B4 school check logo.

Child Health in New Zealand

Information for the health sector

The B4 School Check is a health and development assessment for pre-schoolers. The purpose of the B4 School Check is to promote health and wellbeing in pre-school children, and to identify any health, developmental or behavioural problems that may have a negative impact on the child’s ability to learn and take part at school.

The B4 School Check is the eighth core Well Child contact, and will replace the existing New Entrant Check. The New Entrant Check is being phased out gradually as the B4 School Check is introduced.

Funding of $10 million per annum has been allocated to the delivery of the B4 School Check.

Content of the B4 School Check
The B4 School Check includes the following:

Child Health Questionnaire (PDF, 91 KB) - updated Dec 08
Hearing and vision screening through sweep audiometry, tympanometry and distance visual acuity
Measurement of height and weight for recording in the Child Healthbook and B4 School Check database
Behavioural and developmental questions using the Strengths and Difficulties Questionnaire (SDQ) and Parental Evaluation of Developmental Status (PEDS) tools
An oral health screen using the Lift the Lip resource and check for enrolment in a school dental clinic
Health promotion and education – providing information resources, advice and support as appropriate
Referrals to appropriate health, education or social service where the B4 School Check has identified the need for such services

B4 School Check - A handbook for practitioners
The B4 School Check handbook is the primary resource for nurses and health professionals delivering the B4 School Checks to four year old children. A revised version of the heandbook was released in October 2008 and is provided below.

The B4 School Check - A handbook for practitioners (PDF, 1 MB)

Role of early childhood education services and teachers
In June 2008, the Ministry of Health and the Ministry of Education sent a joint letter to all early childhood education services informing them about the B4 School Check and the role that they can expect to play in the delivery of the Check.

B4 School Check - Role of early childhood education services and teachers (PDF, 105 KB)

Delivery of the B4 School Check
Delivery of the B4 School Check started in four DHBs (Waikato, Nelson Marlborough, MidCentral and Lakes) in June 2008. The remaining DHBs across the country started delivery of the B4 School Check from September 2008

Some DHBs have chosen a predominantly primary health care-based service delivery model, while others are using a more public health or Well Child nursing-based approach. Regardless of the model of delivery, it is important that there is good engagement and collaboration between providers at all levels.

Pilots and evaluation
The B4 School Check was piloted from August to November 2007 in Whanganui and Counties Manukau District Health Boards (DHBs). A formative evaluation of the pilots informed the planning for the national roll-out of the service in 2008.

Child Growth Charts
The PDF files below are World Health Organization Child Growth Standards for use in the B4 School Check.

Height for age

Height-for-age BOYS 2 to 5 years - percentiles (PDF, 786 KB)

Height-for-age BOYS 5 to 19 years - percentiles (PDF, 22 KB)

Height-for-age GIRLS 2 to 5 years - percentiles (PDF, 785 KB)

Height-for-age GIRLS 5 to 19 years - percentiles (PDF, 22 KB)

Weight for age

Weight-for-age BOYS 2 to 5 years - percentiles (PDF, 781 KB)

Weight-for-age BOYS 5 to 10 years - percentiles (PDF, 21 KB)

Weight-for-age GIRLS 2 to 5 years - percentiles (PDF, 780 KB)

Weight-for-age GIRLS 5 to 10 years - percentiles (PDF, 21 KB)

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Page last updated: 3 December 2008