Checking children: how to spot and solve problems

Dental, hearing and eye tests for schoolchildren can diagnose problems so the right treatment can start early, but parents need to know what to look out for


We all have childhood memories of visits from the “school nurse” and bittersweet afternoons off for routine visits to the dentist or eye clinic. It was part and parcel of school life: everyone in the class was tested at about the same time and if inoculations were to be had, no one escaped the dreaded jab.

Apart from feeling apprehensive about being poked and prodded by a stranger, for the most part, you didn’t think too much about it. However, when you become a parent, it’s a whole other story. You want to know what tests your child should have, when he should have them and where should you go if you have any concerns in between.

Tara Moriarty runs a business consultancy and is a community activist in Clonmel, Co Tipperary. She has always trusted the system to ensure that her sons, nine-year-old Jack and three-year-old Seán, get all the developmental checks and immunisations they are entitled to.

“Jack was in first class when he first received a referral letter for an eye test,” she says. “To be honest, it is something that I would have never initiated myself unless I had noticed that Jack was having problems. He attended the first eye appointment at our local clinic in 2010 and, because I have worn glasses since I was four, I knew there would be a possibility that either Jack or Seán would someday need them too. After Jack’s examination, it was diagnosed that he would need to wear an eye-patch for a number of months,” says Moriarty.

Two appointments later he picked out his glasses but his eyesight has improved so dramatically that he no longer needs to wear them. “I am really glad that the service was available through the schools because if he hadn’t been called up, I’m sure his eyesight would be a lot worse today.”

Moriarty says further routine checks have proved invaluable in highlighting other health problems that might have gone unnoticed.

“When Jack was in second class, he received an appointment for a dental check,” she says. “Jack was apprehensive as a few of the children had to get braces but he is now going into fourth class and has had three dental appointments so far, one of which was with a hygienist.

“These appointments are given to all students regardless of whether or not they have a medical card. I have found the service very good . . . but I think there would be great benefit in having a class for parents on dietary requirements and general health issues for children so that we can prevent tooth erosion or eyesight issues.”

Learning difficulties
Rebecca Good is an educational psychologist and director of Éirim: The National Assessment Agency, which provides educational assessments for children, adolescents and adults. She says while these developmental checks are vital, parents should also watch out for emerging problems because many children are diagnosed with learning difficulties when in fact the problem lies with a hearing or sight issue.

“My colleagues and I are often called in to assess children with suspected reading difficulties or those who are struggling at school,” she says. “As part of our assessment we gather information from various sources including the teachers and parents, conduct a battery of tests with the children, and often conduct vision screeners.

“We have found that in a considerable number of reading difficulty cases, the children are also presenting with visual difficulties that haven’t previously been flagged. These difficulties often present as problems with visual convergence or binocular vision, or a type of visual stress, such as words wobbling or moving on the page. In both cases the child’s visual acuity may be perfect and therefore the problem may not be picked up in a school eye test. However, both problems would have a significant impact on the child’s learning, especially their reading.

“While their child is reading, parents can look out for children rubbing their eyes, covering one eye, tiring quickly, squinting or complaining of headaches. Parents should also ask their children whether the words wobble, move or shake. Remember children won’t always know that words are not supposed to move, as this is all they have ever known.”

Hearing problems can also be spotted by vigilant parents.

“Research has shown that children with intermittent hearing loss, due to ear infections or glue ear, struggle with reading in school,” she says. “We also find that those with a history of recurrent ear infections can present with reading problems. These children may have perfect hearing during their school tests as they suffer only intermittent hearing loss when, for example, an infection is present. Parents could look out for children struggling to hear in crowds or when there is background noise present, mumbled speech or difficulties with pronunciation.”

According to a spokesperson for the HSE, all children will receive a call-up for sight, hearing and dental checks during their primary school years. They will also be called for the requisite immunisations – if parents are worried about any of these tests or their child has not received an appointment, they should contact their local health office.

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