School-aged and young person’s health check (6–17 years)

• Healthy childhood and teenage years are important in shaping brain development and future health, particularly reducing risk of chronic conditions
• Key developmental stage with transition to independence
• Before following this protocol you must make sure you understand issues of
• Assessment of competency to make medical decisions
• Limits of confidentiality
• Mandatory reporting requirements
• See Competency, consent and confidentiality.

Do first

• Ask carer and young person about concerns, priorities and goals
• Review previous medical and social history and gather information from other sources with consent (eg school) — attention to
  
• Hearing — audiology reports, surgery
• Vision — glasses, optometry reports
• Respiratory — persistent wet cough, repeated chest infections especially if admitted to hospital
• Acute rheumatic fever with/without heart disease
• Growth concerns including overweight/obesity
• Developmental or learning issues, school attendance, alcohol exposure in pregnancy
• Involvement of other health care providers — child health nurse, paediatrician, psychologist or other agencies (educational, guardian, legal, child and family services)
• Allergies and immunisations
• See HEADSS framework for Psychosocial Health Assessment for examples of questions that can help engage young people

Check

School-aged health check — checklist  

Follow-up

• If problems found — make sure person added to recall system and/or referrals completed
• Team approach needed to manage complex problems — could include the young person, family, clinic staff, doctor, paediatrician, dentist, allied health, hearing/eye/mental health team, support services, council, housing associations, education system services

HEADSS interview for psychosocial health assessment

• Young people are more likely to talk about sensitive issues and seek help if asked directly
• Use HEADSS to help you to
• Engage with young people
• Identify vulnerabilities
• Provide early intervention to manage high risk behaviours
• Provide health promotion advice
• HEADSS is best done with the young person alone
• Ask carers if they have any worries before they leave the room and again when they return
• Explain you will ask lots of questions about parts of their life that may affect their health and wellbeing — explain and stress confidentiality
• You may not be able to cover all questions at one visit — focus on most relevant questions
• Use general statements to be less intrusive (eg Some young people experiment with cigarettes, alcohol and drugs. Do people at your school use these, what about your friends, and you)
• At end of HEADSS
• Ask young person who they can trust and talk to if they have problems
• Check preferred communication about results — what number to call, if anyone else you can talk to
• Follow-up overdue recalls for health check items (eg blood tests, growth checks, vaccinations)
• Treat any health issues and manage health risk behaviours — medical consult or other referrals if required