 |
|||
 |
|||
Healthy
|
|||
Health Screening
in the Childcare Setting
Health screening is an important component of the health program in childcare, and the first step to improved health outcomes for children and staff. Routine screening provides the opportunity for assessment of health status and early identification of health risks. Timely intervention and treatment of physical, developmental, and behavioral problems are dependent on early identification and linkage to appropriate health care resources.
Health screening for infants and young children is primarily focused on physical growth, developmental milestones, and the child's ability to learn. Basic screening procedures include assessment of health status, developmental abilities, and psychosocial skills, with emphasis on those aspects most relevant for each age group. However, as children's growth patterns and abilities are so varied at each stage, an understanding of normal growth and development is essential for accurate assessment and appropriate referral.
Because parents are often the first to identify problems with their child, their observations and concerns should be taken seriously in assessing health status and developmental abilities. Daily observations by knowledgeable, experienced childcare staff also provide an indication of a child's progress and potential problem areas. Children who require further professional evaluation include those who display sensory impairments (visual or hearing), and children who do not function at age-appropriate levels in the areas of speech, language, or motor development.
The child's age and ability to cooperate should be considered during screening procedures. For example, vision screening for children less than three years old may involve observation of the child's ability to track and respond to verbal stimuli; older children would be screened according to the standard eye chart. Similarly, hearing can be assessed by a young child's response to talking, clapping, or other noises.
Considerations for Screening of Children
- You must inform parents in writing prior to the screening date, and obtain written, informed permission. Parents should be informed about the type of procedure to be performed, when, by whom, benefits to the child, and cost (if any). Also, assure parents they will receive results of all screening.
- Screening procedures completed on-site are generally "non-invasive." "Invasive" procedures, such as finger-prick blood tests, are best performed in a clinic or through special arrangements with medical personnel.
- All children should be familiarized with the screening procedure before it takes place. Simple explanations, models, and play-acting are all beneficial methods for preparing children and gaining their cooperation.
Screening Recommendations
Health standards and guidelines vary considerably among programs, with few specifications for health screening. The American Academy of Pediatrics emphasizes routine appraisal of child health, including growth, developmental progress, and screening for immunizations, vision, hearing, and dental health.
Head Start Performance Standards mandate timely screening (within 45 days of entry) for developmental, sensory, and behavioral concerns, and on-going evaluation of health status. Vision and hearing screening are considered essential in most programs for young children. Screening for immunization status is a requirement in many programs and must be accompanied by written documentation of each child's vaccinations
Other types of screening such as TB, hepatitis A, and sickle cell anemia may be mandated by state licensing requirements or identified health risks in a particular community. Many of the required screenings and health services are provided through the state Medicaid Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program.
Health Screening in Your Program
Providing routine health screening in childcare is essential for preventative health and the early detection and prompt treatment of illness or disability. Screening services should be individualized to the needs of children by age group and their know or suspected health risks. Collaboration with parents and health care providers in the community is helpful in identifying priorities and ensuring necessary on-site services. The health advocate or health consultant can be a valuable resource in accessing needed services for the childcare program. It may be possible to have screening procedures performed at the childcare facility through partnership with local health departments, physicians, dentists, and pediatric or public health nurses. Other health professionals or students my also be willing to contribute time and skills to your programs.
By Maureen A. Nalle, PhD., RN
Maureen A. Nalle, PhD., RN, is an assistant professor, University of Tennessee, Knoxville, College of Nursing
Resources
"Caring for Our Children; National Health and Safety Performance Standards, Guidelines for Out-of-Home Child Care Programs" can be obtained from the American Academy of Pediatricians, 800-433-9016.
The text can be found on the National Resource Center for Health and Safety in Child Care web site: nrc.uchsc.edu
Bright Futures: Guidelines for Health Supervision of Infants, Children and Adolescents, National Maternal and Child Health Clearinghouse, 703-356-1964; www.circsol.com/mch.
|
Healthy Childcare® Home Page | Library | Search | Questions & Answers | Links
I Am Amazing | Hip On Health | Health & Safety Resource Guide | Order Form
Product Spotlight | Free Issue | Publisher's Letter | Contact Us | Author Guidelines HEALTHY CHILD PUBLICATIONS Last Revised: |
||