[Early detection program for children in West Germany]

Programs for early detection of diseases and developmental disorders during childhood, in order to prevent or to diminish permanent health damages, have a long history. The Federal Republic of Germany started in 1970 a legal screening program, in order to make such a service available to all children in the whole nation. The program consists of eight examinations, beginning at birth and spread over the first four years of life. Even by satisfactory participation a number of weaknesses, down-grading effectivity and efficiency, can be found. Overdiagnosis as well as missed cases do occur. A number of examples will serve to demonstrate shortcomings and possible causes thereof. From these, suggestions for improved strategies will be derived. The proposals include even those for improved monitoring of effectivity and efficiency, which should be already an integral part at the very beginning of every screening program.