School health screening: history, principles, and analysis

For over a century school health services have provided children with an important safety net-identifying those with disorders that may not be readily apparent to parents or teachers, or to the children themselves. These services became more sophisticated over time, with formal screening of targeted age groups of school children for specific disorders replacing the general medical checks of earlier years. Screening tests now are standard procedures in all school health services and tests cover a wide range of disorders. Growth and development, hearing and vision, speech and language, and dental problems are some of the many health issues handled by school health screening systems. Health screening has developed ethical principles that apply to school-based testing and that aid the qualitative evaluation of screening programs. The history of school health screening and the principles that guide school health screening systems are outlined in this chapter. In addition, procedures can be rigorously evaluated using quantitative methodologies that are often specific to the practice of screening. This chapter details these methods and includes examples of screening programs that have been appraised using quantitative techniques. School screening systems have a valued place within both the health care and education sectors. Systems that are constantly reflected upon and critically evaluated will continue to serve our children well, far into the future