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Health check before school

Health check before the start of the new school year

It’s time to go back to school!

Now is the time to take your child to the paediatrician for a preventative health check. Prevention is always better than cure, and this is especially valid for children. The paediatrician will review your child’s medical history, examine the child, and carefully fill in his personal health record. Collaboration with the doctor, information regarding the health of all pupils, and the particular needs of each, is very important for the school and the teacher.  A check-up before the child begins primary school is particularly significant, and should not be missed.

During this visit, the paediatrician will record any chronic illness the child may have, as well as any medications he may be taking on a long term basis. Will it be necessary for the child take medication at school, and how will this be accomplished? He will also ascertain whether the child has atopic conditions, such as allergic rhinitis, atopic dermatitis, or a known allergy to a food or medication. He will record the infectious diseases from which the child has suffered, and any surgical operations he might have undergone.

Then, the doctor will discuss any behavioral problems and learning disabilities with the parents. Is the child toilet trained? Is he sleeping properly? What is the child’s previous experience of school or nursery? Does he have problems with reading and writing? How has he performed at school until now? Does he have friends, is he sociable? Does he often have moments of aggressive behaviour, is his attention easily distracted, does he have any nervous conditions?

The conversation will continue with safety issues and accident prevention for the child: How will he get to school? Has he been taught road safety? Has he learned what to do if approached by strangers? Does he wear a helmet when cycling?

Then, the paediatrician will check the child’s health record for his vaccinations. Has the child had the recommended vaccines for his age? Are booster doses due this year?

The visit will continue with weighing and measuring of the child. The doctor will ask about his diet, weigh him, measure his height and waist circumference, and calculate his body mass index (BMI, obesity index). Early diagnosis and intervention in cases of childhood obesity, which unfortunately are at epidemic levels in this country, are very important.

During the clinical examination of the child, the doctor will note his general condition and that of his skin. He will check his heart for any murmurs, his breathing, and his pulse. He will confirm that no symptoms relating to exercise persist (fainting, pain in the chest, fatigue after running).

He will then proceed with examination of the abdomen, genitals, and groin, to exclude conditions like abnormal enlargement of an organ, undescended testicles, premature sexual development, and hernias. He will examine the child’s mouth for dental problems, and for conditions such as enlarged tonsils. He will check the child’s ears with an otoscope, and confirm that his hearing is good.

The clinical examination will be completed with a check for curvature of the spine, and measuring of the child’s blood pressure. Unfortunately, high blood pressure is now common in many children and adolescents, so it is important to check your child’s blood pressure at least once a year during childhood.

Finally, and if all is well, your paediatrician will certify in writing that your child can participate in all school activities. It is also possible that he will refer the child to a specialist for any of the above issues, about which he may be concerned.

Your child’s health check before the beginning of the new school year needs to be supplemented with visits to two more specialists: the dentist, who will check for problems, such as dental caries, and the ophthalmologist, who will certify that there are no problems with sight (short-sightedness, astigmatism etc.), and that the child can focus properly.

The child’s personal health record card is available in the child’s new health book provided by the Ministry of Health. Parents should study the health book at regular intervals, because it provides valuable age-based information.

The individual health card is also provided by each child’s school to be filled in by the specialists.

Stelios Papaventsis MRCPCH DCH IBCLC 2010

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