The Plöner Model for the School Entry Screening is a Role Model for the Future

Abstract

The Plöner Model is a stepwise-selective model, similar to the one practised in all of Bavaria since 2008. It was already developed in 2002/2003 for the school entry screening and has been in use since then. Such models are intermittently criticized since not each child is seen by a doctor. The procedure and data of the Plöner Model are analyzed and put into a wider context within Germany and beyond. The current programs in place are therefore categorized into 3 groups and compared with regard to public heath ethics criteria. The primary endpoint is the need for special schooling or assistance. From 2003 to 2016, 1475-1045 children per year before school entry were checked by the pediatric health team of the county health department consisting of 2.1 full time equivalents of medical assistants and 1.5 fulltime equivalent pediatricians having other routine duties. Applying a stepwise-selective model, for children with special needs, 45-60 min instead of the usual 15 min per child were available. The roster consisting of a questionnaire for parents with a comment section for the daycare staff, a health and developmental check by the medical assistants and a detailed catalogue of inclusion criteria allowed to only examine 28-41% of the cohort by a pediatrician. The percentage of children needing further special care was within the mean of the entire cohort of the federal state of Schleswig-Holstein. A stepwise-selective procedure is warranted for the sake of efficiency and public health ethics. The required certainty (true positive and true negative) is guaranteed by the Plöner Model. Any program, either to examine all children by a doctor or moving parts of the school entry screening into the fourth year of life, require a continued critical evaluation and professional guidance.