Health and Development Checks in Early Childhood Education and Care report

Incorporating the voices of children in health and development checks

As part of the Brighter Beginnings initiative, the NSW Ministry of Health and NSW Department of Education are working in partnership to deliver free health and development checks to 4-year-olds in early childhood education and care (ECEC) services (preschool or long day care).

In 2024-2025 they engaged the Office of the Advocate for Children and Young People (ACYP) to ensure the voices of children are meaningfully incorporated into the monitoring and evaluation of the program.

ACYP undertook consultations with children who had just participated in the 4-year-old health and development checks, the ‘Check’, to hear about their experiences in their own words. The consultations sought to better understand:

• what aspects of the process worked well for children

• what adjustments or improvements could be made to make the process more comfortable for them. 

Four key recommendations

The recommendations made in this report have been informed by observations of the health and development checks in ECEC services, the voices of the 4-year-old children who shared what they liked and didn’t like through drawing, gestures and storytelling, and the professional insights of the ACYP team members, whose training in social work, education and child participation guided both the consultation and analysis. 

The recommendations are:

1. Connect With Me
   
   NSW Health Local Health Districts (Districts) are encouraged to pair each child with a single Brighter Beginnings health professional to complete all the child development activities as part of the Check. 
   
   The role of teachers and educators in creating an enabling environment for children to complete the Checks should be emphasised in the implementation of child development activities.
   
   
2. Let's Play!
   
   Brighter Beginnings health professionals should continue to prioritise using a playful and informal manner when facilitating the Checks to encourage engagement. 
   
   The Health and Development Checks in ECEC program should consider providing psychoeducation materials to ECEC staff and/or families.
   
   
3. Follow My Lead
   
   Brighter Beginnings health professionals should wherever possible follow the child’s lead and offer choices to children throughout the Checks, for example asking which activity they would like to do next or picking what colour texta they used.
   
   Brighter Beginnings health professionals should continue using positive reinforcement throughout the process of the Checks, providing ongoing feedback and encouragement to build children’s confidence, support their engagement and create a positive and empowering experience.
   
   
   
4. Listen to Me
   
   NSW Health should consider further opportunities to consult and capture the voices of the four-year-old children completing their Checks both as part of the formal evaluation of the program and ongoing quality improvement activities. 
   
   The Child Safe Standards (Standard 2) emphasise that children should participate in decisions that affect them, and their opinions should be taken seriously.