B4 School Check: Information for Early learning services

Turned 4? A free health and development check for 4 year olds

What is the B4 School Check?

The B4 School Check is a free health and development check for every 4 to 5 year old child in New Zealand. It takes place when a child turns 4 years old and is the last Well Child check.

The B4 School Check is an opportunity for early childhood educators and health professionals to work together to support the health, development and wellbeing of young children by identifying and following up on any health or development issues before the child starts school.

What happens in the B4 School Check?

When a child turns 4, their B4 School Check is due. If a parent or caregiver hasn’t heard from us, it’s important they contact their local provider to organise a check.

A registered nurse will carry out the B4 School Check. They will spend about 45 minutes checking the child’s:

• general health and development
• height and weight
• teeth
• social and emotional wellbeing
• immunisation status.

The child’s vision and hearing will also be screened by a vision and hearing technician – this may happen at a different time.

A person responsible under your service’s license will be asked to complete a Strengths and Difficulties questionnaire (SDQ-T). The B4 School Check provider will supply the SDQ-T and outline the process for returning it once it has been filled in. (Sometimes the parent or caregiver will ask you to complete the SDQ-T.)

The SDQ-T is a tool to identify where a child may need further help before they start school. It focuses on a child’s strengths that can support the child, as well as any difficulties the child is experiencing, such as, difficulties with concentration, behaviour or getting along with others.

The SDQ-T asks for your observations, using your professional judgement, about a child’s interactions as the child participates in the early childhood education environment.

The B4 School Check is an opportunity for health professionals and early education service providers to work with parents and caregivers to ensure a child can reach their potential.

Any information kept as a result of a B4 School Check can only be accessed by properly authorised people who are working with the child, coordinating the B4 School Check or managing the information system.

Why the B4 School Check is so important

The check is a chance for parents and caregivers to ask questions, learn more about their child’s health and development, and be reassured their child will have the best start at school.

The check is an opportunity to connect families to health and support services for further assessment of any issues identified.

A comprehensive health and development check of children who are 4 to 5 years old can pick up health and development issues that would otherwise only become apparent as a child gets older. It is important this happens before the child starts school and the next stage in their learning.

The important role of early learning services

Education and health have critical roles to play in this important check.

Your connection with and observations of children are important to the B4 School Check.

The learning and development information you provide in the B4 School Check is highly valued by parents, caregivers and both the Ministry of Health and the Ministry of Education.

We need your help

We need your help to:

• work with nurses to complete the questionnaire for early learning services on the child’s strengths and difficulties (SDQ-T)
• promote the B4 School Check, by reminding parents and caregivers that it’s FREE and encouraging them to say ‘yes’ to the check
• support and encourage parents and caregivers to attend any appointments if referrals have been made.

For more information

• Visit
• Auckland: Call
• Outside Auckland: Call

Code: HE2439.