To Screen or Not To Screen – That Is the Question

by SKHC Editor on August 5, 2008

The link between vision and hearing problems and barriers to learning is quite straightforward. Not so obvious is the link between postural screening and educational performance.

A quick search of the internet finds that the National Association of School Nurses devotes an entire publication to postural screening. There is a National Scoliosis Foundation and a Scoliosis Research Society. In addition, the Massachusetts Department of Public Health has a very thorough training manual for postural screening programs.

In the Massachusetts document, it states that “Severe curvatures, left untreated, can cause physical deformity, arthritic symptoms, heart and lung disorders, and other medical problems.” What school nurse wouldn’t want to prevent complications as serious as these?

In the part of the country where I live (Wisconsin), there is no mandate for postural screening. Perhaps there should be, if we want to prevent health problems related to severe scoliosis. But given the shrinking resources, both human and financial, that school districts all over the country are experiencing, is this labor-intensive screening cost-effective? Is there anything to substantiate its value in evidence-based practice research?

The statistics from the Massachusetts manual say that “Signs of a lateral curvature (scoliosis) occur in about 10% of the population although only about 2% develop a condition which would require medical treatment.”

Let’s do the math. In my district, screening 5th through 9th graders would result in approximately 5,000 students being screened. Based on the data, I might expect to have 500 students with positive findings. Of those, approximately 10 would have curvature severe enough to require medical treatment. The other 490 may or may not progress to a greater degree of severity.

I would argue that for those 10 students and their families, screening would be life-altering. I’m wondering what you think? To screen or not to screen, that is the question!

Twyla Lato, RN, BSN, NCSN is a School District Nurse for a suburban community in southeast Wisconsin, and a past president of the Wisconsin Association of School Nurses.

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