Health check ... almost half the nation's four-year-olds have a health or behavioural problem. Picture Thinkstock. Source: Supplied
ALMOST half the nation's four year olds could have behavioural, hearing, language and other problems suggests a study into the results of the government's four year old health check.
The study, published in the Medical Journal Australia on Monday, looked at 557 children who were given the checks in two Queensland medical practices between 2010 and 2013.
It found one in five children had problems detected during the preschool check up with speech and language problems the most frequently identified.
Another 19 per cent of children had health problems identified before their four year old check and four per cent developed health problems after they had the check.
Concerns ... speech and language problems are the most common issues detected in child health checks. Picture: Thinkstock. Source: ThinkStock
Half the children aged four (56 per cent) had no problems listed on their medical records.
The four-year-old check was introduced in 2008 and looks at height, weight, vision, hearing, oral health, toileting and allergies of children in the year before they start school.
It is meant to catch health and behavioural problems early so interventions can be made to prevent them becoming bigger problems later in life.
The one off checks are meant to involve more than 282,000 children aged four but experts fear the children most likely to be at risk are least likely to be brought in by their parents for an assessment.
Issues ... the check looks at hearing, oral health, toileting and allergies. Picture: Thinkstock. Source: ThinkStock
The study retrospectively reviewed the medical records of 557 Queensland four-year-olds and found 347 problems were identified in 246 children.
Seventy seven (22 per cent) of the children had speech and language problems, 51 (15 per cent) had hearing problems and 42 (12 per cent) had anatomical concerns.
The most common problems identified as a result of the four year old health check were speech and language (29 children) and toileting (22 children).
Given growing concerns about childhood obesity it was interesting that only four of the children (3 per cent) had concerns recorded about their height and weight.
The report concludes that "GPs are diligent in detecting child health concerns".
It found between 3 per cent and 11 per cent of children with health problems had their management changed as a result of the four-year-old health check.
"A lack of independent toileting was the most detected and least actioned problem, "the study found.
This could be because action on this problem is not clinically recommended until the child is aged five or more.
Warning signs ... many health and behavioural problems emerge before four years of age. Picture Thinkstock. Source: Supplied
There are plans to reduce the age of the child health check to three years of age and include a more comprehensive check on the child's behaviour.
This last change has been highly contentious as was criticised by some experts as a "mental health check" that was inappropriate for children at such a young age.
Frank Oberkaid the director of Melbourne's Centre for Community Child Health and the Royal Children's Hospital Melbourne says significant questions still remain about the efficacy of the child health check.
In an editorial in the Medical Journal Australia, he says many health and behavioural problems emerge before four years of age, there is a lack of reliable measures against which child health and development can be measured and considerable developmental variability in young children.
"Many problems are transient," he said.
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