Preschool health supervision — branching viva

Stem

You are in clinic with a 4-year-old and caregiver for a school-entry health assessment. Speech concern is raised. [1] [4]

Examiner: What is preschool health supervision for? [4]

Strong answer: A structured preventive package before school entry — growth/BMI, development and school readiness, vision and hearing pathways, oral health, immunisation reconciliation, lifestyle and safety guidance, and social risk — not vaccines alone. [1] [4]

Examiner: How do surveillance and screening differ? [1]

Strong answer: Surveillance is continuous concern elicitation, observation and documentation; screening uses a validated tool at key ages or on concern. Evaluation diagnoses and opens services. [1]

Examiner: The child has few word combinations. Immediate priorities? [1] [2]

Strong answer: Full domain observation, hearing pathway, early speech-language and developmental referral as indicated; do not pure wait-and-see until school. [1] [2]

Examiner: Caregiver asks if a toddler autism checklist alone diagnoses autism today. [3]

Strong answer: No. Tools such as M-CHAT-R/F risk-stratify in supported age windows with follow-up; they are not standalone diagnoses, and age-mismatched tools must not falsely reassure. [3]

Examiner: Family prefers the older sibling to interpret. [12]

Strong answer: Use a professional interpreter for history and counselling; children are not interpreters. [12]

Examiner: Close with your safety-net. [16]

Strong answer: Written plan, red flags for earlier return, how to chase referrals, interim strategies, and scheduled review if waits are long. [16]