B4 school health checks announced

A New Zealand-wide programme of ready for school health checks for 60,000 Kiwi kids will roll out from February next year, Health Minister Pete Hodgson announced today.

The B4 School programme will be piloted with up to 1000 four year olds in Wanganui and South Auckland and has been designed to ensure that all New Zealand children are prepared and supported to learn before they walk through the school gates.

It will identify any health, behavioural, social, or developmental concerns which could affect a child's ability to learn, for example a hearing problem or communication difficulty.

The programme was a key feature of Labour's 2005 manifesto.

"The Labour-led government believes that all children deserve the best possible start in life," Pete Hodgson said.

“Finding problems early will help a whole new generation of learners, and better support them as they adjust to their new life as school pupils.

"If any concerns are identified action can be taken early - for example, it might mean referring the child to an appropriate service such as a family doctor, hearing specialist, child development service or specialist education service." The B4 school checks will be funded with $23.6 million over four years through Budget 2006.

Counties Manukau and Whanganui District Health Boards will pilot the programme before it is progressively rolled out to 60,000 children nationwide from February 2008.

The check will be provided to children aged 4 to 5 years old and will include a general health questionnaire, hearing and vision screening, height and weight measurement, behavioural/developmental screening, an oral health assessment, and the provision of health education, advocacy and support.

B4 school checks – Questions and Answers

1) Why have a B4 School check?

 The B4 School check is designed to support the transition of a child into school in collaboration with early childhood education and other services for children under five years and their families/whânau. It aims to identify any behavioural, developmental, social or health concerns which could affect a child's ability to learn at school, for example a hearing problem or communication difficulty. If any concerns are identified, referrals can be made or actions taken to support the child, their family and the school to improve the child's health and educational outcomes. It might mean referring the child to hearing specialist, family doctor or specialist education.

2) How will the B4 School check work?

 Families with four-year-olds will be sent a letter inviting them to have a free B4 School check from a registered nurse with training in child health. Informed consent from parents or caregivers will be required for a child to receive the check. The checks are recommended but will not be compulsory. They will be free of charge to the parents. If any concerns are identified, a child and their family will be referred to an appropriate service, such as a hearing specialist, family doctor or special education. Parents will be asked at school entry whether their child has had a B4 School check and the school will notify the district health board of those children who have not had a check so that one can be offered at school entry.

For the Pilot, four year olds and their families from Counties Manukau and from Whanganui will be invited to have a B4 School Check. The B4 School check will be progressively rolled out across the rest of New Zealand from February next year. Four year olds and their families will be invited in writing once the checks begin in their area.

3) What will the B4 School check include?

 The B4 School check will include a general health questionnaire, hearing and vision screening, height and weight measurements, an oral health assessment and questionnaires about the child’s behaviour/development. It is expected that the checks will take about 30 minutes to complete. The general health questionnaire will include questions about immunisation, hospital admissions, pre-existing and chronic conditions such as asthma, allergies or disabilities and whether the child has glasses prescribed or grommets inserted.

Hearing screening for the B4 School check will involve sweep audiometry, where a child wears a set of headphones and responds when they hear a beep. Tympanometry, where a tympanometer probe is placed in the child’s ear, would be carried out if there is evidence of reduced hearing.

Vision screening will involve testing for distance visual acuity with vision charts.

The oral health assessment will involve the nurse looking at the child’s teeth and gums for evidence of gum or tooth problems and ensuring the child is enrolled with a dental service.

Parents/caregivers will be asked to complete questionnaires to identify any developmental concerns or behavioural issues. Where possible the child’s early childhood or new entrant teacher will also be asked to complete the questionnaire. These questionnaires will be scored by the nurse and where there are concerns, the scores will be discussed with the parent/caregivers.

4) Who will do the checks?

 The B4 School checks will be delivered by a variety of providers, including practice nurses, public health nurses, Maori and Pacific providers, Well Child/Tamariki Ora providers, and Vision/Hearing Technicians.

5) Where will the checks be done?

 It is likely that children will receive their B4 School check in one of a range of settings, including home visits, early childhood education centres and kohanga reo, general practices, community settings and schools.

6) What happens if problems are identified?

 If any concerns are identified, the nurse delivering the check will discuss the concerns with the parent/caregivers and refer the child to an appropriate service, such as a hearing specialist, family doctor or special education, with the informed consent of the parent/caregivers.

7) How will we know if the programme is making a difference?

 Children with behavioural, developmental and/or health concerns will be identified and provided with appropriate referrals and support to ensure they start school able to participate and enjoy it to the best of their ability. In addition, health and educational professionals will have a greater awareness of the child’s needs and will be supported to deliver quality care.

The Ministry has received multi-regional ethics committee approval for the pilot to be evaluated. CBG Health Research Ltd will evaluate the pilot to look at the most effective ways of delivering the services and the opportunities to improve linkages and referrals between primary health care, education, Well Child/Tamariki Ora providers and other government agencies. It will also cover issues around the available workforce and how best to identify and access children and families.

8) When will be checks be available in my area?

 For the Pilot, four year olds and their families from Counties Manukau and from Whanganui will be invited to have a B4 School Check. The B4 School check will be progressively rolled out across the rest of New Zealand from February next year. Four year olds and their families will be invited in writing once the checks begin in their area.