This annual report - Taranaki District Health Board

Ministry of Health. 2008. The B4 School Check: A handbook for practitioners. Wellington: Ministry of Health.http://www.health.govt.nz/publication/b4-school-check-handbook-practitionersThis handbook provides guidance to clinicians on the standard protocols for each component of the B4 School Check,and can be used for planning services, training nurses and vision and hearing technicians, and improving quality.Clinical pathways and referral processes for the screening and surveillance aspects of the B4 School Check areprovided. The purpose of the B4 School Check is to promote health and wellbeing in preschool children and identifybehavioural, developmental or other health concerns that may adversely affect the child's ability to learn in the schoolenvironment. The check includes: advice and support for parents about child health and development; a child healthquestionnaire; a hearing screen; a vision screen; an oral health screen; questionnaires to identify developmental andbehavioural problems (completed by parents and teachers in discussion with health professionals using the Strengthsand Difficulties Questionnaire and the Parental Evaluation of Developmental Status questionnaire); height and weightmeasurement; and referral of the child to specialist services if the child appears to have problems that need furtherinvestigation.Cochrane Systematic ReviewsPowell C & Hatt SR. 2009. Vision screening for amblyopia in childhood. Cochrane Database of Systematic Reviewsdoi:10.1002/14651858.CD005020.pub3 http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005020.pub3/abstractThis systematic review aimed to assess the effectiveness of vision screening in reducing the prevalence of amblyopia,a reversible deficit of vision that has to be treated within the sensitive period for visual development. No RCTs or clusterRCTs comparing the prevalence of amblyopia in screened versus unscreened populations were identified. The authorsconclude that there is currently insufficient evidence to determine whether or not screening programmes reduce theproportion of older children and adults with amblyopia, and some robust evaluation of screening programmes that are inplace is required.Simpson SA, et al. 2007. Identification of children in the first four years of life for early treatment for otitis mediawith effusion. Cochrane Database of Systematic Reviews doi:10.1002/14651858.CD004163.pub2http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004163.pub2/abstractThis systematic review assessed the effectiveness of screening and treating children with clinically important otitismedia with effusion (OME or ‘glue ear’) in the first four years of their life on language and behavioural outcomes. NoRCTs comparing outcomes for children randomised to be screened for OME with outcomes for children randomised tonot be screened for OME were identified. Three RCTs (668 participants) evaluating interventions for OME in childrenidentified through screening were included in the review. Children with OME were randomised either to treatment withventilation tube insertion or ‘no treatment’, ‘watchful waiting’ or ‘late treatment with ventilation tubes’. No evidence of aclinically important benefit in language development from screening and treating children with clinically important OMEwas found in any of the studies.Other Systematic ReviewsOberklaid F, et al. 2002. Child Health Screening and Surveillance: a critical review of the evidence. Canberra:National Health and Medical Research Council. http://www.nhmrc.gov.au/guidelines/publications/ch42This extensive review of child health screening and surveillance examined the evidence base for specific screening andsurveillance activities in childhood (birth to 18 years) and provides a summary of the evidence, recommendations and aresearch agenda for each child health topic identified. Topics covered include: congenital adrenal hyperplasia, cardiacdisease, congenital hypothyroidism, cystic fibrosis, hearing loss, hip dysplasia, undescended testes, vision, dentalhealth, development, height and weight. Relatively few topics could be recommended for formal screening programmes(congenital hypothyroidism – good evidence, cystic fibrosis – fair evidence, hip dysplasia – fair evidence for ultrasoundscreening, insufficient evidence for examination, universal neonatal hearing – fair evidence, phenylketonuria –fairevidence). Formal screening programmes could not be recommended for many conditions, for a variety of reasonsincluding: multidimensional conditions on a continuum of normality-abnormality that do not lend themselves to pass/failcriteria; available screening tests not considered sufficiently acceptable to the target population, based on reporteduptake rates of either the screening test or definitive referral; sensitivity could not readily be balanced against specificity(very large numbers of false positives a by-product of capturing all or most of those with the target condition); the targetcondition itself was too variable over time to justify screening at a single time point, but evidence to support periodicscreening (surveillance) was not available; management for those detected by screening has not shown to significantlyalter outcomes or there was not an agreed therapy.Well Child/Tamariki Ora Services - 182