The School Entry Health Examination: A Critical View of History and Status Quo.

Abstract

At the end of the 19th century, the school entrance medical examination of all school beginners was established in Germany. The focus was on exclusion of infectious diseases and illnesses that could make school attendance more difficult or worsen during the school visit. In the middle of the 20th century the concept of "school maturity" came to the foreground. Different "school maturity concepts" were applied but abandoned because they could not withstand an evaluation. Meanwhile, the concept of "school maturity" has been replaced by the concept of "school ability". The question no longer arises as to whether or not a child can be taught at school, but rather the assistance and support with which this can be achieved. Today, the school entrance medical check-up in nearly all the federal states includes, in addition to a medical history, an assessment of the precautionary and vaccination status, a visual and hearing test as well as assessment of the development of the child and his/her individual support requirements, especially in the field of cognition and language. In almost all German federal states, the school entrance examinations use up considerable resources of the pediatric and adolescent services in the public health departments. In the paper presented, this is critically discussed, and a discourse is suggested as to whether these resources could be used more effectively in terms of child health considering changed social conditions, such as the mandatory health checks in childhood in many federal states, the increase of immigrants from other countries, in particular asylum seekers, or the "Inclusion", i. e. with closure of special-needs schools and the associated challenges in the regular schools.