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CCHP Health Screenings

Health screenings are an essential part of the child’s health and can identify potential issues that may interfere with a child’s ability to learn. Not all families attend well child or dental appointments on the recommended schedule. CCHP offers free vision, hearing, nutrition, and dental screenings for your childcare center.

Dental screenings and fluoride varnish is available to all children ages 0-5. Vision, hearing, and nutrition screenings are only offered to children ages 3-5. Screenings will only be done on children whose parents/legal guardians have signed the CCHP consent forms.

A screening is not a diagnostic test. Screenings identify if a child needs further testing and assessment by a healthcare provider, to determine if an issue exists, and if any treatment is needed.

WHAT TO EXPECT:

  1. The director or designee will gather all signed consent forms from parents who desire the health screenings and return them to CCHP staff at least 4 weeks prior to the first health screening.
  2. The director or designee will plan the dates for screenings with CCHP staff.
  3. The director or designee will provide CCHP an appropriate space for the health screenings and equipment (e.g. tables, chairs, electric outlet, water).
  4. Staff will place name tags on children before health screenings.
  5. CCHP staff will discuss instructions with staff, e.g. how many children at a time should be sent to the screening/waiting area.
  6. CCHP will provide all screening result letters to the director or to the designee, if parents consented for results to be disclosed to the childcare center.

Dental Screening and Fluoride Varnish – Ages 0-5

  • CCHP staff will provide a circle time with puppets to demonstrate to children what will be done during the screening, engage the children in discussing dental health, and sing songs about brushing teeth.
  • The RDH will do the oral screening to look for evidence of poor hygiene, gum disease, dental cavities, or infection.
  • The RDH or a trained assistant will apply fluoride varnish (if parents consented).
  • The child’s dental health will be classified on the result letter as either Class 1 (healthy), 1+, 2 mild, 2 moderate, 2 severe, or Class 3 (most severe). Additional individualized recommendations may be also listed on the result letter such as brushing better on the gum line or back teeth, flossing, more frequent dental appointments, etc.

Hearing Screening – Ages 3-5

  • Children under 3 years old can be screened if the parent/legal guardian has concerns or if childcare center staff have concerns about the child’s hearing.
  • A certified audiometrist will conduct the hearing screening on children in a group of 2-4 children.
  • The two hearing screening methods used are: conditional play pure tone and otoacoustic (OAE). The pure tone screening involves the child wearing headphones, the Audiometrist presents different tones at a specific volume. During this screening the child is instructed to place a block into a box whenever they hear a sound. The OAE screening is conducted by placing a foam tip similar to an earbud, which is inserted into the ear. It plays a range of tones and measures the sound that reflects back.  The screening methods evaluate each ear separately. The audiometrist may also look inside the child’s ear with an otoscope as needed.
  • Result letters will indicate that the child passed, is referred for follow-up, or was unable/uncooperative with screening. Children who are unable/uncooperative are also referred for follow-up.
  • Follow-up should be with the child’s primary care provider for further assessment, testing, or treatment. Some children may need to be referred to an audiologist or ear nose and throat (ENT) doctor.

Vision Screening – Ages 3-5

  • Before the screening, childcare center staff should practice learning the names of shapes with the children. This will allow the children to be more successful during the screening. The shapes used during the screening are: circle, square, house, and apple.
  • A Public Health Nurse will conduct a visual acuity screening using the LEA vision screening tool designed for children ages 3-5.
  • Children’s results will indicate either normal vision for age, referred for follow-up, or unable/uncooperative. Children who are 4 years or older and who are unable or uncooperative with the screening are also referred for follow up.
  • For vision follow-up, the family can either make an appointment directly with an optometrist or have a repeat screening with the child’s primary health care provider. If they fail the screening again, the provider will refer the child to an eye specialist (either an optometrist or ophthalmologist).
  • Vision concerns for children under 3 years old should be referred to their primary health care provider.
  • Observations should be made throughout the year for possible vision concerns. If the student begins to frequently and or consistently exhibit signs or symptoms, a referral should be made for the child to have a complete eye exam by an eye doctor. Signs of vision concerns include:

Sings and symptoms of a Possible Eye or Vision Problem

Student Sings

  1. Eye turns in or out at any time
  2. Pupils/eyes appear to be different sizes
  3. Red eyes and/or swollen eyelids
  4. Droopy eyelids
  5. Discharge from the eye
  6. Sensitive to light
  7. Squints, closes, or covers one eye
  8. Squints to see board or far away
  9. Frequent headaches
  10. Abnormal head posture or head tilt

Student Symptoms

  1. Double vision
  2. blurry vision
  3. Hazy vision
  4. Difficulty seeing small print
  5. Eye pain

Nutrition Screening – Ages 3-5

  • Health Worker will conduct a circle time with the children to discuss healthy nutrition.
  • The Health Worker will measure a child’s weight and height to determine their Body Mass Index (BMI) percentile.
  • The Health Worker will use a device called the “Veggie Meter” to measure the level of a child’s fruit and vegetable intake over the last 2 months. The device is similar to a pulse oximeter – a child simply places their finger into the device. The light waves shining through the skin will measure the child’s levels of carotenoids. It is non-invasive and not painful at all.
  • Result letters will notify parents of their child’s BMI percentile and general fruit and vegetable intake. Resources and information on healthy nutrition and exercise is provided to parents.
  • Children will be screened twice per year for BMI percentile and carotenoid.

Screening Follow-Up

If a child was referred for vision, hearing, or dental concerns, CCHP staff will provide a referral letter to be completed by the child’s health care provider or dentist. If the referral letters are not returned to the childcare center, then CCHP will call the families to follow-up on the referral and offer additional resources.  Please let CCHP know if a family does not want to be contacted for follow-up.