My school is all pre-K and we have to use the HOTV chart, the kids get a card with HOTV on it and just point to the one that matches. But maybe that's only valid in TX ...
I got this from the previous nurse but she got kid sunglasses, popped out the lenses, and covered one side with a fun shape. Way easier than having little ones try to hold an occluder or cup to their eye.
I get 3-5 kids at a time with a teaching assistant, explain the directions to the group, and give each kid a chance to show me they're able to match the letters up close. Having the TA or teacher there really helps.
I start with just a few of the really large letters to build their confidence and ensure they're understanding the matching part.
I've found that with hearing, I have to help a lot of them understand the procedure by playing the tone and raising their hand for them a few times before they catch on.
It takes FOREVER for me to screen these littles! This is probably the only time I miss my middle schoolers who breezed through screenings.