Trainee Assessment
Vision and hearing screening for children
Unit standard / Version / Level / Credits28527Carry out vision and hearing screening tests for children in a health or wellbeing setting / 1 / 3 / 25
Your name:
Your workplace:
Your date of birth:
Your National Student Number (NSN), if you know it:
Declaration
- I was told about and understand the assessment requirements and appeals process.
- I have prepared my answers myself.
- Any evidence I have provided as my own, I produced myself.
- I understand that this assessment may be used for moderation and quality control purposes.
- I understand that when I achieve this unit standard my result will be registered with the New Zealand Qualifications Authority.
I confirm the above declaration: / Yes / No / Date:
Assessment summary (completed by assessor)
Trainee's performance summary
Assessment tasks / Assessor signature / Date achievedTask 1: Prepare for and carry out screening
Task 2: Equipment cleaning and storage
Unit standard results
I have assessed the trainee and confirm the requirements have been met to demonstrate competency in:
Unit Standard(s) / Version / Level / Credits /28527Carry out vision and hearing screening tests for children in a health or wellbeing setting / 1 / 3 / 25
/ Assessor name: / Assessor number:
Signature: / Date:
Trainee information
Before you start:
- The assessor/observer will meet with you and talk about what you need to do.
- You may have been observed doing some of these tasks already, or there may be workplace documents you have completed which documents what you have done at work.
As you go:
- Follow instructions for each task.
- Answer all questions.
- For knowledge assessment questions you can choose to write your answers or your assessor may record your verbal answers for you.
- If you need help with this assessment, please contact your assessor.
When you finish:
- Make sure you have completed any parts where the assessor/observer has said you need more work.
Appeals
If you wish to appeal against the assessment result or process, talk to your assessor. If you are still not satisfied, you can appeal to Careerforce by completing the assessment result appeal form that can be found online at
Feedback
Careerforce regularly reviews our assessment and learning resources. As a user, we would appreciate feedback on how you found it. Feedback can be provided to Careerforce via:
- our online feedback form at
- email to
Task 1: Prepare for and carry out screening
For this task, you need to demonstrate that you can prepare for and carry out vision and hearing screening for children.
Your observer or assessor will confirm that you have prepared the cohort, venue and equipment correctly, and they will observe you while you are undertaking the screening.
Your assessor will observe you and complete the observation checklists and may ask you questionsabout what you are doing.You can explain what you are doing and why you are doing it as you work through the assessment.
Before you are assessed, make sure that you are very familiar with the requirements of:
- the Ministry of Health National Vision and Hearing Screening Protocols 2014.
- your organisation’s policies and procedures.
- manufacturer’s instructions for use of test equipment.
What you need to do:
1Select a cohort of children that is appropriate to each screening type.
2Select a suitable screeninglocation and check that the environment is appropriate.
3Select and check the equipment you need to use for the screening.
4Explain the screeningprocedures to the children.
5Carry out the vision and hearing screening, includinga minimum of:
- six initial audiometry screens.
- six hearing concerns audiometry screens.
- six tympanometry screens.
- six Parr letter matching vision screens.
- four Snellen vision screens.
- two Ishihara colour vision screens.
6Follow correct hygiene and infection control procedures throughout the screening.
7Clean and store the equipment appropriately after you have completed the screening.
Review the observation checklists to ensure you understand all the requirements and know how your performance will be assessed.
Observation checklist for initial and hearing concern audiometry screening
The trainee must do the following tasks.The observer/assessor may also use this column to record comments. / Assessor/observer to complete
You prepared for audiometry screening with children by: /
- selecting an appropriate venue. Please name the venue.
- selecting an appropriate cohort group for the screen type.
- selecting an appropriate screening location. Please record the ambient noise level.
- correctly checking the suitability of screening environment for the screen type.
- correctly selecting and checking equipment for the screen type. Record the calibration date of the equipment.
Carry out initial audiometry screening for six children /
1 /
2 /
3 /
4 /
5 /
6
Screens are carried out in accordance with national screening protocols and organisational policies and procedures.
Screening procedure is explained to the child.
Screening equipment is operated correctly, according to manufacturer’s instructions.
Screening results are recorded accurately and correctly, using the appropriate forms.
Personal hygiene and infection control procedures are followed.
Please add comments you wish to make about the initial audiometry screening.
Carry out hearing concern audiometry screening for six children /
1 /
2 /
3 /
4 /
5 /
6
Screens are carried out in accordance with national screening protocols and organisational policies and procedures.
Screening procedure is explained to the child.
Screening equipment is operated correctly, according to manufacturer’s instructions.
Screening results are recorded accurately and correctly, using the appropriate forms.
Personal hygiene and infection control procedures are followed.
Please add comments you wish to makeabout the hearing concern audiometry screening.
Observation checklist for tympanometry screening
The trainee must do the following tasks.The observer/assessor may also use this column to record comments. / Assessor/observer to complete
You prepared for tympanometry screening with children by: /
- selecting an appropriate cohort group for the screen type.
- selecting an appropriate screening location.
- correctly checking the suitability of screening environment for the screen type.
- correctly selecting and checking equipment for the screen type. Record the calibration date of the equipment.
Carry out tympanometry screening for six children /
1 /
2 /
3 /
4 /
5 /
6
Screens are carried out in accordance with national screening protocols and organisational policies and procedures.
Screening procedure is explained to the child.
Screening equipment is operated correctly, according to manufacturer’s instructions.
Screening results are recorded accurately and correctly, using the appropriate forms.
Personal hygiene and infection control procedures are followed.
Please add comments you wish to make about the tympanometry screening.
Observation checklist for Parr letter matching vision screening
The trainee must do the following tasks.The observer/assessor may also use this column to record comments. / Assessor/observer to complete
You prepared for Parr letter matching vision screening with children by: /
- selecting an appropriate cohort group for the screen type.
- selecting an appropriate screening location. Please record the lux levels.
- correctly checking the suitability of screening environment for the screen type.
- correctly selecting and checking equipment for the screen type.
Carry out a Parr letter matching vision screening for six children /
1 /
2 /
3 /
4 /
5 /
6
Screens are carried out in accordance with national screening protocols and organisational policies and procedures.
Screening procedure is explained to the child.
Screening equipment is operated correctly, according to manufacturer’s instructions.
Screening results are recorded accurately and correctly, using the appropriate forms.
Personal hygiene and infection control procedures are followed.
Please add comments you wish to make about the Parr letter matching vision screening.
Observation checklist for Snellen vision screening
The trainee must do the following tasks.The observer/assessor may also use this column to record comments. / Assessor/observer to complete
You prepared for Snellen vision screening with children by: /
- selecting an appropriate cohort group for the screen type.
- selecting an appropriate screening location.
- correctly checking the suitability of screening environment for the screen type.
- correctly selecting and checking equipment for the screen type.
Carry out Snellen vision screening for four children /
1 /
2 /
3 /
4
Screens are carried out in accordance with national screening protocols and organisational policies and procedures.
Screening procedure is explained to the child.
Screening equipment is operated correctly, according to manufacturer’s instructions.
Screening results are recorded accurately and correctly, using the appropriate forms.
Personal hygiene and infection control procedures are followed.
Please add comments you wish to make about the Snellen vision screening.
Observation checklist for Ishihara colour vision screening
The trainee must do the following tasks.The observer/assessor may also use this column to record comments. / Assessor/observer to complete
You prepared for Ishihara colour vision screening with children by: /
- selecting an appropriate cohort group for the screen type.
- selecting an appropriate screening location.
- correctly checking the suitability of screening environment for the screen type.
- correctly selecting and checking equipment for the screen type.Record date of Ishihara book.
Carry out the Ishihara colour vision screening for two children /
1 /
2
Screens are carried out in accordance with national screening protocols and organisational policies and procedures.
Screening procedure is explained to the child.
Screening equipment is operated correctly, according to manufacturer’s instructions.
Screening results are recorded accurately and correctly, using the appropriate forms.
Personal hygiene and infection control procedures are followed.
Please add comments you wish to make about the Ishihara colour vision screening.
Please add any further comments you wish to make.
If you are anobserver, please give your details as the assessor may wish to contact you.
Observer Name: / Designation:Signature: / Date:
Contact details (phone/email):
Task 1: Assessor’s feedback to trainee
When the assessor agrees that you have completed this task successfully, they will sign it off on the assessment summary page at the front of this assessment.
Task 2: Equipment cleaning and storage
For this task, you need to demonstrate that you can clean and store screening equipment.
Read the checklist so you know what is being observed.
Your assessor may contact your observer to discuss this observation.
Observation
Note to observer:You have been asked to complete this observation. You must have observed the trainee working over a period of time.
You need to be confident that the trainee consistently cleans and stores screening equipment according to the standards listed in the checklist below.
Please comment on the trainee performance. The assessor may wish to contact you to discuss this observation.
I confirm that the trainee: /
Please check
- cleans and disposes of screening equipment in accordance with national screening protocols and organisational policies and procedures.
- stores screening equipment according to their organisation’s policies and procedures and manufacturer’s recommendations.
Please add any further comments you wish to make.
If you are anobserver, please give your details as the assessor may wish to contact you.
Observer Name: / Designation:Signature: / Date:
Contact details (phone/email):
Task 2: Assessor’s feedback to trainee
When the assessor agrees you have completed this task successfully, they will sign it off on the assessmentsummary page at the front of this assessment.
Carry out vision and hearing screening for children(US 28527 v1) Trainee Assessment© Careerforce – Issue 1.1–August 20161