Guidance on the age-appropriate focus for tiered assessments across each domain is represented in Table 1 below.

The Framework proposes that the elements outlined in red form the focus of the Preliminary Health Check (see section 2.3.1). It is proposed that elements outlined in blue (and italicised) be additional foci for the Comprehensive Health and Developmental Assessment (see section 2.3.3).

Specific elements have been identified as guidance only. These provide a useful list of potential assessment areas that have been informed by practising clinicians. Table 1 should not be considered an exhaustive check-list (i.e. the absence of elements should not be read to infer that assessment/investigation of particular issues is unwarranted). The Framework defers to the clinical acumen of practitioners based on the unique health needs of each child or young person.

The Framework recognises that practitioner consideration of a number of these elements may be assisted by the use of one or more screening/assessment tools; further guidance is provided in Table 2 (see section 2.5).

Age Range Focus of assessment (Domain)
Physical health Developmental Psychosocial and mental health
Under 1 year

Physical health history
• pregnancy and birth information
• past and present health conditions (including acute and chronic)
• immunisation status
• past and present medications
• allergies
• dietary history (feeding and nutrition)
• safe sleep arrangements

Physical examination and assessment
• general physical health assessment (including vital signs, growth; height, weight and head circumference and skin examination)
comprehensive physical examination

Oral health assessment
• general dental health screening
• comprehensive oral examination including teeth, gums, soft and hard palate (including details of any decayed, filled or missing teeth)

Developmental history
• birth parent and records of past placements (including history of middle-ear infections, potential Foetal Alcohol Spectrum Disorder)
• developmental milestones
investigate indicators of trauma associated with past abuse and neglect

Speech, language and communication
• development of receptive (comprehension) language
play and pre literacy skills

Motor development
• fine and gross motor function

Cognitive development
problem solving skills

Sensory
• vision and hearing screening
hearing test and ear health assessment (including whether hearing loss is present and if so whether it is conductive, sensorineural or neural in origin)
• vision test and eye health assessment - to detect vision disorders including diminished visual acuity, amblyopia, refractive errors and strabismus

History
• birth parent and carer concerns (including behavioural)
• physical/emotional abuse

Mental health
• enjoyment of life/happiness
trauma related problems (including anxiety)
• depression

Behavioural
• conduct, sleep and self regulation

Emotional development
• engages with carer e.g. mutual gaze
• Explores confidently trusting parent’s availability
• attachment disorders
• positive attachment

Social Competence
socialisation

Development of identity
• cultural and spiritual identity essential for Aboriginal and Torres Strait Islander children as appropriate for other populations

  The Framework proposes that the elements outlined in red from the focus of the Preliminary Health Check. It is proposed that elements outlines in blue (and italicised) be additional foci for the Comprehensive Health and Developmental Assessment.
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Age Range Focus of assessment (Domain)
Physical health Developmental Psychosocial and mental health
1-5 years

Physical health history
• pregnancy and birth information
• past and present health conditions (including acute and chronic)
• immunisation status
• past and present medications
• allergies
• dietary history (feeding and nutrition)

Physical examination and assessment
• general physical health assessment (including vital signs, growth; height, weight and head circumference and skin examination)
• comprehensive physical examination

Oral health assessment
• general dental health screening
• comprehensive oral examination including teeth, gums, soft and hard palate (including details of any decayed, filled or missing teeth)

Developmental history
• birth parent and records of past placements (including history of middle-ear infections, potential Foetal Alcohol Spectrum Disorder)
• developmental milestones
investigate indicators of trauma associated with past abuse and neglect

Speech, language and communication
• speech/articulation
• expressive and receptive (comprehension) language
play, pre literacy and literacy skills

Motor development
• fine and gross motor function

Cognitive development
problem solving skills

Sensory
• vision and hearing screening
hearing test and ear health assessment (including whether hearing loss is present and if so whether it is conductive, sensorineural or neural in origin)
• vision test and eye health assessment - to detect vision disorders including diminished visual acuity, amblyopia, refractive errors and strabismus


History
• birth parent and carer concerns (including behavioural)
• child’s friendships, relationships and socialisation
• physical/emotional abuse
• exposure to violence (personal and domestic)

Mental health
• enjoyment of life/happiness
• self-esteem
trauma related problems (including anxiety)
• depression

Behavioural
• conduct, sleep and self regulation
behavioural problems and conduct disorders (defiance, inattention and hyperactivity)
• self-harm

Emotional development
• explores confidently (for longer periods) trusting parent’s availability on return
• aspirations
• attachment disorders
• relationship insecurity

Social Competence
socialisation
• social communication (pragmatics)
• social skills (including self-help skills)

Development of identity
• cultural and spiritual identity essential for Aboriginal and Torres Strait Islander children as appropriate for other populations

  The Framework proposes that the elements outlined in red from the focus of the Preliminary Health Check. It is proposed that elements outlines in blue (and italicised) be additional foci for the Comprehensive Health and Developmental Assessment.

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Age Range Focus of assessment (Domain)
Physical health Developmental Psychosocial and mental health
6-11 years

Physical health history
• pregnancy and birth information
• past and present health conditions (including acute and chronic)
• immunisation status
• past and present medications
• allergies
• dietary history (feeding and nutrition)

Physical examination and assessment
• general physical health assessment (including vital signs, growth; height and weight)
• maintenance of personal hygiene
comprehensive physical examination
• management of specific health conditions

Oral health assessment
• general dental health screening
comprehensive oral examination including teeth, gums, soft and hard palate (including details of any decayed, filled or missing teeth)

Health literacy
• understanding of healthy lifestyle (including diet, exercise, sleep)
• understanding of physical/emotional changes associated with puberty (as appropriate)
• understanding of health issues, including the risks of alcohol, tobacco and other substance use and behaviours that can be a health risk (as appropriate)


Developmental history
• birth parent and records of past placements (including history of middle-ear infections, potential Foetal Alcohol Spectrum Disorder)
• developmental milestones
• educational progress
• investigate indicators of trauma associated with past abuse and neglect

Speech, language and communication
• speech/articulation
• expressive and receptive (comprehension) language
• play and literacy skills

Motor development
• fine and gross motor function

Cognitive development
• problem solving skills

Sensory
• vision and hearing screening
hearing test and ear health assessment (including whether hearing loss is present and if so whether it is conductive, sensorineural or neural in origin)
• vision test and eye health assessment - to detect vision disorders including diminished visual acuity, amblyopia, refractive errors and strabismus



History
• birth parent and carer concerns (including behavioural)
• child’s friendships, relationships and socialisation
• school performance
• physical (including sexual)/emotional abuse
• exposure to violence (personal and domestic)

Mental health
• enjoyment of life/happiness
self-esteem
• trauma related problems (including anxiety)
• depression

Behavioural
• conduct, sleep and self regulation
• behavioural problems and conduct disorders (defiance, inattention and hyperactivity)
• self-harm
sexual behaviour problems

Emotional development
• aspirations
attachment disorders
• relationship insecurity

Social Competence
• socialisation (including ability to make relationships and to relate to peers
social communication (pragmatics)
• social skills (including self-help skills)
• awareness of basic safety issues, including road safety

Development of identity
• cultural and spiritual identity essential for Aboriginal and Torres Strait Islander children as appropriate for other populations


  The Framework proposes that the elements outlined in red from the focus of the Preliminary Health Check. It is proposed that elements outlines in blue (and italicised) be additional foci for the Comprehensive Health and Developmental Assessment.

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Age Range Focus of assessment (Domain)
Physical health Developmental Psychosocial and mental health
12-18 years

Physical health history
• pregnancy and birth information
• past and present health conditions (including acute and chronic)
• immunisation status
• past and present medications
• allergies
• dietary history (eating and nutrition)

Physical examination and assessment
• general physical health assessment (including vital signs, growth; height, weight)
• dermatological health
• maintenance of personal hygiene
• comprehensive physical examination
• management of specific health conditions

Oral health assessment
• general dental health screening
• comprehensive oral examination including teeth, gums, soft and hard palate (including details of any decayed, filled or missing teeth)

Health literacy
• understanding of healthy lifestyle (including diet, exercise, sleep)
• understanding of physical/emotional changes associated with puberty (as appropriate)
• understanding of health issues, including the risks of alcohol, tobacco and other substance use and behaviours that can be a health risk
• understanding of issues relating to sexuality and sexual activity (inc. its role in relationships) contraception; sexually transmitted infection and particular risks of early sexual activity


Developmental history
• birth parent and records of past placements
• developmental milestones
• educational progress
• investigate indicators of trauma associated with past abuse and neglect

Speech, language and communication
• speech/articulation
• expressive and receptive (comprehension) language
• literacy skills
• interpersonal skills

Motor development
• fine and gross motor function

Cognitive development
• problem solving skills

Sensory
• vision and hearing screening
hearing test and ear health assessment (including whether hearing loss is present and if so whether it is conductive, sensorineural or neural in origin)
• vision test and eye health assessment - to detect vision disorders including diminished visual acuity, amblyopia, refractive errors and strabismus




History
• birth parent and carer concerns (including behavioural)
• child’s friendships, relationships and socialisation
• school performance
• physical (including sexual)/emotional abuse
• exposure to violence (personal and domestic)

Mental health
• enjoyment of life/happiness
self-esteem
• trauma related problems (including anxiety)
• depression

Behavioural
• conduct, sleep and self regulation
• behavioural problems and conduct disorders (defiance, inattention and hyperactivity)
• self-harm
sexual activity
• sexual behaviour problems
• independent living skills and support
• partner violence

Emotional development
• aspirations
attachment disorders
• relationship insecurity
• sexual knowledge

Social Competence
• socialisation (including ability to make relationships and to relate to peers
social communication (pragmatics)
• social skills (including self-help skills)
• awareness of basic safety issues, including road safety

Development of identity
• cultural and spiritual identity essential for Aboriginal and Torres Strait Islander children as appropriate for other populations



  The Framework proposes that the elements outlined in red from the focus of the Preliminary Health Check. It is proposed that elements outlines in blue (and italicised) be additional foci for the Comprehensive Health and Developmental Assessment.