School-age health supervision — formative SAQs

SAQ 1 (10)

A 7-year-old is brought “only for the school form.” Caregivers report homework battles. Nightly sleep is about 8 hours with a tablet in bed. Vision has not been checked for two years. BMI is rising across two centile channels. [1]

1. Define school-age health supervision and contrast it with form-only care. (2) [1]
2. List universal versus selective tasks for this visit. (3) [1]
3. Outline your stepwise management of sleep, vision, BMI talk and learning concern. (3) [8] [5] [3]
4. State two red flags that would convert this visit to acute care. (2) [12]

Model answer

Definition. Structured medical-home preventive care in primary-school years covering growth, senses, oral health, sleep, activity, mood, safety and school function — not a signature alone. [1]

Universal vs selective. Universal: child voice history, height/weight/BMI trend, BP, exam, vision pathway, dental/fluoride advice, immunisation check, anticipatory guidance. Selective here: deeper learning/ADHD evaluation steps, possible food-insecurity screen, earlier BMI follow-up; audiology if hearing risk. [1] [5]

Stepwise plan. Fix sleep opportunity toward AASM school-age needs and remove bedtime screens; arrange vision assessment; discuss BMI with non-stigmatising family-based goals; gather teacher information before ADHD labelling. [8] [3] [16] [5]

Acute conversion examples. Suicidal ideation; abuse disclosure; symptomatic severe hypertension; respiratory distress; sports cardiac red flags. [12] [15]

SAQ 2 (10)

An 11-year-old needs club football clearance. There is a history of exertional dizziness. A classmate is bullying him online. [15]

1. List essential PPE history domains before clearance. (3) [15]
2. Explain why unrestricted clearance is unsafe today. (2) [15]
3. Outline bullying/mood screening and safety actions. (3) [12]
4. Give activity guidance appropriate for ages 5–17 years once cleared. (2) [6]

Model answer

PPE history. Exertional symptoms, syncope, chest pain, palpitations, prior cardiac tests, family premature sudden death/cardiomyopathy, concussion, asthma, bleeding, medicines/supplements. [15]

Why not clear. Exertional dizziness is a red flag until evaluated; PPE is risk triage, not paperwork. [15]

Bullying. Ask privately about online and school bullying, mood, self-harm thoughts; involve caregivers/school safely; escalate if suicidality. [12]

Activity. When safe, aim for ≥60 minutes daily moderate-to-vigorous activity with enjoyable movement, not only matches. [6]