Screening, surveillance, monitoring and assessment
The aim of a screening programme is to examine all the children at risk. The role of screening tests in child health is to detect conditions that might otherwise be overlooked by both parent and professional unless a specific search is undertaken. With most screening tests, some cases are missed (false negatives) and some children are incorrectly identified as possibly abnormal. Screening works poorly for developmental difficulties such as speech and language problems or behaviour problems, such as aggression or hyperactivity. Child health surveillance refers to a programme of regular age-related reviews that incorporate screening tests and other means of identifying problems. Assessment is undertaken when concern is expressed by parents or professionals about a child in order to determine if there is a problem and define its nature and severity. In most cases, primary care staff refer children to specialists when there are concerns, but in some circumstances it is helpful to undertake some initial assessment before referral.