Rx for Readers: Should my daughter undergo screening tests before school

My daughter is generally healthy, but I wonder whether she should undergo any screening tests to see whether she is ready for school.

By JUDY SIEGEL-ITZKOVICH
My daughter is about to start first grade. She is generally healthy, but I wonder whether she should undergo any screening tests to see whether she is ready for school. R.A., Ramat Gan Dr. Akiva Fredkin, director of the Clalit Health Services' Center for Children's Health in Or Akiva, comments: Besides buying books and a schoolbag before your child enters first grade, it is worthwhile making sure she is physically healthy so that no problem interferes with her studies. Between 3 percent and 5% of first graders suffer from fuzzy or double vision or vision-related headaches. Epidemiological studies show that 15% of schoolchildren have difficulty seeing distant objects such as the board. Some schools have school nurses who check these two types of vision, but studies show that that vision tests by school nurses identify only half of the problems, so it is best to take her to a health fund ophthalmologist. Amblyopia (lazy eye) may also occur, and it must be treated early in the school career. Untreated vision problems in children often lead to behavioral problems and poor school performance as they can't see the board and are frustrated. An examination by a pediatric orthopedist is not mandatory, unless the family doctor/pediatrician has found a spinal or postural problem such as scoliosis. If it is left untreated, carrying a heavy schoolbag can aggravate it. Make sure that the new schoolbag you buy for her is suited to her body size. The upper border of the bag should not be higher than her shoulders when worn, and the bottom of it should be above her buttocks. It should be made from light materials and have broad shoulder straps, with cushioning protecting her back from sharp objects. The straps should be tightened comfortably so the bag is close to her back. According to regulations, the filled schoolbag should not weigh more than one-fifth of the child's body weight. Lockers at school are recommended. Check your daughter's vaccination booklet to ensure that she has had all of her shots; in first grade, children get oral polio vaccine and a booster of the "triple vaccination" against childhood diseases. A visit to her dentist is also recommended so she has no cavities or other problems with her teeth, especially as permanent teeth begin to emerge at this age. And if your family doctor/pediatrician has not done so, check to see whether her weight and height correspond with the norms in charts available in reference books on children's health. Deviations from the norm could be the first signal of a hormonal or other health problem that should be treated before it manifests itself. My son, who is entering first grade, insisted that all the sandwiches he took to kindergarten be filled with chocolate spread. I know it is bad for him and his teeth, but I fear that if I prepare a healthful sandwich, he will leave it in his schoolbag uneaten. What should I do? H.G., Rehovot Shira Nehushtan, a clinical dietitian at Ziv Medical Center in Safed, replies: It is best to have no chocolate spread in the house or at least to limit it only to special occasions. Parents must get children used to eating nutritious foods. One can even decorate them with pieces of vegetables to make them look attractive. Breakfast is very important, and it is best if your child eats something healthful such as a yogurt or whole-grain cereal with milk even before leaving for school. It is worth getting up a few minutes earlier for this. As for sandwiches, try a variety of whole-grain breads in the form of rolls, sliced bread or pita and find out what he likes. Fill them with 5%-fat cheese or low-fat yellow cheese with a vegetable; humous; tuna; a hard-boiled egg; peanut butter; or even "chocolate spread" made from carob rather than real chocolate. But if it's a hot day, don't send an egg or tuna salad sandwich that has mayonnaise or even humous because it is likely to spoil. Always put a bottle of ordinary cold water in the schoolbag that he should refill during the day. Avoid giving him fruit juices and of course sweetened drinks like colas and prepared chocolate milks. If your child has a long school day, fresh fruit, granola bars, cornflakes, low-salt pretzels or dried fruit will fill his energy stores. The most important thing is to consult with your child on what healthful things he likes and to explain that junk food reduces his energy, will make him tired and harm his health, while fresh food without artificial colors and flavors, lots of sugar and salt will keep him healthy. Make sure he also gets exercise outdoors when he comes home. Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting. Write Rx for Readers, The Jerusalem Post, POB 81, Jerusalem 91000, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or e-mail it to jsiegel@jpost.com, giving your initials, age and residence.