Can items used in 4-year-old well-child visits predict children's health and school outcomes?

Lisa Smithers, Catherine Chittleborough, Nigel Stocks, Michael Sawyer, John Lynch

    Research output: Contribution to journalArticlepeer-review

    4 Citations (Scopus)


    To examine whether items comprising a preschool well-child check for use by family doctors in Australia with 4-5-year old children predicts health and academic outcomes at 6-7 years. The well-child check includes mandatory (anthropometry, eye/vision, ear/hearing, dental, toileting, allergy problems) and non-mandatory (processed food consumption, low physical activity, motor, behaviour/mood problems) items. The predictive validity of mandatory and non-mandatory items measured at 4-5 years was examined using data from the Longitudinal Study of Australian Children. Outcomes at 6-7 years included overweight/obesity, asthma, health care/medication needs, general health, mental health problems, quality of life, teacher-reported mathematics and literacy ability (n = 2,280-2,787). Weight or height >90th centile at 4-5 years predicted overweight/obesity at 6-7 years with 60 % sensitivity, 79 % specificity and 40 % positive predictive value (PPV). Mood/behaviour problems at 4-5 predicted mental health problems at 6-7 years with 86 % sensitivity, 40 % specificity and 8 % PPV. Non-mandatory items improved the discrimination between children with and without mental health problems at 6-7 years (area under the receiver operating characteristic curve 0.75 compared with 0.69 for mandatory items only), but was weak for most outcomes. Items used in a well-child health check were moderate predictors of overweight/obesity and mental health problems at 6-7 years, but poor predictors of other health and academic outcomes.

    Original languageEnglish
    Pages (from-to)1345-1353
    Number of pages9
    JournalMaternal and Child Health Journal
    Issue number6
    Publication statusPublished - Aug 2014


    • Child health
    • Mental health problems
    • Obesity
    • Predictive validity
    • Screening


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