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Commissioner supports early health scre

Friday 8 February 2008

Children's Commissioner supports early health screening

Children's Commissioner Dr Cindy Kiro said today early health screening programmes, such as B4 School Checks, are vital to the wellbeing of children in New Zealand.

"Cases such as a young boy at Favona Primary School (in Mangere, Auckland) who had a hearing issue picked up in the B4 School Check pilot programme highlight this," Dr Kiro said.

"The earlier in a child's life we can identify any concerns that will affect their good health, education, safety and economic wellbeing, the better our chances are of seeing our children grow up to be happy and healthy adults.

"The B4 School Checks programme fits well with my proposal for the establishment of a plan for every child that integrates and builds on existing health, education and social development services.

"For most children, their needs will be met within universal education and health services. But we also must be able to identify children who have additional needs.

"Investments early in the life of the child and early in the life of the problem are most likely to bring good returns to society as a whole, both socially and economically. An ageing population with increasing economic dependency means the future productivity of every child and young person is important."

For further information:

Please note: A summary of the Children's Commissioner's plan for an integrated framework for children and their families ­ Te Ara Tukutuku Nga Whanaungatanga o Nga Tamariki is attached.


Te Ara Tukutuku Nga Whanaungatanga o Nga Tamariki: Weaving Pathways to Wellbeing ­ an Integrated Framework for Children and Their Families


Te Ara Tukutuku Nga Whanaungatanga o Nga Tamariki provides a systematic approach to monitoring development of every child and young person in New Zealand, and supporting families to make sure children have the opportunity to reach their full potential.

The vision underpinning Te Ara Tukutuku Nga Whanaungatanga o Nga Tamariki is that every child in New Zealand is safe, nurtured, educated, healthy, and has hope for the future.

In practical terms the framework aims to ensure that families are supported within their communities to help children thrive in each of the four domains of physical, emotional, cognitive and social development.

Assessments at key transition or change points will lead to development of individual plans to guide progress through universal services, and to access any additional services that are required.


Ensuring that children are safe and nurtured, have the resources to develop to their full potential, and have their views considered in matters that affect them, is a fundamental responsibility of governments and communities.

An ageing population structure, with increasing economic dependency and caregiver ratios, means that the future productivity of every child and young person is important.

Investments in childhood are most likely to bring good returns to society as a whole. Economic modelling shows that the optimum return to investment in human capital occurs in the first years of life. Estimates of the benefit to cost ratio of early childhood intervention for disadvantaged children in the United States are as high 17:1 as by age 40 (i.e. US$17 net benefit to society for every dollar spent.)

Te Ara Tukutuku Nga Whanaungatanga o Nga Tamariki will provide accurate information, which is essential to plan well for individual children and families.

The framework will also mean that educators, health service providers, community planners and child protection services have access to anonymous aggregated data so that they can prepare and plan appropriately for current and future needs.

Values for success

Te Ara Tukutuku Nga Whanaungatanga o Nga Tamariki will apply to every child, and will mean that physical, emotional, cognitive and social wellbeing is assessed in a consistent way.

The framework will be child-centred, family focused and strengths-based.

Details of the framework will need to be developed and implemented with the support and in partnership with children and their families.

The framework allows for early identification of additional needs, which may be met within universal services, and early intervention in the life of a problem where necessary.

Planned assessment across domains and sectors

Te Ara Tukutuku Nga Whanaungatanga o Nga Tamariki adopts a life cycle approach, recognising that as children grow and develop there are some key transition times where it will be wise to have an opportunity to ensure that they have the skills and resources to manage the transition well.

Planned assessment at key life stages, including early childhood, primary and secondary school entry, and moving to tertiary education or employment and training opportunities, is a key component of the framework.

The assessment will take into account the whole child; their physical, social, educational, emotional, and psychological development. Within these domains different factors will be more important depending on the age of the child.

In the early years there is would be a focus on attachment between infant and caregivers, and on physical growth and development. School engagement is important between ages five and nine. At entry to secondary school the focus is on a review of general health, personal identity and social wellbeing, which are key issues. The final assessment focus is on preparedness for transition from compulsory education to further education, training or employment.

Responsive services

Te Ara Tukutuku Nga Whanaungatanga o Nga Tamariki builds on current universal health, education and social development services provided to all children and young people in Aotearoa New Zealand.

The framework expects that individual plans, owned by the child and held by the family, will be developed in partnership with children and families, using strengths-based approaches in a community development paradigm.

For most children their needs will be met within universal education and health services. Each child would have a named primary professional responsible for ensuring the child and family have access to services and advice as needed.

Where additional needs requiring additional social, educational or health services are identified, either through universal service delivery or through planned assessment, a referral will be made. The primary professional will generally remain with the universal service provider, who has responsibility to liaise with the specialist.

Where multiple needs are identified the support provided to the child and their family will be integrated through a lead professional, who has responsibility to collate information and co-ordinate service delivery. A common record will include entries from all practitioners involved, and will continue to be owned by the child and held by the family.

Where statutory interventions or specialist intervention are required the integrated service delivery will continue, co-ordinated by a practitioner with statutory or professional responsibility to take the lead professional role.

A key strength of an integrated approach is the potential for all professionals to be working to the same frame of reference. This is, of course, in stark contrast to the silo effect often observed between, and even within, agencies who may be engaged with families but do not co-ordinate their work.

For the framework to function effectively, those involved with a child or family will need to have access to information that helps them to make better decisions. A sound information base is essential if we are going to make sure that every child is safe and protected, enjoys the resources to take an active role in society, and understands and enjoys their human rights.

The clear benefits of sharing integrated information are that each and every social service provider has a clear picture of the child's experiences, strengths and needs, and can more effectively promote that child's rights, best interests and welfare.

Sharing of information will require trust, shared ownership and commitment, with careful attention to privacy considerations and concerns.


Te Ara Tukutuku Nga Whanaungatanga o Nga Tamariki is a 10-year long-term vision for the wellbeing of children in New Zealand.

The framework builds on existing services, supports and capacity. It can be rolled out incrementally, possibly beginning with areas that have high perceived need, or at specific ages, and eventually reaching all children and young people.

Co-located services for children and families are most likely to be accessible, and to foster the community development approach that is a key value of Te Ara Tukutuku Nga Whanaungatanga o Nga Tamariki.

Workforce development will be an important area of investment in the implementation of Te Ara Tukutuku Nga Whanaungatanga o Nga Tamariki. This workforce development will include additional capacity in terms of assessment, data management, and service co-ordination. The principal investment will need to be in developing the capacity of the existing workforce to implement a whole child approach, use a common assessment framework, and deliver integrated services.


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