[A study of infant and child health care "follow up clinic"]

Health screening examinations of children. The 1st. health screening forms a major part of the public health services in community health, but it still encounters many problems. In the present study, the health screening programs and the infant and child health care follow-up clinic (2nd health screening) conducted by the Yoshikawa health center in Saitama-pref., as well as by each city and town, were investigated and analyzed. The findings are as follows: 1. In the first, health screening they pointed out some developmental disorders of 21.2%. About 80% of them are "to continue with follow-up observation". And 20% are "to go to the hospital and are to have an examination at once". Almost all of the above problems are related to psychomotor developmental disorders and physical growth delay. 2. The number of the children who made use of public expense was only 7 in 1st health screening. 3. The major complaints of the 2nd health screening are as follows: 1) speech and language delay 130 (36.4%); 2) motor behavior delay 117 (32.8%); 3) physical growth retardation 51 (14.3%); 4) emotional disturbances 12 (4.8%). The results of medical diagnosis for 2 years (1988-1990) were as follows: 1) speech and language disorders 55 (27.5%); 2) mental retardation 29 (14.5); 3) motor disturbances 28 (14.0%). The number of children without any problems is 18 (9.0%). 5. After they took the 2nd health screening, 138 (38.7%) children consulted with this clinic, and still keep consulting. 107 (30.0%) children had a medical examination, and 44 other children (12.3%) were introduced to other related facilities. As matters stand, there are not enough nurseries or training facilities for borderline children, and high-risk children. We don't have a complete system for border and high-risk children. The facilities for border and high-risk children do not give any specific details as to the various special services available. In the future, we forecast that the number of children with speech disorders and children with emotional disorders including infantile autism will increase, we should analyze the system of border and high-risk infants and children in connection with the 2nd health screening and discuss how to serve high-risk children effectively.