The Scottish Child Health Programme: Guidance on the 27-30 month child health review

Guidance on the core issues which should be addressed and recorded at the 27-30 month review, and standardised methods of assessment to ensure consistency of practice across Scotland.

Core components of the 27-30 month review

9. Consideration of what should be included in the 27-30 month review has taken account of:

  • The prevalence of different health and developmental problems at this age, their implications for long term outcomes, and their contribution to inequalities,
  • The availability of effective interventions for this age group that improve long term outcomes,
  • The feasibility of including different issues within a universal child health review,
  • Best practice in other settings, and
  • The opinion of a wide range of stakeholders from across Scotland.

10. The overall priorities of the 27-30 month child health review have been agreed as:

  • Promotion of strong early child development (particularly social/emotional and language/cognitive) within a context of helpful parenting and wider family wellbeing, and
  • Promotion of child healthy weight.

11. The core issues that should be covered in the review are shown in Table 1. This list represents the minimum range of issues that should be considered for every child. A wide range of other issues may also be addressed depending on children's individual circumstances and local priorities.

12. Although the core issues listed in Table 1 should be considered for every child at every review, this does not mean that lengthy assessment/discussion of each issue will always be necessary. For example, if information available prior to a review shows that a child has been fully immunised on time, parents may simply be reminded that they will be called for the pre-school vaccination contact in due course and asked if they have any questions about that. Conversely, if a child is found to be inadequately vaccinated, detailed discussion of the benefits and potential harms of immunisation and parents' views and concerns may be required.

13. Consideration of children's development and their nutrition and growth are likely to be major components of each review in line with the overall review priorities hence assessment of these issues is discussed in more detail in the next chapter. As each review is aiming to provide a balanced view of a child's overall strengths and needs within the context of their family and wider environment, the way that the Getting it right for every child (GIRFEC) approach can support this is also discussed in the next chapter.

Table 1: Core issues to be covered in the 27-30 month review

Core issue

Specific topics to consider

How I grow and develop

Child development

All domains including

Social, emotional and behavioural

Speech and language

Gross and fine motor

Child nutrition and growth

Nutrition and healthy eating

Physical activity


Child physical health


Dental health

Unintentional injuries

General physical health

What I need from people who look after me

Parenting and family relationships

Parenting capacity, enjoyment and stress

Parent - child relationship and attachment

Wider family relationships including domestic abuse

Parental health*

Parental smoking

Parental alcohol or drug misuse

Learning disabilities

Mental health

General physical health

My wider world

Home learning environment

Play opportunities

Books and reading

Screen time (e.g. television, computer)

Early learning and childcare

Nursery/childminder/playgroup attendance or registration

Family finances

Poverty and debt

Overall need for support

Health Plan Indicator

* Note that wherever 'parent' is used, this indicates all those in a parenting role, including foster parents and other carers.


Email: Mary Sloan

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