R384-201-10. Vision Symptom Questionnaire

(1) The DHHS will provide to the LEA the Vision Symptom Questionnaire for the classroom teacher to potentially identify a vision problem. The DHHS will update the questionnaire as needed. (2) For a student who fails to achieve benchmark status on the benchmark reading assessment in grades 1-3: (a) the LEA shall notify the teacher within 30 calendar days of student performance on the benchmark reading assessment; (b) the teacher must complete the Vision Symptom Questionnaire within 45 calendar days of the administration of the assessment and submit the questionnaire to the school nurse; (c) the teacher need only complete the Vision Symptom Questionnaire once per school year; and (d) the school nurse shall use the Vision Symptom Questionnaire to evaluate the need for a tier 2 screening or refer to an eye care professional within 30 calendar days of receiving the Vision Symptom Questionnaire. (3) For a student who is being referred or reevaluated for special education for a suspected disability affected by a vision difficulty: (a) the teacher must complete the Vision Symptom Questionnaire and submit to the school nurse; and (b) the school nurse shall use the Vision Symptom Questionnaire to evaluate the need for a tier 2 screening or refer to an eye care professional within 30 calendar days of receiving the Vision Symptom Questionnaire. (4) For a student who is being referred by parent or guardian for vision concern: (a) the parent or guardian should complete the Vision Symptom Questionnaire and submit to the school nurse; and (b) the school nurse shall use the Vision Symptom Questionnaire to evaluate the need for a tier 2 screening or refer to an eye care professional within 30 calendar days of receiving the Vision Symptom Questionnaire.