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Ask The Lawyer

Posted by: tdt -

 “I am wondering, are spinal screenings really required by law, or could I have said no to the screening?”


    Question:  During this past school year my daughter attended the intermediate school.  She had to have a spinal curvature screening, but she didn’t want to do it.  She was embarrassed because she’s a little bigger than the other girls, and she didn’t want anyone to see her have the screening.  I was told that the screening was required by law.  I told my daughter it was no big deal and she had the screening, but I am wondering, are spinal screenings really required by law or could I have said no to the screening?

    Answer:  Yes, abnormal spinal screenings are required in Texas under the Health and Safety Code Title 2, Health, Subtitle B, Texas Department of Health Programs, Chapter 37, Abnormal Spinal Curvature in Children.  And although screening is required by law for children in grades 6 and 9 under the Code, parents may opt out of the screening under certain circumstances.

    A normal, healthy spine should have curves that may be seen by viewing the spine from the side.  Too much or abnormal curvature is evidence of a spinal disease which is relatively easy to detect in a screening.  The Texas Legislature enacted laws requiring the screening of children in 1989.  

    Many adults over the age of forty may remember that when they were young they had hearing tests, vision tests, speech tests and the like in school, and probably had all of their immunizations given by a school nurse.  Today, schools still provide some screening services, and screening for an abnormally curved spine is one such service.  Most people who have an abnormal curvature of the spine never require any type of treatment, but some do, including surgery that is very invasive and requires a lengthy recovery period.  Providing the minimally invasive screening for all school children is an early detection mechanism that many parents may never realize should be considered.

    Too much curvature in the thoracic spine, mid-back, is called kyphosis.  One type of kyphosis is Scheurmann’s kyphosis, or Scheuermann’s disease, and was first discovered by a radiologist of that name in the 1920’s.  Scheuermann’s kyphosis develops during periods of bone growth.   Children between the ages of 11 and 15 experience a great amount of bone growth due to puberty.  When the front of the spine doesn’t grow as fast as the back of the spine, then vertebrae become triangular-shaped and wedged together. This causes the thoracic spine to curve abnormally and people with Scheuermann’s kyphosis become stooped forward with a bent-over posture.

    Other causes of abnormally curved spines include scoliosis.  Scoliosis includes lateral or to the side curvatures of the spine.  Scoliosis is relatively common in children and adults, but rarely requires any form of treatment. Scoliosis may develop due to a number of causes.  The different types of scoliosis depend upon the cause.  In children and adolescents, the most common type of scoliosis is called Idiopathic Scoliosis and its cause is not known but may be caused by a combination of hormonal, genetic and neurological factors. In idiopathic scoliosis, a portion of the spine rotates and shifts away from the midline. Seen from the back the spine is not straight and a hump is visible on the side that the curved spine has shifted.

    Texas law states that each individual required to be screened shall undergo approved screening for abnormal spinal curvature. The individual’s parent, managing conservator, or guardian may substitute professional examinations for the screening.  Proof of a private professional screening must be provided to the school.  Another exception from the screening is if the screening conflicts with the tenets and practices of a recognized church or religious denomination of which the individual is an adherent or a member. To qualify for the exemption, the individual’s parent, managing conservator, or guardian must submit to the chief administrator on or before the day of the screening procedure an affidavit stating the objections to screening.

    Screening of children in grades 6 and 9 is required in all Texas schools, public or private.  A school district may elect to provide the screening program for children earlier than grade 6, so long as the screening process complies with the rules promulgated by the State.  Unless a legitimate exemption exists to opt out of the screening program, it is a simple and free service that may detect an abnormality that may be treated early.

    This article is meant for informational purposes only and not as a substitute for sound legal advice.

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