It is not often that something makes my blood boil but this has. I received a letter from the Federal Government informing me of its new Healthy Start For School “ initiative”. This is a scheme whereby any parent receiving an income support payment in the financial year that their child turns four must take the child for a “check” to ensure the child is “healthy, fit and ready to start school”.
The propaganda sheet informs me that as a doctor I can expect requests for these assessments. The check that I am supposed to do includes (and I won’t bore you with all twelve points) height and weight, oral health, and toileting. It must also include “making an overall assessment of the child and recommending appropriate interventions”.
The rationale for this as with most of these schemes is that it will “… help with the early identification of life risk factors and development delays and conditions”. Really? Even if you could understand this double speak it is meaningless.
Now whilst on the surface it may sound well and good to want to detect problems early there are major fundamental flaws with these schemes. The primary one is that not all children develop at exactly the same rate and that does not mean they have any condition. Not all children walk or talk at exactly the same age. Not all children are the same height; this does not mean there is anything wrong with them.
The second major flaw is the assumption that children are not healthy until screened to be so. In other words all children are deemed to have something wrong with them, which requires “ appropriate intervention” unless proven otherwise.
The third flaw is the assumption that screening is actually capable of sorting out those who do have a problem (a tiny number) from those who just are developing at their own rate. For example 10% of normal ten year olds are not dry overnight. “Intervention” can be useful if sought but not if imposed.
The final howler in all this is that lots of worried well, will get shunted down the line of further assessment and intervention only to find that there was no problem in the first place. This places stress on the family, has the capacity to damage the child who feels there must really be something wrong and means that those few children who actually need help will be more likely to miss out.
The screening lobby loves this kind of stuff and will bleat about how wonderful it is. The screening lobby is the main beneficiary of this as they get more government money for their programs. And guess what, they will find all sorts of “conditions” in numbers far higher than ever thought to occur which will need even more government “funding” to solve.
The fact that most of these “conditions” will not actually exist or that considerable harm will be done to families and that those in genuine need will miss out through dilution never bothers the zealots.
And there is worse to come! In 2012 the program will extend to include “… consideration of emotional wellbeing and development in three year olds”. This is being delayed “…to allow expert input on the assessment instrument(s) and resources for professional development”.
What absolute rubbish! There is no such thing (and nor should there be) as an unemotional three year old. Tragically there are people out there who diagnose conditions like ADHD and bipolar in three year olds and then prescribe drugs. This may increase exponentially if this “screening” of three year olds goes ahead and will end up damaging children.
You can be certain that “screening” will turn up an army of three year olds in need of emotional counseling or drugging of some kind!
Here is the bottom line. Children develop at their own pace and need to be allowed to do so. A few genuine objective measures like sight and hearing have some value. Mass screening of this nature, medicalizes childhood on the assumption that all children have “conditions”, just waiting to be found and “treated”.
Reality is far different. Children need basics to thrive. They need nutritious food and adequate sleep. They need to be able to play outside, to be read to, and above all to be loved. Whilst not every child may get all of this, no useless government mandated screening test will replace it.