[Preschool Examination in Baden-Wuerttemberg: Results of a Survey by Local Health Authorities].

Aims: German federal states conduct preschool examinations of children, to assess risks to their success in school. In 2009, step 1 of the preschool examination (ESU) in the German federal state Baden-Wuerttemberg (BaW) was preponed to the second-to-last year of kindergarten (age 4-5) to gain enough time for developmental interventions. Procedures and practice of ESU by local health authorities (HAs) in step 1 and step 2 (last year of kindergarten) were analyzed to infer strengths, weaknesses and requirements for change in the current ESU format.

Methods: The staff of 38 local HAs completed an extensive questionnaire on basic data, resources, acceptance, cooperation, content, methods and effects of ESU and enhanced their responses in free-text comments. The questionnaire was based on the statewide, standardized procedures of the ESU.

Results: In step 1, a median number of 2091 children were examined per HA. In step 2, the median number of children was 192. Staff resources were rated as insufficient by some HAs. ESU was rated as indispensable or helpful by most HAs. Much emphasis was placed on communication with parents and kindergarten teachers. ESU was performed completely or largely in accordance with the state-wide standards. Some changes in developmental screening were desired. Ratings of kindergarten teachers and parental questionnaires were regarded as helpful. According to HA estimates, about 20% of children suffer from health or developmental problems that are relevant to success in school, especially language problems. Information on developmental interventions following ESU is often missing.

Conclusion: According to HAs, conducting step 1 of the ESU earlier, i. e. in the second-to-last year of kindergarten, has been a success and this change is well accepted. It seems sensible to further refine ESU screening methods and questionnaires. Feedback on developmental interventions following ESU should be the rule. Step 2 of the ESU in the last year of kindergarten should focus on children with special needs and their parents and teachers.