Missed opportunities: Do states require screening of children for health conditions that interfere with learning?

PLoS One. 2018 Jan 17;13(1):e0190254. doi: 10.1371/journal.pone.0190254. eCollection 2018.


Methods: Investigators reviewed websites of state departments of health and education, and legislation for all 50 states and DC. For states with mandated screenings and a required form, investigators applied structured analysis to assess HBL inclusion.

Results: No state mandated that schools require screening for all 7 HBLs. Less than half (49%) required comprehensive school health examinations and only 12 states plus DC required a specific form. Of these, 12 of the forms required documentation of vision screening, 11 of hearing screening, and 12 of dental screening. Ten forms asked about asthma and 9 required documentation of lead testing. Seven asked about general well-being, emotional problems, or mental health. None addressed hunger. When including states without comprehensive school health examination requirements, the most commonly required HBL screenings were for vision (80% of states; includes DC), hearing (75% of states; includes DC) and dental (24% of state; includes DC).

Conclusion: The lack of state mandated requirements for regular student health screening represents a missed opportunity to identify children with HBLs. Without state mandates, accompanying comprehensive forms, and protocols, children continue to be at risk of untreated health conditions that can undermine their success in school.

MeSH terms

  • Asthma / complications
  • Asthma / diagnosis
  • Child
  • Female
  • Hearing Disorders / complications
  • Hearing Disorders / diagnosis
  • Humans
  • Learning Disabilities / diagnosis*
  • Learning Disabilities / etiology
  • Male
  • Mass Screening / legislation & jurisprudence*
  • Mental Disorders / complications
  • Mental Disorders / diagnosis
  • Toothache / complications
  • Toothache / diagnosis
  • Vision Disorders / complications
  • Vision Disorders / diagnosis

Grant support

The authors received no specific funding for this work.