Monday, January 25, 1999
Announcements:
                            None
Lecture notes:

School Health Services (part two of the Comprehensive School Health Program) continued...

• Who provides these school health services?
• school nurse
• nurse's aid
• secretary
• staff
• volunteers

• How do you, the teacher contribute?

• daily observations and referrals
• helping to prepare for screening services

• The most common types of health appraisals at the school site
• health exams
                    --most, but not all, school districts require a physical examination prior to
                        enrollment in  their school district for the first time
                    --the Joint Committee of School Children and Health Problems recommend 4
                        physicals between kindergarten and grade 12
• disease control
            --such as requiring  immunizations
• emergency care
             --some school districts require their teachers to get first aid training
• screening programs
             --Four major types of screening programs
                          1.) vision 
                                  a.) Snellen vision screening test
                                              --In Connecticut in 1899, Herman Snellen established the first vision
                                                 screening in schools.  His exam is easy to administer, inexpensive, and
                                                 there is a high success rate.  This is the screening that we are most familiar
                                                 with.  It is a series of rows of lettters in various sizes.  Vision is classified
                                                 by the distance at which the test is given (20) over the value of the smallest
                                                 line that can be read.  Vision is thought to be excellent at 20/20.
                                  b.) Ishihara color deficiency screening
                                              --About 10% of school age boys have color deficiency, but very few girls 
                                                  have it.  The Ishihara test is very expensive to administer due to the 
                                                  extensive training that is required to interpret the results.
                                                  The test consists of a series of patterns within pictures.  The patterns are
                                                  composed of tiny dots of muted shades of color.  These patterns are 
                                                  surrounded by tiny dots of differing shades of muted color.  The test 
                                                  subject is asked to identify the "hidden" patterns.
                          2.) hearing
                                  --Even a slight hearing problem can affect a person's speech.  For this reason, hearing
                                     screenings are mandated from pre-kindergarten registration through grade 12.
                                  --The most common type of hearing screening is the pure tone audio meter.
                          3.)scoliosis
                                  --usually screened in grades 5-10
                                  --During the screening, the shoulders, scapula, arm hang, and hips are looked at.  
                                      The administrator of the screening looks for a lateral curvature of the spine.
                                  --Scoliosis usually occurs during preadolescence and it tends to run in families.
                                  --1/2% to 2% of young people develop scoliosis.
                                  --Girls are more likely than boys to develop scoliosis.
                          4.) immunizations
                                  --reduce the risk of communicable disease
                                  --most states, but not all, require immunizations before kindergarten registration
                                  --some students can be exempt from immunizations due to:
                                              a.) religion (i.e. Amish)
                                              b.) philosophical objection (i.e. parents think the risks outweigh the benefits)
                                              c.) potential allergic reaction
                                  --Four major types of immunizations
                                              1.) diptheria
                                                      a.) caused by a bacteria
                                                      b.) affects the throat and larynx
                                              2.) pertussis
                                                      a.) associated with whooping cough
                                                      b.) inhalation is extremely difficult
                                                      c.) can cause rupture of lungs and convulsions
                                              3.) tetanus
                                                      a.) associated with lock-jaw
                                                      b.) Tetanus germ lives in the ground.  The carrier is fecal.  
                                                      c.) Farms and inner-cities are both high risk sites for tetanus contraction.
                                              4.) measles
                                                      a.) rash lasts for 4-7 days
                                                      b.) can cause central nervous system damage