Developmental screening cut for preschool kids in St. John's area
Public health nurses swamped, says Eastern Health
An early warning system to detect learning and developmental problems in preschoolers has been quietly cut back in the most populated region of Newfoundland and Labrador.
Public health nurses in the St. John's area have stopped screening for developmental issues when they give four-year-olds their immunization needles, unless parents ask for it.
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It's a move the Learning Disabilities Association of Newfoundland and Labrador calls shortsighted and disappointing.
"We're upset to hear about it," said the group's executive director David Banfield.
"We'd like to see it reinstated, and added to."
Eastern Health told CBC the automatic screening was stopped in 2014 for children in St. John's, Conception Bay South, Portugal Cove-St. Philip's, Torbay, Bell Island and the Southern Shore.
The change was not made public and kindergarten teachers learned about it when children began showing up in the classroom with undiagnosed issues — too late to put appropriate supports in place for the first year of school.
Nurses just don't have the time, said Eastern Health.
It said 2,244 babies were born in the urban area in 2013-14, half the total births in the province.
"The number of births and the growth in the population, as well as the complexity of the public health nurses' work, has impacted workload," the health authority said in a statement.
'Not fair' to parents
It said screening has been limited "due to the growth in the preschool population entering Kinderstart, the availability of public health nursing resources and the need to ensure all children beginning school receive vision and hearing screening and appropriate immunization."
The broader screening is offered only if children have already been identified to be at higher risk or when caregivers raise a concern.
"It's not fair to put the responsibility on parents," said Banfield.
"They might not know what a learning disability looks like or what the signs are."
Developmental screening, which helps identify problems that need further assessment, includes a check of communication and motor skills, and uses toys and other tools to evaluate problem-solving and social skills.
It is still being offered to all children in rural areas like Whitbourne where a mother told CBC's On the Go on Monday that a public health nurse confirmed her son's speech problems two years after she first went looking for help.
"If you eliminate early screening you're pushing the timeline further from early diagnosis," said Banfield, who says the Department of Education doesn't test for learning disabilities until Grade 3.
Add to that a year-long wait, sometimes more, for services and Banfield said too many children develop other problems that cost more to treat down the road.
He said there has been a dramatic increase in the demand for services like tutoring in math and English.
"We have a two-tier special education system," he said.
"Families who can afford a private program are getting it. Parents who can't afford it aren't."
A preschool screening program, he said, gives early insight into possible learning disabilities.
"We're losing an extra bit of information. The earlier we know, the better future outcome."
Impact on schools
Eastern Health said it has not received any complaints from the school district or the Newfoundland and Labrador Teachers' Association about the reduced screening.
However, CBC has learned that teachers are flagging concerns about what's being missed because of reduced screening by public health.
At least one primary school noted that some children are starting kindergarten with no preschool check and incomplete immunization records.
The president of the NLTA, Jim Dinn, said Thursday that he's hearing about the changes at Eastern Health from CBC.
"We would have concerns with any cut in service that helps identify the needs of children before they get in school," he said, adding that teachers are already frustrated by the number of high needs children in large classes.
Dinn said there is not enough resources for children who need extra help.
"It's certainly a concern that when full-day kindergarten comes in, it will be a little more evident."
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