School Entry Health Checks

Before starting school, all children in Germany have to go through "Schuleingangsuntersuchung" or school entry health tests. That's what the law in Germany mandates. Such examinations ensure that your child is ready for school. If your child does not take part in school entry health tests, the Health Office notifies the Youth Welfare Office. So, if you cannot keep the appointment, make sure you contact the Health Department in advance and arrange a new appointment. You will receive an invitation for school entry health tests by post. You can find out more in the section "When and where do the school entry health tests take place?".

Paediatricians of the Health Office carry out the tests. They are also known as school doctors ("Schularzt"). These are doctors specifically responsible for school children. During the tests, childcare professionals assist the doctors. The doctors check your child's health, physical development and behaviour towards others. The doctors inspect, for instance, whether your child can hear and see well, tolerate separation from parents for a certain period of time and work with scissors and pen. At the end of the examination, the doctors will share and discuss the results with you and give you a certificate. You need to present this certificate to enrol your child in school.

Please note: School entry health tests are not a substitute for the U9 early detection examination ("Früherkennungsuntersuchung U9"). You need to take your child to both tests. Soon you can learn more about these check-ups in our upcoming chapter "Preventive check-ups for children and young people".

The exact details of school entry health tests depend on your municipality or city as they are the body organising such examinations. As a rule, school entry health tests consist of two parts:

In the first part, the doctors look at your child's vaccination and preventive check-up booklet ("das gelbe Heft" or "the Yellow Booklet") to see whether your child has had all the necessary vaccinations and check-ups. The doctors will also check your child's weight and height. They test whether the child can hear and see well enough to follow lessons at school - if the doctors determine that your child is struggling, they may prescribe glasses or hearing aids. The doctors also check your child's mental development and motor skills. That means they examine the following:

• Social and emotional development: The doctors observe, for instance, how well your child can concentrate, how they interact with strangers and people they know, whether they are curious about school and how self-confident they are.
• Physical and motor skills development: The doctors observe, for instance, whether your child can imitate movements and whether they can work with a pen or scissors.
• Mental Development (cognitive skills): The doctors observe, for instance, whether your child speaks German well enough, can distinguish colours and shapes, write their name and knows how old they are. The doctors also inspect whether your child can remember things and recognise connections.

The second part of the examination is called "schulärtzliche Untersuchung" or "school medical examination". However, this part doesn't always take place - it is carried out in the following cases:

• You missed the preventive medical check-up U9.
• There were abnormalities in the preventive medical check-up U9.
• Your child did not attend Kindergarten
• You are not sure whether your child should start school yet

During the second part of the examination, the doctors check how your child has generally developed physically and mentally. These tests are similar to the preventive check-ups U8 and U9. Soon you can learn more about these check-ups in our upcoming chapter "Preventive check-ups for children and young people".

The doctors will discuss the test results with you at the end of the examinations, regardless of whether your child has gone through the first or both parts. If there are any abnormalities, the doctors will recommend support options available in your area. You can learn more in the section "Where can I find support for my child?".

You will also receive a confirmation that your child has taken part in the school entry health tests. Please keep the confirmation document safe. You will need it to register your child at school. You can learn more about the details of school enrolment in our upcoming "School enrolment" chapter soon.

The doctors will send the test results to your child's future school. However, they only include general information about your child, for example, whether they need support in a specific area. You will be notified about any information they plan to share with the school. The school will only receive the information if you consent.

Important: Every child is unique and has different needs for starting school. The school entry health tests are intended to ensure that your child is well prepared for school and their needs are not overlooked. Don't be too concerned if it turns out that your child requires some additional support. The test results often also depend on how your child is doing on the examination day. For instance, if the child is tired, sick or excited, the results are likely affected.

As a rule, school entry health tests take place one year before your child starts school when your child is about five years old. However, your child can also take part in school entry health tests beforehand. Participation is possible up to two years before school enrolment.

In principle, you will receive a written invitation from the Health Office for school entry health tests. You may also receive an invitation from your child's daycare centre or prospective school. The letter contains the exact date and location of the tests. In addition to the invitation, some offices also send a questionnaire. The questionnaire mainly includes questions about your child's health and development. For example, your child's possible prior illnesses or when they started walking. You can learn more about the questionnaire in the section "What do I need to present during school entry health tests?".

The time you receive the invitation to school entry health tests depends on respective deadlines ("Stichtag") in your federal state. "Stichtag" is the fixed date which determines whether your child can start school the following year: if your child reaches a certain age by this date, they are allowed to start school next year. In other words, if your child was born before or on this specific date, they could begin school in the coming school year. However, the deadline ("Stichtag") differs from one federal state to another. You can find out the key dates specific to your federal state on the website of the Bildungsserver in German. All federal states and their current regulations are listed there.

If you have not received an invitation for the examinations, contact the Health Office at your place of residence. You can find the Health Office responsible, for instance, on the website of the Robert Koch Institute. You just need to enter the name of your place of residence or your postal code in the search box. You will then see the address, telephone number and e-mail address of your local Health Office.

Children must take part in school entry health tests regardless of any disability or chronic illness they might have. During the examinations, the doctors check the child's possible special needs and can recommend which school is best suited for them. In Germany, all children, with or without disabilities, are allowed to go to the same school. But if you as a parent prefer, your child can go to a so-called special needs school ("Förderschule"). A special needs school is better equipped to accommodate your child's individual needs. For instance, in these schools, subject matters are taught at a somewhat slower pace and children benefit from more support from specially trained teachers.

During the examination, you can ask the doctors about suitable schools or support offers in your area. If you think you have already found the right school, you can also discuss it with the doctors. If you are still doubtful, make sure you share your doubts and questions during the examination.

You can also seek support from the administration of the school you have chosen or the Inclusion Office ("Inklusionsstelle") at your local Education Office("Schulamt"). You can find the relevant Inclusion Office online by entering the keywords "Inklusionsstelle", "Schulamt", and the name of your place of residence on Google or another search engine. You can also seek advice from the Youth Migration Service or the Parents' Hotline. Their staff speak many languages, and their service is free of charge.

You can learn more about support options for people with disabilities in our chapter "Living with disabilities".

After receiving the invitation, you must make a specific appointment, i.e. make arrangements for the exact day and time when your child will be examined. You can learn how to register from the invitation letter sent to you by the Health Office. Some municipalities require you to make an appointment by phone. Others also allow you to register online. 

If you're not sure how to make an appointment, call your Health Office. You can find their telephone number in the invitation letter. You can also search (in German) for your local Health Office on the website of the Robert Koch Institute. To do so, enter the name of your place of residence or your postal code in the search box. You will then see the address, telephone number and e-mail address of your Health Office.

If you need support, the staff of the Youth Migration Service or the Parents' hotline can help you. They speak many languages, and their service is free of charge.

You must present the following documents during school entry health tests:

• Your child's vaccination card
• Your child's preventive check-up booklet ("das gelbe Heft" or "the Yellow Booklet")

If your invitation included a questionnaire, you need to fill it out and hand it in on the examination day. If you have any questions about the questionnaire, you can directly ask the doctors during the tests. If you do not understand a question, you can also contact a counselling centre. To find a counselling centre nearby, check the section "Where can I find advice and support?".

At least one parent or someone who knows the child very well must be present during school entry health tests. During the tests, the doctors will ask you questions about your child's development to date. They will also discuss with you after the examination whether your child is ready for school.

Not all children develop at the same rate. In Germany, however, there are numerous ways in which you can help your child's development. The specific options available depend on where you live and the type of support your child needs.

If your child has difficulties with specific movements, ergotherapy, for example, can help. In ergotherapy, specially trained therapists help your child practice and learn particular movements required in everyday life, For example, working with scissors and pens.

If your child stutters or has other speech difficulties, speech therapists can help. These are therapists with special training in dealing with language and speaking issues.

Please note: You need a referral ("Überweisung") from a doctor for the types of support mentioned above. Otherwise, you have to pay the costs of the treatment yourself. Talk to a doctor to see if your child needs such therapies. On bundesaerztekammer.de, you can search for doctors in your area who speak your language. You can learn how to get a referral from a doctor in our chapter "Health care for refugees".

Important: If your child is not covered by a health insurance company and does not have an electronic health insurance card, obtaining a referral ("Überweisung") can be challenging. If that is the case, it is best to seek counselling, for example, by contacting the Refugee Council in your federal state.

If your child cannot speak German well enough yet, you can, for instance, try to read stories to your child in German. On stiftung-lesen.de, you will find multilingual tips on reading aloud to children as young as 3. On Projekt Bilingual Picture Book, you will find various bilingual picture books for your child. There are also special support programmes in the daycare centres in some federal states. You can soon learn more in our upcoming chapter "School enrolment" in the section "My child doesn't speak German yet. Can they start school?".

In our chapter "School", you will find the section "My child has special educational needs. What can I do?" with further counselling offers. You can also ask your child's daycare centre or prospective school for additional support options in your area. Alternatively, you can search for such offers at the Youth Welfare Office in your place of residence. To find your local Youth Welfare Office check jugendaemter.com.

Yes - you can ask an interpreter to accompany you during your child's school entry health tests. It is best to discuss with your child beforehand whether they would like to have an interpreter and choose a person together when possible.

If you don't know anyone personally, the Youth Migration Service may be able to help you. There, you can also ask whether you have to cover the costs of an interpreter's service personally. You can also ask the Parents' Hotline to recommend an interpreter in your language.

Parents can seek counselling and support from the Youth Migration Service and the Parents' Hotline. Their staff speak different languages, and their service is free.

You can find other counselling centres in your area on the Federal Association for Educational Issues website (Bundesverbandes für Erziehungsfragen e.V.) in German. There you can also search for offers in your language.

If you have questions about specific issues related to family and children, you can find specialised counselling centres on the website of the German Association for Youth and Marriage Counseling (Deutsche Arbeitsgemeinschaft für Jugend- und Eheberatung e.V.) in German. You need to enter the name of your place of residence or your zip code in the middle field and select the topic in the left drop-down menu. You will then receive a list of available counselling centres in your area.