers specifically to a screening pure-tone audiometer used to conduct hearing screenings at prescribed intensity levels to identify individuals who may require further evaluation. Diagnostic audiometers are reserved for use by licensed audiologists to conduct comprehensive hearing assessments and are not permitted for screening purposes.
5. (5) Audiometric calibration equipment--Electronic devices used to adjust audiometers.
6. (6) Automated vision screening device--A vision screening instrument that uses automation technology (like computer control systems, software, etc.,) to perform vision screening tasks with little or no direct human intervention for each individual sample or patient.
7. (7) Biological calibration check--A method to check an audiometer's accuracy by evaluating the device on an individual with known hearing levels.
8. (8) Calibration--The process of comparing an instrument or device to a standard and making adjustments to an acceptable level of accuracy.
9. (9) Certificate--A qualification given to individuals who complete vision or hearing screener training provided by either the Department of State Health Services (DSHS) or a DSHS-certified instructor.
10. (10) dB--The decibel is a unit for measuring the loudness of sounds. Decibels range from zero, which is the quietest sound an average person can hear, up to around 130, which is the average level of sound that causes pain.
11. (11) Electronic eye chart--Any computerized or other electronic system, device, or method of displaying on an electronic screen medically accepted and properly sized optotypes, which may be letters, numbers, or symbols a health care practitioner or other person uses to assess an individual's visual acuity. The term does not include an automated computer program that assesses an individual's visual acuity through the individual's interaction with the program by playing a game.
12. (12) Exhaustive calibration--An audiometer calibration that checks all settings for both earphones.
13. (13) Extended recheck--A hearing screen used after a child has failed two sweep-check screens.

14. (14) Facility--Includes public and private preschools and schools, defined as follows:

    1. (A) schools, as defined in Texas Health and Safety Code §36.003;
    2. (B) preschools, as defined in Texas Health and Safety Code §36.003;
    3. (C) child care centers licensed by the Health and Human Services Commission (HHSC); and
    4. (D) child care homes licensed by HHSC.
15. (15) Hz--Hertz is a unit of frequency equal to one cycle per second.
16. (16) Instrument-based vision screeners--A broad term for any vision screening tool used for precise measurement, monitoring, or recording of visual information. Automated devices like photoscreeners and autorefractors that estimate refractive errors and other factors that may cause vision problems in children are types of instrument-based vision screeners.
17. (17) Optotype--A standardized figure or letter used to evaluate visual acuity.
18. (18) Otoacoustic emissions (OAE) testing--A hearing screen that checks vibrations from the inner ear using sounds from a small device placed in the ear. OAE is an alternate screening method for children with intellectual or developmental disabilities.
19. (19) Pass/Fail--Allowable documentation of results if photoscreening is used for vision screening, as outlined in this subchapter.
20. (20) Photoscreener--A device that uses a special camera to check a child's vision using light reflexes to identify vision problem risk factors.
21. (21) Professional examination--A diagnostic evaluation by a provider with expertise to address the diagnostic needs of an individual with possible vision or hearing issues. This examination meets the requirements of this subchapter and Texas Health and Safety Code Chapter 36.
22. (22) Program--DSHS Vision and Hearing Screening Program.
23. (23) Provider--A person who delivers remedial services to individuals who have special senses and communication disorders, including a physician, audiologist, speech pathologist, optometrist, or psychologist. The term provider used here also includes locations such as a hospital, clinic, rehabilitation center, university, or medical school.
24. (24) Reporting year--A 12-month period beginning June 1 of each year and ending May 31 of the next year.
25. (25) Screener--An individual conducting vision or hearing screenings. A screener is either a provider as defined in this subchapter or is trained and certified by DSHS or a DSHS-certified external vision or hearing instructor to conduct vision or hearing screenings, or both.
26. (26) Screening--An evaluation to see if someone might need a professional examination.
27. (27) Screening equipment--An instrument or device used to measure sensory abilities.
28. (28) Sweep-check--A hearing screen using a pure-tone audiometer to check if an individual can hear tones at 1000 Hz, 2000 Hz, and 4000 Hz at 25 dB.
29. (29) Telebinocular instrument--A device used to check for various eye defects and measure visual acuity.
30. (30) Vision disorder--An impairment of the sense of vision.
31. (31) Visual acuity--The ability to distinguish letters or symbols at 20 feet or with a chart that simulates 20 feet. In this subchapter, visual acuity specifically means how clearly an individual can see things far away, measured as a standard ratio like 20/20.

Source Note:The provisions of this §37.22 adopted to be effective August 1, 2004, 29 TexReg 3791; amended to be effective August 17, 2014, 39 TexReg 6055; amended to be effective February 9, 2026, 51 TexReg 732.