Care of school- children and adolescents

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Care of school- children and adolescents
General comments
After school entrance, there are a limited number of medical conditions for which routine screening is an important part of health care. Early detection of psychosocial, developmental , and socioeconomic risks should receive the highest priority during the school years. At the most general level, the objective of screening all children should be thought of as identifying the at risk child , which includes the child in an risk household to be more limited for the school age group than it is for younger children, who must be accompanied on their visits for care by a parent or other member of the household. Mass screening of children on entering school provides an opportunity to review preschool (maternal and infant) records, which should contain information on the risk status of households. After that, however, properly trained teachers should be in an excellent position to detect evidence of problems in schoolchildren s overall development and well-being. This comes under the broad heading of early detection (of a manifest problem) rather than screening proper (i. e., uncovering problems for which there are as yet on recognizable signs or symptoms).
Teacher and care providers should be alert to signs that a child or adolescent is at high risk, e.g., frequent injuries, a history of child abuse or neglect in the household, or a precarious social situation at home (domestic violence, alcohol-related problems). They should also look for signs of depression in adolescents, including violent or self-destructive behavior, and pay special attention to those who have frequent acute illness or chronic illness, or who have just been in hospital . poor school performance, behavioural  problems, and poor attendance are all indicators of a high-risk child . children identified as at high risk will require more intensive surveillance than others, as well as special screening schedules, not covered here.
In the case of children or adolescents not at school or living here school based screening is not feasible for other reasons, most screening should be provided by primary care workers trained in the relevant techniques. The routine screening of children not at school will be difficult, and the opportunities for intervention may  be limited owing to the socioeconomic conditions responsible for their not attending school in the first place.

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