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Vision Screening and Children with Special Healthcare or Learning Needs Survey (Jan 2021)

Thank you for agreeing to complete this survey. We hope to use the information from this survey to offer a starting point for to create resources to support you in supporting the vision and eye health needs of children with special health care or learning needs. Answers will be confidential and we will not share any names when sharing the results.
1.What is your title/role in terms of your work with children with special learning or healthcare needs?
Please select all that apply.
2.Where do you work?
3.Please describe your current program.
4.What ages do you serve?
The next set of questions relate to how your program assesses vision for children being evaluated for receipt of services. 
5.If your program assesses childrens'/students' vision, for what purposes do you provide this assessment?
6.In what ways does your program assess vision for children being evaluated for special education or health services? Please check all that apply.
7.What is your process for vision screening when a child is considered "untestable" via an instrument (sometimes called a camera) or a wall chart? 
8.Are you involved in assessing vision for your program?
9.Who performs vision screening in your program?
10.If your program uses a questionnaire for parents, what is the source of the questions that are used?
11.If you administer a special needs questionnaire for parents, please list the questions about vision or provide a link if your questionnaire is online (and please send a copy of any questionnaires to dfishman@preventblindness.org)
12.What methods do you use to perform vision screening?
13.Please tell us about any training required for staff who screen children's vision. (Check all that apply)
14.If training is required, please describe the training. Check all that apply.
15.Under federal, state, or local regulations, do children receive vision screening even if they are currently receiving eye care and/or treatment?
16.When a child is considered to need an eye exam, please describe your referral protocols. Please check all that apply. 
17.Please describe your process for helping families obtain eye care regarding health or vision insurance coverage.
18.If a child does not have the ability to cover the costs of an eye exam, does the school district, Head Start, or other program have any resources to subsidize the cost of an exam? 
19.Do you provide any educational materials on vision for parents on childhood vision? If yes, please email them to dfishman@preventblindness.org
20.What are your 2-3 biggest challenges in assessing vision in the population that you serve? We are particularly interested to know if you serve non-English speaking populations and how you adapt questionnaires and parent education materials for those families. We are also interested in your experiences with referring children for eye exams to support the eligibility/IEP process. Please describe.
21.The NCCVEH is wishing to support children with special health care needs. What resources (vision screening training, handouts, brochures, factsheets, videos etc.) from the NCCVEH could be helpful to you in the process of assessing children's vision, referring to eye care?
22.As the NCCVEH develops materials related to eye care for children with special healthcare or learning needs, we are eager to get input from practitioners. If you are willing, please enter your first/last name and email address.
Thank you so much for completing this survey! The information you have provided us is greatly appreciated! If you have any questions or concerns please contact dfishman@preventblindness.org