A review of annual growth screening in Aboriginal schoolchildren in Australia.

OBJECTIVES: To determine if growth screening in school-age Aboriginal children detects new, treatable growth problems. METHODOLOGY: A retrospective review of health centre records of children identified as stunted or wasted from school screening from 11 remote Aboriginal communities in the Top End of the Northern Territory. The age of onset of growth faltering, the occurrence of new growth problems in school-age children and initiation of treatment in response to the school screening results were determined. RESULTS: Weight faltering had occurred in all children by 18 months. The average age of onset of weight faltering was 6.6 months (range 3.5-12 months) for stunted children and 8.9 months (range 7.5-18 months) for wasted children. Height faltering in stunted children commenced in all children with documented height measurements by 3 years. Staff did not report any new interventions for poor growth as a result of screening school-age children in 1993 although many children had previously been assessed by the local doctor or visiting paediatrician and were being monitored. CONCLUSIONS: All children that were found to be stunted or wasted were already known to have poor growth prior to school entry. A change in focus is needed from repeatedly weighing and measuring school-age children to developing community- based interventions to improve the nutritional status of all children. Annual measurement of weight and height beyond 5 years of age is not recommended unless it is used to help evaluate interventions aimed at improving nutritional status and educational achievement.