Tackling Health Barriers to Learning – Does Your State Mandate Student Health Screenings?

The link between a student’s health status and learning has been well established in the literature. According to the Centers for Disease Control and Prevention’s Division of Adolescent and School Health, “healthy students are better learners” and “schools are the right place for a healthy start.”

Maximizing the school experience and success of every American child must remain a vital national priority. And while there is a plethora of reasons that children do not have optimal academic performance, especially children exposed to persistent adversities or chronic toxic stress, far too often unrecognized or undermanaged health conditions are among the reasons. These health conditions, commonly referred to as “Health Barriers to Learning,” include: uncorrected vision problems, unaddressed hearing loss, uncontrolled asthma, dental pain, persistent hunger, untreated mental and behavioral health problems, and the effects of lead exposure.

Research continues to emerge demonstrating the importance of school-based student health screenings and annual comprehensive child and adolescent well-care visits to detect and intervene early on Health Barriers to Learning. Routine screening of students for Health Barriers to Learning can help children and youth get linked to the early intervention services they need so they can be successful in school and in life.

A new study published online in PLOS ONE found that not one single state across the U.S. has mandated that schools require screening of all seven Health Barriers to Learning. Authors of this study asked the question: To what degree do states mandate (if at all) that schools require screening of children for all seven of the Health Barriers to Learning? The study revealed that less than half (49%) of all states required comprehensive school health examinations:

  • Of the states requiring comprehensive school health examinations, only 12 states (CA, CT, GA, HI, IL, KS, KY, MD, MA, NC, PA, RI) and the District of Columbia required a specific state school health form. And of these:
    • 12 of the forms required documentation of vision screening
    • 12 of the forms required documentation of dental screening
    • 11 of the forms required documentation of hearing screening
    • 10 of the forms asked about asthma
    • 9 of the forms required documentation of lead testing
    • 7 of the forms asked about general well-being, emotional problems, or mental health
    • None of the forms asked about hunger
  • And of the states that did not require comprehensive school health examinations (51%), the most commonly required HBL screenings were for:
    • Vision (80% of states, including D.C.)
    • Hearing (75% of states, including D.C.)
    • Dental (24% of states, including D.C.)

The study also brings into sharp focus the need to adequately support schools as a point of influence and access for student health screenings and as a vital referral and linkage partner for Health Barriers to Learning. Schools can help ensure low-income children and families who have yet to be engaged with a medical home are screened and connected to the early intervention and health care services they need. With this said, legislation and appropriate funding, including Medicaid reimbursement, are both necessary to support schools to be able to effectively offer student health screenings and referral and linkages to local health care providers.

The bottom line: States that want to tackle the Health Barriers to Learning for children and youth could start by mandating regular student health screenings of the seven Health Barriers to Learning and providing school districts with comprehensive health screening forms and protocols.  For states already mandating student health screenings, assessing compliance and exploring the degree to which their school districts are monitoring and tracking resolution and management of the health conditions identified through screenings can go a long way to preventing children from remaining at risk of untreated and undermanaged health conditions that can compromise their learning.