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A Childcare Worker’s Guide for Hearing and Vision Screening

Understand the importance of hearing and vision screening at your childcare center and how to support children with impairments.

A Childcare Worker’s Guide for Hearing and Vision Screening

From nurturing curiosity to fostering a love for learning, early childhood education sets the foundation for a child's academic and personal growth. However, an often-overlooked aspect of nurturing this growth is the regular screening and care for foundational senses—especially hearing and vision. These critical screenings play a pivotal role in ensuring that children can engage fully in their learning environment.

Given the subtle yet profound impact that undiagnosed issues with sight and hearing can have on a child's development, it's imperative for childcare providers to integrate these screenings into their programs. In this article, we explore the importance of hearing and vision screenings in early childhood education and ways to support children with impairments in the classroom.

Five children seated around a blue round table engaged in small parts play.Source

Why are hearing screenings important?

The first three years of a child’s life are an important time for speech and language development. Hearing, as well as all the other facets of development, is a key part of a child’s interpersonal growth. Even mild hearing loss can impact a child’s learning and social skills. 

Hearing screenings are done within the first three weeks of life, and again at ages 4, 5, 6, 8, and 10, as well as once during the preteen years and once during the teen years. Treatment, however, is most successful if it starts before a child is 6 months old, so the initial test after birth is especially crucial.

According to the CDC, up to 15% of school-age children have hearing loss in at least one ear. This makes screening especially important because it can provide early detection. The early years of life are a time of rapid growth, and children need to maintain their learning progress. An unattended hearing impairment could disrupt not only the child’s education but also their overall development. And the sooner it is diagnosed, the sooner the child can get the proper resources and assistance they need. Early intervention can prevent developmental delays and allow children to learn to communicate to the best of their ability with any impairment they may have.  

Children are a very vulnerable population, so their safety is also of utmost concern. A child who cannot hear well may not be as well equipped to keep themselves safe. They could have a harder time being alert to things like sirens, safety instructions, or car honking. Therefore, they  may need more assistance from adults to be kept safe or may require special training to learn how to keep themselves safe. The sooner they acquire those tools, the better.

In addition to hearing screenings, you can maintain a healthy classroom by using brightwheel's digital daily health checks. Upon arrival each morning, you can easily log temperatures or illness symptoms directly in the app and keep a record of any medications or allergies for each student. You can also conduct daily health screenings for staff, ensuring a healthy environment for all. 

Hearing loss support

Educators and families play an essential role in providing support to children with hearing impairments. These children simply need proper care and attention for them to learn to the best of their ability. It starts with knowing how to identify a child that may have a hearing impairment, then understanding how it can affect their learning, and lastly adjusting teaching methods and the classroom environment to help them succeed.

Knowing the signs

Hearing difficulty or hearing loss can show up differently, depending on the age of the child. 

For infants, some symptoms may be:

  • No reactions to loud noises
  • Still not saying any words by 1 year old
  • Hearing some sounds but not others
  • Not responding to their name
  • Not turning their head toward noises by 6 months old

For toddlers or older children, some symptoms may be:

  • Delayed or unclear speech
  • Trouble paying attention and following directions
  • Listening to things at a high volume
  • Continuously asking others to repeat things
  • Speaking loudly
  • Learning problems

How it can affect learning

Being hard of hearing can impact how children learn and what they need from educators. Because hearing loss can impact their ability to communicate and understand language, it can affect what they need in school. Their range of vocabulary could be limited, so they may struggle with learning English, reading, and writing. They may have a hard time receiving information that is given only by word of mouth, and it may take them longer to receive learning material.

In the classroom, there is a lot that can be distracting for children who are hard of hearing. For instance, background noise or bad acoustics can make it especially difficult for them to hear the teacher. For children who read lips or have an in-class interpreter, back-lighting makes it especially difficult for them to see what is being said.

There is also a social aspect to how hearing difficulties can impact a child. A child may feel isolated or uncomfortable because they feel “different” from their classmates. Group projects could also be challenging if they do not have the proper assistance in the classroom. Communicating with other children may be complicated, making cooperating and socializing a bit frustrating.

All of these aspects of how hearing loss can impact learning can be a lot for a child without the right support. Not knowing or understanding what they are experiencing can lead to a lot of anxiety or emotional stress, which can be a big distraction to learning. Without the support they need, these effects on their learning can slow their overall development and growth.

What you can do in your classroom

Creating the best environment for children with hearing impairments starts with you as the educator. Knowing and understanding the signs so that children can be properly screened is the first step. After that, focus on things you can do on a daily basis to help them as you are teaching. Consider the following:

  • Develop an individualized education program or 504 plan
  • Make a lot of eye contact and speak very clearly and specifically
  • Reduce back-lighting and minimize background noise
  • Work with a sign language interpreter in the classroom, but still talk directly to children, not the interpreter
  • Don’t rely solely on verbal teaching, also provide vocabulary lists, study guides, and pre-written notes ahead of each lesson and allow time for children to review them ahead of time
  • Seat children in a circle or semicircle so that children with trouble hearing can better interact and engage with other children
  • Frequently check for understanding and possible questions
  • Use any technology at your disposal, such as hearing aids, microphones, or assistive listening devices, to help communicate lessons 
  • Maintain an open line of communication with families to discuss children’s progress and ensure they are getting proper support at home
  • Ensure that any videos played in class include captions
  • During assessments, provide alternative forms of testing and be flexible with assignment deadlines and time limits
  • Have open conversations and raise awareness about hearing loss so that children can feel a sense of empathy and have some understanding about hearing impairment

If you're looking for ways to help children grow and learn across developmental domains, check out our free list!

Download a free list of activities across developmental domains!

Why is vision screening important?

As with hearing impairment, vision impairment can have a big impact on a child’s ability to thrive in school. According to the CDC, about 6.8% of children under age 18 have a diagnosed eye and vision condition.  There are several types of eye disorders, and some of them can lead to permanent vision impairment if they are not identified and treated early. Diagnosing them early also gives families and educators the time to figure out the proper assistance a child needs so they do not fall behind in their learning.

Vision screenings start soon after a baby is first born to check for any abnormalities, infections, or issues like glaucoma and cataracts. At 6 months, a different test will be used to check the light reflected through the pupil with an ophthalmoscope. The size and shape of the pupil and entire eye will also be checked. At age 1 or 2, the test will include photo screeners and autorefractors, which are computer-animated devices able to gauge vision ability. Visual acuity screening is recommended at ages 3, 4, and 5. Those tests will involve how well a child can see details, symbols, or letters from a set distance away. These screenings and exams are precautionary to understand how a child’s vision is progressing and if there is anything that needs to be addressed or treated.

Staying informed about a child’s visual ability is important because the vision center of their brain is not fully developed until they are 7 years old. So, if they have a visual impairment, early diagnosis is key for treatment. These screenings help families and educators stay informed on a child’s visual needs in and out of the classroom.

Girl in an eye examination room holding a white paddle in front of her right eye as she looks ahead with her left eye.Source

Visual impairment in the classroom

Children may be unaware that their vision is changing or may not know how to articulate it. They may not understand what they are experiencing and could be suffering in silence. The longer a vision impairment goes undiagnosed, the more the child could potentially be falling behind in learning and development. Therefore, educators must know and be able to recognize the signs indicating that a child may have a visual impairment. Some of those signs may include:

  • Squinting or tilting head to read
  • Poor hand-eye coordination
  • Rubbing eyes frequently
  • Bumping into things often
  • Having trouble learning to read
  • Avoiding tasks that require good vision

How it affects learning

Children who are struggling with their vision may have a hard time keeping up in class. They may not be able to read books or handouts or may miss visual cues at short distances. These instances can make children feel isolated and “different” from their peers, causing them to feel uncomfortable participating in class or engaging in group activities. Proper support and assistance are needed to prevent their vision impairment from negatively impacting their learning experiences.

How to best support children with visual impairments

Educators should always be aware of how any of their children may have unique needs. This includes visual impairment. There are plenty of strategies, technology, and accessibility tools for teachers to support children with visual impairment. The following are some examples you can consider for your classroom:

  • Develop an individualized education program or 504 plan
  • Do not gesture when referring to things or people, always verbalize
  • When you write on a board, say out loud what you are writing
  • Avoid speaking with generic directional terms like “over there” or “over here” and use more specific phrasing instead
  • Seat the classroom in a way that favors a child’s vision, for instance if they have a stronger right eye or left eye, and avoid the front of the class being backlit
  • Prepare as many things as possible in an electronic format to make it more accessible and adaptable
  • Use contrasting colors for as many things as possible
  • Ensure that children know the general setup of the school and classroom to help them navigate better
  • Give children the option to view any class videos or presentations ahead of time
  • Foster open, honest conversations about disabilities to create an atmosphere of acceptance

Young boy in a green t-shirt and glasses looks at an open textbook and takes notes on a notepad.Source

Help children do their best

As an educator, every child you come across will be unique and may have different needs. It’s part of your role to adapt and give every child the same opportunity to succeed. Work with families and your staff to continue making awareness and testing for hearing and visual disabilities the standard. Pay attention to the signs to know when a child may be struggling or need extra care.


Brightwheel is the complete solution for early education providers, enabling you to streamline your center’s operations and build a stand-out reputation. Brightwheel connects the most critical aspects of running your center—including sign in and out, parent communications, tuition billing, and licensing and compliance—in one easy-to-use tool, along with providing best-in-class customer support and coaching. Brightwheel is trusted by thousands of early education centers and millions of parents. Learn more at mybrightwheel.com.

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