Preschool health supervision — formative SAQs · Paeds SAQs

Prompt

Preschool health supervision

SAQ 1 (10 marks)

A 4-year-old attends for a preschool/school-entry health check. The caregiver mainly wants “the form signed.” [4]

List the essential domains you will cover beyond immunisation status. (4) [1] [4]
How will you approach developmental and school-readiness assessment at the bedside? (3) [1] [2]
Outline your safety-net if you refer for speech and hearing concerns. (3) [16]

Model answer

Domains: growth and BMI-for-age; developmental/school-readiness surveillance; vision and hearing gates; oral health/fluoride; immunisation reconciliation against the official schedule; behaviour, sleep and media; injury prevention (including passenger safety); social determinants and safeguarding. [1] [4] [5] [6] [8]

Bedside approach: open caregiver concerns; observe language, social reciprocity, play and motor skills; use evidence-informed milestones; deploy validated screens per local programme; document domains and sources. [1] [2]

Safety-net: written plan, red-flag symptoms for earlier return, how to chase appointments, interim strategies, and clear review timing if waitlists are long. [16]

SAQ 2 (10 marks)

A 3-year-old has rising BMI-for-age, long recreational screen time and night-time sweet drinks. Speech is limited and the family needs an interpreter. [5] [12]

What concurrent problems must you not miss while discussing weight? (3) [1] [6]
Give non-shaming anticipatory guidance priorities. (4) [5] [6]
How do language access and consent shape your plan? (3) [12] [14]

Model answer

Do not miss speech/hearing pathways, oral caries risk, sleep debt, and social determinants while focusing on weight alone. [1] [6]

Guidance: limit sugar-sweetened drinks; fluoride toothpaste and dental home; sleep routine; replace solo screens with co-viewed limited high-quality content and active play; family food goals without blame. [5] [6]

Use a professional interpreter for history and counselling; never the child. Explain information sharing with preschool or services with consent principles. [12] [14]

References

[1]Lipkin PH Promoting Optimal Development: Identifying Infants and Young Children With Developmental Disorders Through Developmental Surveillance and Screening. Pediatrics, 2020.PMID 31843861
[2]Zubler JM Evidence-Informed Milestones for Developmental Surveillance Tools. Pediatrics, 2022.PMID 35132439
[3]Robins DL Validation of the modified checklist for Autism in toddlers, revised with follow-up (M-CHAT-R/F). Pediatrics, 2014.PMID 24366990
[4]COMMITTEE ON PRACTICE AND AMBULATORY MEDICINE 2023 Recommendations for Preventive Pediatric Health Care. Pediatrics, 2023.PMID 36938620
[5]COUNCIL ON COMMUNICATIONS AND MEDIA Media and Young Minds. Pediatrics, 2016.PMID 27940793
[6]Clark MB Fluoride Use in Caries Prevention in the Primary Care Setting. Pediatrics, 2020.PMID 33257404
[7]Flynn JT Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents. Pediatrics, 2017.PMID 28827377
[8]Durbin DR Child passenger safety. Pediatrics, 2011.PMID 21422094
[9]US Preventive Services Task Force Screening for Elevated Blood Lead Levels in Children and Pregnant Women: US Preventive Services Task Force Recommendation Statement. JAMA, 2019.PMID 30990556
[10]Kuo DZ Recognition and Management of Medical Complexity. Pediatrics, 2016.PMID 27940731
[11]Mills E Association between caregiver concern for clinical deterioration and critical illness in children presenting to hospital: a prospective cohort study. The Lancet. Child & adolescent health, 2025.PMID 40451224
[12]Boylen S Impact of professional interpreters on outcomes for hospitalized children from migrant and refugee families with limited English proficiency: a systematic review. JBI evidence synthesis, 2020.PMID 32813387
[13]Starmer AJ Changes in medical errors after implementation of a handoff program. The New England journal of medicine, 2014.PMID 25372088
[14]Katz AL Informed Consent in Decision-Making in Pediatric Practice. Pediatrics, 2016.PMID 27456510
[15]Forkey H Trauma-Informed Care. Pediatrics, 2021.PMID 34312292
[16]Burvenich R Effectiveness of safety-netting approaches for acutely ill children: a network meta-analysis. The British journal of general practice : the journal of the Royal College of General Practitioners, 2025.PMID 39117428

SAQ 1 (10 marks)

A 4-year-old attends for a preschool/school-entry health check. The caregiver mainly wants “the form signed.” [4]

List the essential domains you will cover beyond immunisation status. (4) [1] [4]

How will you approach developmental and school-readiness assessment at the bedside? (3) [1] [2]

Outline your safety-net if you refer for speech and hearing concerns. (3) [16]

Model answer

Safety-net: written plan, red-flag symptoms for earlier return, how to chase appointments, interim strategies, and clear review timing if waitlists are long. [16]

SAQ 2 (10 marks)

A 3-year-old has rising BMI-for-age, long recreational screen time and night-time sweet drinks. Speech is limited and the family needs an interpreter. [5] [12]

What concurrent problems must you not miss while discussing weight? (3) [1] [6]

Give non-shaming anticipatory guidance priorities. (4) [5] [6]

How do language access and consent shape your plan? (3) [12] [14]

Model answer

Do not miss speech/hearing pathways, oral caries risk, sleep debt, and social determinants while focusing on weight alone. [1] [6]

Use a professional interpreter for history and counselling; never the child. Explain information sharing with preschool or services with consent principles. [12] [14]

References

[1]Lipkin PH Promoting Optimal Development: Identifying Infants and Young Children With Developmental Disorders Through Developmental Surveillance and Screening. Pediatrics, 2020.PMID 31843861
[2]Zubler JM Evidence-Informed Milestones for Developmental Surveillance Tools. Pediatrics, 2022.PMID 35132439
[3]Robins DL Validation of the modified checklist for Autism in toddlers, revised with follow-up (M-CHAT-R/F). Pediatrics, 2014.PMID 24366990
[4]COMMITTEE ON PRACTICE AND AMBULATORY MEDICINE 2023 Recommendations for Preventive Pediatric Health Care. Pediatrics, 2023.PMID 36938620
[5]COUNCIL ON COMMUNICATIONS AND MEDIA Media and Young Minds. Pediatrics, 2016.PMID 27940793
[6]Clark MB Fluoride Use in Caries Prevention in the Primary Care Setting. Pediatrics, 2020.PMID 33257404
[7]Flynn JT Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents. Pediatrics, 2017.PMID 28827377
[8]Durbin DR Child passenger safety. Pediatrics, 2011.PMID 21422094
[9]US Preventive Services Task Force Screening for Elevated Blood Lead Levels in Children and Pregnant Women: US Preventive Services Task Force Recommendation Statement. JAMA, 2019.PMID 30990556
[10]Kuo DZ Recognition and Management of Medical Complexity. Pediatrics, 2016.PMID 27940731
[11]Mills E Association between caregiver concern for clinical deterioration and critical illness in children presenting to hospital: a prospective cohort study. The Lancet. Child & adolescent health, 2025.PMID 40451224
[12]Boylen S Impact of professional interpreters on outcomes for hospitalized children from migrant and refugee families with limited English proficiency: a systematic review. JBI evidence synthesis, 2020.PMID 32813387
[13]Starmer AJ Changes in medical errors after implementation of a handoff program. The New England journal of medicine, 2014.PMID 25372088
[14]Katz AL Informed Consent in Decision-Making in Pediatric Practice. Pediatrics, 2016.PMID 27456510
[15]Forkey H Trauma-Informed Care. Pediatrics, 2021.PMID 34312292
[16]Burvenich R Effectiveness of safety-netting approaches for acutely ill children: a network meta-analysis. The British journal of general practice : the journal of the Royal College of General Practitioners, 2025.PMID 39117428