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Growth Assessment at School

2 March 2025

In the first and seventh grades, a growth assessment is performed on all school pupils. The growth assessment is designed to identify students whose growth may be outside the normal growth range to facilitate a referral for further examination and appropriate treatment.

  • Growth assessment: growth assessment is performed by measuring the weight and height of each pupil, placing the measurement results on growth charts that depict the breakdown of weight and height, and calculating the body mass index (BMI) by sex and age.
  • Updating parents and continued monitoring: if the pupil is below the 3rd percentile or in the 97th percentile or higher on the BMI index or the height chart - parents will receive a referral for monitoring with the attending physician, in writing or by text message.

    If the pupil is in the range between the 85th percentile (including) and the 97th percentile (not including) - parents will receive a referral to a nutritionist for family guidance on a healthy lifestyle.

The growth assessment will not be conducted on pupils whose school equipment does not allow measurement, or those whose growth cannot be assessed using the charts that are routinely in use.

While we track closely the growth of babies, as children grow we measure their development less and less. Their growth and development pace vary and and it is not always easy to tell if their growth is normal. Many factors affect the children’s growth: diet, environment, hygiene, health and disease, heredity and more. The range of normal growth is very broad, and most pupils are within the range. It is, however, important to identify underweight, which can affect growth and development, and 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.

Growth assessments are part of the student health services. If you do not want your child's growth assessed, please inform the school nurse.

The growth assessment is conducted by:

  • A nurse who works in the student health services and was trained to assess growth.
  • A nutritionist who works in the student health services and was trained to assess growth.

Course of the assessment

Growth assessments are done by measuring height and weight, and by using growth charts that depict the breakdown of weight and height and a calculation of the body mass index (BMI) by sex and age.

Before the assessment day, parents will be given an explanation sheet about the growth assessment that will be performed in school.

Before the examination, pupils will receive an explanation in class about the test and general recommendations for a healthy lifestyle, and have an opportunity to ask questions about it. The conversation will not be about weight and diets, but about adopting a healthy lifestyle. We strongly recommend to not address weight and diets at home either.

The test itself is performed in class or in a room in the school where privacy is protected. It is recommended to take the test in light clothing (without a coat or shoes).

  • Weight measurement: weight is measured, and the result is entered into the pupil’s weight chart.
  • Height measurement: height is measured, and the result is entered into the pupil’s height chart.
  • BMI 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.

You should know every child has an individual growth rate and in most cases there is no reason to worry. However, in case of a deviation from the normal growth range, it is important to check what is the reason for it - and initiate a proper treatment.

What is a growth chart?

Results of the assessment and guidelines for the parents

In the end of the examination day, parents will receive a digital report on the growth assessment that was performed. The children are not told the results of the measurement in the examination room. The results are sent directly to the parents. Growth assessment results are documented by the Ministry of Health (but not sent to the HMO).

Possible results and guidelines for the parents according to the text message sent after the growth assessment:

In the growth assessment performed at school, the weight and height were found to be appropriate for the age of the child.

In the growth assessment performed at school, the weight to height ratio was found to be between the 85th percentile (including) and the 97th percentile (not including).

You should know every child has an individual growth rate and in most cases there is no reason to worry. At the same time, to determine whether there is a reason for this result, it is important to contact a nutritionist at your HMO for a family guidance about a healthy lifestyle.

The meeting will be with the parents only. The children will not be at the meeting. Until the meeting, it is not advised to make extreme changes to the eating habits.

In the growth assessment performed at school, the weight to height ratio was found to be in the 97th percentile or above.

You should know every child has an individual growth rate. However, if there is a reason for this result, it is important to diagnose it as early as possible and treat it. Contact your family physician for this purpose. Please inform the school nurse of the results of the physician's examination.

It is not advised to make extreme changes to the eating habits of the child without consulting a professional in the community first. You can contact a nutritionist at your HMO with any question you may have.

In the growth assessment performed at school, the weight to height ratio was found to be under the 3rd percentile.

You should know every child has an individual growth rate and in most cases there is no reason to worry. At the same time, to determine whether there is a reason for this result, it is important to diagnose it as early as possible and treat it. Contact your family physician for this purpose. Please inform the school nurse of the results of the physician's examination.

It is not advised to make extreme changes to the eating habits of the child without consulting a professional in the community first. You can contact a nutritionist at your HMO with any question you may have.

In the growth assessment performed at school, your child was found to be relatively tall for this age.

You should know every child has an individual growth rate, and in most cases there is no reason to worry. However, if there is a reason for this result, it is important to diagnose it as early as possible and treat it. If the child's growth is not monitored by a physician, contact your family physician. It is important to inform the school nurse of the results of the physician's examination.

In the growth assessment performed at school, your child was found to be relatively short for this age, under the 3rd percentile.

You should know every child has an individual growth rate, and in most cases there is no reason to worry. However, if there is a reason for this result, it is important to diagnose it as early as possible and treat it.

If the child's growth is not monitored by a physician, contact your family physician. It is important to inform the school nurse of the results of the physician's examination.

It is not advised to make extreme changes to the eating habits of the child without consulting a professional in the community first. You can contact a nutritionist at your HMO with any question you may have.

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 (the parents may also contact the school nurse to report the follow-up test results). Growth assessment results and actions taken will also be documented by the Ministry of Health.

Note

Note

We recommend not to make extreme changes to the eating habits of your child without consulting the attending physician, or a nutritionist at the HMO.

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).

For information and questions

You can contact the school nurse or the school's health services provider.

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More information

Prevention of discrimination on the basis of weight

Ministry of Health circular (Hebrew)

Guide for Conducting Growth Assessment for Students in School

Ministry of Health Circular (Hebrew)