Parents’ guide to back-to-school screenings

vision screeningIt’s that time of year. As children head off to school every fall, they’ll undergo a series of health screenings. Massachusetts requires public schools to conduct the following screenings: body mass index (or BMI), vision, hearing and scoliosis.

Parents may have many questions:

  • When are children screened?
  • What’s normal? What’s not?
  • How should parents handle results?

Dr. Alexandra Epee-Bounya, from Boston Children’s Primary Care at Martha Eliot, reviews the ins and outs of various school screenings.

Body mass index (BMI) screening

BMI screening

BMI may be the most upsetting screening for parents and children, says Dr. Epee-Bounya. “At the Martha Eliot Health Center, I explain to parents that this screening casts a wide net, and it is designed to catch worrisome and not-so-worrisome results. If there is a problem, we can work together toward a solution.”

Grade levels screened: 1st, 4th, 7th  and 10th grade.

Target: BMI is a body fat measure based on height and weight. A result of less than 5 percent indicates a child may be underweight, while a BMI of 85 percent or greater suggests she may be overweight, and 95 percent or greater suggest she may be obese.

Recommendations: If the school sends a letter alerting you about your child’s BMI results, make an appointment with your pediatrician. “Your child’s doctor can see her history and take a holistic approach to weight issues. We have interventions available, including a nutritionist, weight management programs and activity modifications,” says Dr. Epee-Bounya.

Additional screening: Primary care providers measure BMI at well child visits every year beginning at age 2.

Vision screening

vision screening

Grade levels screened:  yearly starting in kindergarten; some schools with specific waivers will screen yearly until 5th grade, once in middle school and once in high school.

Target: visual acuity. Is your child able to determine letters or objects at a fixed distance? If not, she may be nearsighted or farsighted.

Recommendations: If there any concerns, your child should be referred to an optometrist or ophthalmologist.

Additional screening: Primary care providers screen children at every well child visit. They review family history and assess children for acuity and alignment.

Hearing screening

hearing screening

Grade levels screened: yearly until grade 3, once in middle school and once in high school.

Target: hearing loss.

Recommendations: If your child does not pass her hearing screen, she should be referred to an audiologist.

Additional screening: In Massachusetts, all newborns are screened after birth. Any newborn who fails that screening is referred for a full audiological evaluation. Primary care providers perform hearing screening if risk factors are identified during risk assessment at any well child visit and for all children at 4, 5, 6, 8, and 10 years. Children who fail those screens or those with a family history of hearing loss or a complicated neonatal course can be referred to an audiologist or an otorhinolaryngologist.

Scoliosis screening


shutterstock_181675178Grade levels screened: yearly in grades 5 through 9.

Target: scoliosis.

Recommendations: If there are concerns about the curvature of your child’s spine, she should be assessed by her primary care physician who may recommend an x-ray of the spine and possibly an evaluation by an orthopedist.

Additional screening: Providers at the Martha Eliot Health Center examine children’s spines before and during puberty.

Learn more about Boston Children’s Primary Care at Martha Eliot.

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