School Entrance Examination for Lateral Entrants - What Can and What Should They be Able to Do? A Discussion Contribution Based on the Data from the Health Authority Frankfurt am Main 2006-2016

Abstract

The medical investigation of school beginners is one of the essential tasks of the child and youth services of the health authorities. While in all federal states in Germany, the examination of all school beginners is legally clearly stipulated, the situation for "lateral entry", that is, children of school age, who are moving from a foreign country to a local German community and attending school there, is not clearly regulated in the respective school laws. This article presents the experiences of the lateral entry investigations in Frankfurt am Main. All children of school age who moved to Frankfurt from abroad undergo a health check. This encompasses a standardized questionnaire-based history with the help of interpreters, including a review of the available vaccination document (case history sheets are available in different languages), an eye examination, hearing test and a physical examination. Children over the age of 15 who came from countries with a high prevalence for tuberculosis had chest x-ray. Between 2006 and June 2016, a total of 8245 children and adolescents were examined, in 4% of the children abnormalities in hearing, and in 22% in visual screening showed noticeable problems, with an increasing trend in recent years. The vaccination status was unknown in two-thirds of the children, one quarter of the children were sufficiently vaccinated against tetanus, diphtheria, polio and pertussis, and 19.5% were immunized against measles (vaccine or disease). Diseases of the respiratory tract, the heart and the circulation were predominant with a total of 4%, followed by musculoskeletal disorders with 3%. Lice infestation was found in 1.7% of children. In 0,7% of 2171 children with chest-X-rays, a conspicuous pulmonary lesion was diagnosed, but no tuberculosis. The focus of the lateral entrance examination is a school-related health status. On the basis of experience gained in Frankfurt am Main, it should be pointed out that investigations by the lateral entrants from other countries seem necessary, in particular visual and hearing screening, physical examination and checking the vaccination status, possibly in combination with vaccination. On the other hand, a detailed developmental screening does not appear to be urgent in the case of pupils who will be starting compulsory school, in whom there is no chance for additional encouragement before the start of school.