Health Screening Assessment
by Robin Brocato, M.H.S., Health Specialist, Head Start Bureau
The purpose of health screenings is to identify children who need a more complete professional evaluation. Early detection of health problems in young children can prevent more serious problems later in life. Screening does not take the place of a comprehensive evaluation by a health care professional.

The Head Start Program Performance Standards for the health component require that each child receive the following health screening within 45 days after the child enters the Head Start program:

Screenings are conducted by many individuals and agencies, such as health coordinators in Head Start programs, and physicians, physicians assistants, nurses, nurse practitioners, nursing assistants, nutritionists, dentists, dental assistants, and dental hygienists in local health departments or private offices.

The results of the screenings, along with a medical and developmental history, are to be made available to parents at the time of the medical examination. This information is stored in the child's permanent file and is kept confidential at all times. It is the responsibility of the program to arrange for a diagnostic evaluation for all children with abnormal findings detected in the screenings.

Many children enrolled in Head Start are eligible to receive Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) services under the Medicaid program. The EPSDT program is an important resource for Head Start and is a good place to start when a referral for further evaluation and treatment is needed. EPSKT screening services are similar to those required by Head Start and include a comprehensive health and developmental history, a comprehensive unclothed physical examination, appropriate immunizations, laboratory tests (including lead), and health education/guidance.

Each State establishes its own plan for providing EPSDT services and a schedule for these services, which is known as the Periodicity Schedule. The State Plan also identifies where screening services can be obtained. Usually, are provided by either local health departments, private physicians, hospitals, dentists, and other authorized providers, which can include Head Start programs. Medicaid/Head Start children who require diagnosis and treatment services identified during the screening process can receive these services from authorized EPSDT providers.

Parent involvement in the health screening and assessment process is critical. Parents should take or at least accompany their children to the screenings and other health services. Parents need to know they their children are receiving these services, what kinds of health problems may or may not be detected, and the results of the screening. Parents should receive information that is clear, complete, and understandable. This is especially important in the event that further diagnosis and treatment are needed.

While it is important that parents assume responsibility for their children's health care by making appointments for care, following through, etc., it also is important to remember that Head Start can be of much assistance to parents in these situations.

Records should be reviewed periodically to ensure that proper follow up and treatment are being provided and that the results from screenings and examinations are being sent to Head Start in a timely manner. It also is important that at all medical information for the child be kept in one place, i.e., the child's record, and that only authorized staff have access to the information.

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