Changes in Rule Chapter 45: Vision and Hearing Screening in Maine Schools

This notice is to inform you of the recent changes to Chapter 45: Rule for Vision and Hearing Screening in Maine Schools. This rule outlines the standards and processes for periodic vision and hearing screenings. The purpose of a screening is to identify potential hearing or vision deficits among school age children and refer for further care. Updates to this rule reflect current national recommendations for hearing and vision screenings. The rule also clarifies techniques and acceptable research-based tools for schools to use.

This new requirement is in effect for the start of the school year 2018-19. Chapter 45 includes definitions, school nurse responsibility, general guidelines, vision screening schedule including distance and near acuity, alternative screening methods, and referral guidelines, hearing screening schedule and referral guidelines.  The complete rule can be reviewed at

In brief, vision screening is required for preschool, kindergarten, and grades 1, 3, 5, 7, 9; hearing screening is required for preschool, kindergarten, and grades 1, 3, 5. The rule acknowledges that some children, because of their medical histories, have a higher rate of vision problems and may bypass routine screening at school to be directly referred to an eye specialist. The school nurse may determine which children should be referred directly.

The rule also clarifies which research-based tools are acceptable for screening. Particularly, using evidence-based instruments to screen for amblyopia risk factors and reduced vision risk factors may be used for certain school children in place of tests of visual acuity.

If you have questions about hearing and vision screening, please contact the Maine Department of Education School Nurse Consultant, Emily Poland at 624-6688 or .