Preschool: Everything You Need to Know About the New National Health Assessment for 4-Year-Olds

The High Authority of Health has just published its very first official guide to standardize health assessments in preschools across the country. Aimed at children aged 3 years and 9 months to 4 years and 6 months, this comprehensive examination allows for the early detection of potential developmental difficulties. Here’s everything you need to know about this key appointment to support your child’s schooling with peace of mind.

What is this famous "BSEM"?

Intended for children aged 3 years and 9 months to 4 years and 6 months, this health assessment in preschool is completely free and takes place directly at your child’s school. The maternal and child protection services (PMI) organize it by sending a written invitation to families.

In short, the idea is simply to take a comprehensive look to ensure everything is going well or, if necessary, to guide families to the right specialists (speech therapist, ophthalmologist, ENT...) before small delays turn into real learning challenges.

On the agenda: 45 minutes to check everything (without taboo)

The assessment lasts about three-quarters of an hour and scrutinizes all dimensions of your child's life. The PMI teams come to the school to analyze:

• Growth and physical health: Weight, height, calculation of BMI (to monitor the infamous rebound of adiposity), examination of teeth, walking, breathing, and a small blood pressure measurement with an appropriate cuff. It is also checked that the mandatory vaccinations are up to date.
• The senses on alert: Fun vision tests (to detect strabismus or a refractive problem) and hearing tests (with headphones or images if the headphones are scary) are on the menu.
• Language and development: Using standardized tools and small games, professionals evaluate fine motor skills, emotional management, socialization, and speech fluency.

The cool bonus: It is also a privileged moment of exchange with guaranteed zero judgment. The teams take the opportunity to chat with you and your child about everyday topics: sleep, nutrition, physical activity, and... screen management (we know this topic is hot in living rooms).

Who is in charge (and do you need to take half a day off)?

It is the health professionals from the PMI who manage the consultation: doctors, pediatric nurses, or specialized nurses. Depending on the staffing in your department, the organization may vary: either a doctor-nurse duo handles everything on site, or the pediatric nurse conducts the initial tests and hands over to the PMI doctor if a medical opinion is needed.

Should you go? Ideally, yes! Your presence is highly desired by the teams. A written invitation is sent to you in advance, accompanied by a questionnaire to fill out at home. This is the perfect time to share your doubts, little victories, or parental concerns. If you are stuck at work, don’t panic: the assessment will take place if you provide the health record and the answers to the questionnaire, and the PMI will contact you to follow up.

What if a small delay is detected?

Don’t panic; this is precisely where the new HAS guide is useful. It sets very clear referral criteria. If an anomaly is detected, the child is referred to their primary care physician or a specialist with a referral letter. Even better: the PMI ensures follow-up to help families obtain these appointments (because we all know how finding an available speech therapist can sometimes be a real challenge).

All conclusions are recorded directly in your child's health record and transmitted to the school health service of the National Education so that the continuation of their schooling takes place under the best possible conditions.