School-based health screenings for early detection of pediatric sensory and musculoskeletal conditions: A cross-sectional study

Vision, hearing, pes planus, and scoliosis are common conditions in school-aged children and can impair learning and long-term health if unrecognized. School-based screening offers a scalable route to early identification and timely referral. We aimed to evaluate the yield of a large provincial school screening program and describe subsequent diagnostic and management outcomes. In this cross-sectional study, we retrospectively evaluated routine school health screenings conducted in Batman, Türkiye, during the 2022 to 2023 academic year. A total of 8433 students (6-17 years) underwent standardized assessments: Snellen visual acuity testing, otoscopy followed by pure-tone audiometry (500-4000 Hz at 20 decibels hearing level), clinical inspection for pes planus, and the Adams forward-bend test. Screen-positive children were referred for confirmatory diagnosis and management. Demographic characteristics, definitive diagnoses, initial treatments, and follow-up plans were summarized descriptively. At least 1 abnormal finding was detected in 1876/8433 (22.3%) students. Screening yields were as follows: vision 695 (8.24%), hearing 308 (3.65%), pes planus 753 (8.93%), and suspected scoliosis 120 (1.42%). Among vision-positive cases, the distribution of refractive errors was myopia 405 (58.3%), astigmatism 224 (32.2%), and hyperopia 66 (9.5%); spectacles were prescribed in 688/695 (99.0%). Hearing-positive cases were unilateral in 202/308 (65.6%) and conductive in 277/308 (89.9%). For pes planus, 698/753 (92.7%) were flexible; 41/753 (5.4%) received orthoses. Of Adams-positive students, 78/120 (65.0%) had radiographic scoliosis (Cobb > 10°), and 45/78 (57.7%) received bracing. School health screening is feasible and low cost, yields clinically actionable findings, and enables early, conservative management of common conditions. Standardized protocols, trained teams, and clear referral pathways can support scale-up and improve child health and educational outcomes. To our knowledge, this is one of the first population-based evaluations from Türkiye linking school screening yields to confirmed diagnoses and initial treatments, with implications for national screening protocols.