Three-year-old health checks are back – here's what to expect

Referred to as the Medicare Healthy Kids Check, they are designed to provide an opportunity for early identification of developmental delay and/or neurodevelopmental differences.

What is it for?

The assessment will consider a child’s physical, social and emotional development, health and wellbeing.

The federal Department of Health has said the assessment will identify children who may require additional supports, including monitoring and interventions in primary care settings, referral to appropriate supports (including Thriving Kids supports) or further assessment when required.

Feeling a sense of déjà vu?

The assessments have been instigated by changes to NDIS eligibility and the introduction of the federal government’s Thriving Kids initiative, but the concept is not new.

Health checks for three-year-olds were in place from 2008 but scrapped in 2015 by the then Abbott government which cited underperformance, cost blowouts and duplication of state and territory programs for the decision.

A Medical Journal of Australia article at the time noted that while the assessments found lower than expected prevalence for some childhood conditions such as overweight and oral health problems, significant numbers of children could benefit from them.

About half of all three-year-olds made the most of the checks known simply as Healthy Kids Check-ups, in that final year they were funded.

What does the check need to include?

A patient’s medical history, including previous presentations, hospital admissions, medication, immunisation status and allergies should be taken during these assessments.

In addition, doctors should include relevant details about the patient’s behaviours and wellbeing, family relationships, social circumstances, care arrangements and engagement in early childhood education and care.

Details of the patient’s family environment and exposures, including nutrition, physical activity, screen use, sleep hygiene and sleep patterns and toileting should also be recorded.

An assessment of the patient against age-appropriate developmental milestones must be included in the check-up.

The Australian Journal of General Practice suggests using a framework such as CHILD domains as a tool for engagement. While a formal standardised development tool was not required for all children, it put forward the Red flags early identification guide (birth to 5 years) for potential guidance.

A basic physical examination should also be carried out, including measuring height and weight and examining eyesight, hearing and oral health.

The doctor can assess the patient and provide advice to the patient’s parent or carer to support. They can also make or arrange necessary interventions and referrals for the patient.

As well as adding a copy of the health assessment to the child’s health record, doctors can offer a written report on the health assessment to the patient’s parent or carer, with recommendations on matters that have been covered.

NDIS service provider Autism360 has highlighted this as a vital step where developmental concerns may be raised.

"Without a clear pathway after the check, families risk being told their child may need support without knowing where to turn next," a spokesperson for the organisation said.

How will the reinstated checks be administered?

The Medicare Healthy Kids Check can be carried out once per child per lifetime when a child is three years old.

GPs and prescribed medical practitioners can use the time-tiered health assessment items 701-707 and 224-227.

More information is available via the Department of Health.