Growth Assessment at School
Many factors affect the children’s growth: diet, environment, hygiene, health and disease, heredity and more. The range of normal growth is broad, and most pupils are within the range. It is, however, important to identify overweight, which increases the risk of morbidity such as cardiovascular disease and diabetes, and underweight, which can affect growth and development.
Growth assessment is designed to identify pupils whose growth may be outside the normal growth range to facilitate a referral for further examination and appropriate treatment. Identification of these conditions allows for pupils to be referred for further examination and to receive appropriate treatment. Additionally, growth assessment identifies populations that are at risk of a poor nutritional status and ensures their treatment.
The growth assessment is conducted by
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A nurse
who works in the student health services and was trained to assess growth
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A nutritionist
who works in the student health services and was trained to assess growth
Course of the growth assessment and results
Before the examination, pupils will receive an explanation in class about the test and general recommendations for a healthy lifestyle. The test itself is performed in class or in a room in the school where privacy is protected.
Growth assessments are done using growth charts that depict the breakdown of weight and height and a calculation of the body mass index (BMI) by sex and age.
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1Weight measurement
Weight is measured, and the result is entered into the pupil’s weight chart.
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2Height measurement
Height is measured, and the result is entered into the pupil’s height chart.
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3BMI calculation
Once the weight and height measurement results are entered, the BMI (body mass index) is calculated. This measure reflects the ratio between weight and height squared. It reflects the amount of body fat and can be used to determine whether the weight is normal, or if the pupil is underweight or overweight. BMI for girls and boys differs and changes with age.
Updating the parents and continuing monitoring
- Reporting to parents: before the test, parents will be given an explanation sheet about growth assessments that will be performed in school. In the end of the examination day, parents will receive a digital report on the growth assessment that was performed.
- Referral if necessary:
In the BMI calculation, if the pupil is in the range between the 85th percentile (inclusive) and the 97th percentile (exclusive) - parents will receive a referral to a nutritionist for family guidance on a healthy lifestyle.
If the pupil is below the third percentile or in the 97th percentile or higher on the BMI index, or if the pupil is below the third percentile on the height chart - the pupil will be referred for further examination in the HMO.
What is a growth chart and what is a percentile? - Documentation: growth assessment results are documented by the Ministry of Health (but not sent to the HMO).
- Continued monitoring: the school nurse will inform the parents that a growth assessment follow-up is performed within two months from the growth assessment performed in school. Growth assessment results and actions taken will also be recorded by the Ministry of Health.
Pupils excluded from growth assessment in school
- Pupils whose school equipment does not allow measurement (for instance, pupils who are in wheelchairs).
- Pupils whose growth cannot be assessed using the charts that are routinely in use (for example, if there is a chronic disease that causes the growth rate to be abnormal).