• Acanthosis Nigricans

    The Texas Risk Assessment for Type 2 Diabetes in Children is a legislatively mandated program developed, coordinated, and administrated by The University of Texas Pan-American Border Health Office (BHO). The program assesses children who may be at high risk of developing Type 2 Diabetes in Texas Education Agency Regional Education Service Centers 1, 2, 3, 4, 10, 11, 13, 15, 18, 19, and 20. During vision/hearing and scoliosis screenings of 1st, 3rd, 5th, and 7th graders in public and private schools, certified individuals assess children for the acanthosis nigricans marker, a skin condition that signals high insulin levels. Children who are positively identified with the marker undergo additional assessments of body mass index (BMI), BMI percentile, and blood pressure. Referrals are issued to the parents of these children, alerting each parent of their child's risk factors and encouraging further evaluation from a health professional. Becoming aware of and understanding what the risk factors suggest can help stimulate the changes necessary to prevent or delay future health problems for children at risk of developing Type 2 Diabetes and other conditions.



    Spinal Screening Policy Effective 2018-2019 School Year

     House Bill 1076, 85th Legislature, Regular Session, 2017, allows the Department of State Health Services (DSHS) to consider the most recent, nationally-accepted, peer-reviewed recommendations when considering appropriate age for conducting mandatory spinal screening.

    As of September 2, 2015, the Scoliosis Research Society (SRS) published a joint position statement paper with the American Academy of Orthopedic Surgeons (AAOS), the Pediatric Orthopedic Society of North America (POSNA), and the American Academy of Pediatrics (AAP) and have the following recommendation: “AAOS, SRS, POSNA, and AAP believe that screening examinations for spine deformity should be part of the medical home preventative services visit for females at age 10 and 12 years, and males once at age 13 or 14 years.”

    In compliance with Health and Safety Code, Chapter 37, all children shall undergo screening for abnormal spinal curvature in accordance with the following schedule: 

    • Girls will be screened two times, once at age 10 and again at age 12.
    • Boys will be screened one time at age 13.

    NOTE: Children enrolled in a facility who meet the above age requirements after September 1 of that school year are exempt from screening until the following September.

    Current professional recommendation encourages screening performed in a medical home. Texas Health and Safety Code, Chapter 37, requires school administrations to ensure compliance with the screening requirement. Soliciting documentation from parents that spinal screening has been performed by a professional may reduce the number of students who need to be screened and prevent unnecessary additional screening.



     As part of Health and Safety Code, Chapter 36, the Vision Screening Program requires that all children enrolled for the first time in any public, private, parochial, or denominational school or in a Department of Family and Protective Services (DFPS) licensed child care center and licensed child care home in Texas, or who meet certain grade criteria, must be screened or have a professional examination for possible hearing or vision problems.

    The requirements for screening apply each year for children enrolled in any licensed child care center and licensed child care home or school program at the ages or grades listed below: 

    Screening Requirements
    Who Must Be Screened  When Screening Must Be Done
    • 4-years-old by September 1 
    • Kindergartners
    • Any other first-time entrants
      (4 years* through 12th grade)
    Within 120 days of admission 
     1st, 3rd, 5th and 7th graders  Anytime within the school year
    (preferably within first semester)