B4 School Check information for the health sector

The B4 School Check is a health and development assessment for 4-year-olds.

The purpose of the B4 School Check is to promote health and wellbeing in 4-year-olds, and to identify any health, developmental or behavioural problems that may have a negative impact on the child’s ability to learn and take part at school.

The B4 School Check is the 12th core Well Child contact.

B4 School Checks delivered

The B4 School Check is a universal programme offered to all families with children turning 4. B4 School Checks were rolled out nationwide in September 2008.

Each district health board (DHB) agrees to a target number of checks which it expects to deliver in a year.

Each graph shows the percentage of checks achieved by each DHB against their target number of checks. The ‘high dep’ column refers to high deprivation children – those in most need.

For 2015/16, the target across the country for B4 School Checks was 56,506 children.

For 2014/15, the target across the country for B4 School Checks was 57,357 children.

For 2013/14, the target across the country for B4 School Checks was 58,804 children.

For 2012/13, the target across the country for B4 School Checks was 51,929 children.

For 2011/12, the target across the country for B4 School Checks was 52,144 children.

Content of the B4 School Check

The B4 School Check includes the following:

  • Child Health Questionnaire (Word, 278 KB)
  • hearing and vision screening through sweep audiometry, tympanometry and distance visual acuity
  • measurement of height and weight for recording in the Well Child health book and B4 School Check database
  • behavioural and developmental questions using the Strengths and Difficulties Questionnaire (SDQ) and Parental Evaluation of Developmental Status (PEDS) tools
  • an oral health screen using the Lift the Lip resource and check for enrolment in a school dental clinic
  • health promotion and education – providing information resources, advice and support as appropriate
  • referrals to appropriate health, education or social service where the B4 School Check has identified the need for such services.

B4 School Check – A handbook for practitioners

The Well Child/Tamariki Ora Programme Practitioner Handbook 2013 is the primary resource for nurses and health professionals delivering the B4 School Checks to 4-year-old children. A revised version of the handbook was released in October 2013.

Delivery of the B4 School Check

Some DHBs use a predominantly primary health care-based service delivery model, while others use a more public health or Well Child nursing-based approach. Regardless of the model of delivery, it is important that there is good engagement and collaboration between providers at all levels.

Pilots and evaluation

The B4 School Check was piloted from August to November 2007 in Whanganui and Counties Manukau DHBs. A formative evaluation of the pilots informed the planning for the national roll-out of the service in 2008.

Vision and hearing screening

The following resources are available free from the HealthEd website:

Child growth charts

Combined growth charts and health professionals’ notes provides New Zealand World Health Organization child growth charts for use in the B4 School Check. In mid-2010, these amended growth charts were introduced to the Well Child/Tamariki Ora health book and for use by providers.

Access, Use and Disclosure Policy for B4 School Check Information System Users

Access, Use and Disclosure Policy for B4 School Check Information System Users is the policy for the management and use of the health information collected as part of the B4 School Check and held on the national B4 School Check information system. This document must be read and adhered to by all users of the system.

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