Efficacy of pre-school surveillance services in identifying children with special needs

In Sheffield, a selective health visitor (HV) three-year review programme was introduced in 1995 in advance of the national selective programme recommended in Health For All Children (HFAC 4) (2003). This study aimed to determine how effective this targeted programme was, alongside other preschool surveillance services, in the early identification of children who developed special educational needs (SEN) by their sixth birthday. The available records of 74 SEN children born 01/04/94 to 31/03/95 were studied to determine when and how their pre-school problems were identified; 51% of three-year-olds who developed SEN by six years had a three-year review, compared with 27% in the general population; 81% of the total sample had had problems identified by their fourth birthday, of whom 46% had been seen for three-year review. The HV selective three-year review programme was thus reasonably well focused on children who later developed SEN, but a significant proportion of children with SEN were identified both before and after the three-year review stage by other means. This points to early identification of SEN children as now being a multi-professional responsibility, requiring both improved information systems and the exchange of information between professionals.