Key takeaways
- School entry health checks are mandatory in Germany.
- The medical check is free and intended to support the child and the parents in preparing for school.
- The medical examination results are shared with the health department, school authorities (if needed), and parents.
- Parents have the final say on when the child will start school in Germany. The health office and teachers can only provide recommendations.
This is how you do it
- You get a school entry check-up invitation from the local health department.
- You must bring the child’s medical book (Kinderpass), vaccination booklet (Impfungspass), and questionnaire, if any, to the health check-up.
- The doctor will suggest the required measures based on the medical examination results.
Table of Contents
Starting primary school is a big change for the kids. It’s the beginning of a new, exciting phase of life for your child and yourself.
Your child must be physically, mentally, and emotionally healthy to successfully enter this phase. The school entry health check-up offers the opportunity to ensure your child is ready for school.
Use this Visualization: You may use this image for free with proper attribution to GermanPedia (i.e., by linking back to GermanPedia).
What is the school entrance health examination (Einschulunguntersuchung)?
In Germany, school entry health check-ups are mandatory before school enrolment. The medical examination checks whether your child is fit for school.
These health checks have different German terms, such as:
- Enschulungsuntersuchung
- Schuluntersuchung
- Schuleingangsuntersuchung
During the school entry health check-ups, the pediatrician examines the following things.
Use this Visualization: You may use this image for free with proper attribution to GermanPedia (i.e., by linking back to GermanPedia).
- Physical health: The doctor checks the child’s eyesight, hearing, and age-appropriate psychomotor development.
- Cognitive abilities include the ability to complete work assignments, maintain focus for a long period of time, and demonstrate age-appropriate language development.
- Social-emotional skills include self-confidence, enthusiasm for learning, and the ability to interact with other children.
The purpose of these health checks before starting school is to give parents and children time to work on issues found during the examination. We have created a checklist of things your child should be able to do before starting school in Germany. You can download it here.
Checklist to assess if your child is ready for school in Germany
- Checklist of things your child should be able to do.
- These are only recommendations and not must-haves.
- Make learning fun for your child
Are the school entry health check-ups and early detection health check-ups the same?
No, the school entrance medical examination differs significantly from the early detection health check-ups (U8 and U9). The school entry health checks (Einschulunguntersuchung) focus on the child’s school readiness.
On the other hand, the early detection check-ups (U8 and U9) or “Früherkennungsuntersuchung” focus primarily on identifying acute and chronic illnesses that require treatment.
All children between the ages of 46 and 48 months must undergo the U8 preventive medical examination. Similarly, all children between 60 and 64 months undergo U9 health checks.
The doctor needs the most recent age-appropriate preventive health check (U8 or U9) during the school entry medical checkup. Your child’s health insurance covers U8 and U9 checks. So, you don’t pay anything for them.
What is the right health insurance for your child in Germany ->
Two parts of school entry health checks (Einschulunguntersuchung)
The school entry medical examination (Einschulunguntersuchung) consists of two parts.
- School entrance screening (Schuleingangsscreening)
- School medical examination (Schulärztliche Untersuchung)
The table below summarizes the two parts of the medical checkup.
| Parameters | School entrance medical screening (Schuleingangsscreening) | School medical examination (Schulärztliche Untersuchung) |
| Who is it for? | Mandatory for all children | For individual cases only. Your child should undergo it if: – They missed early detection check-ups (U8 or U9) – Their early detection check-ups or school entrance screening identified developmental concerns – They did not attend kindergarten (Kita) – The parents requested it because they are unsure whether their child is ready to start school |
| What happens during this part? | – The pediatrician checks the medical history of the child. – The doctor reviews the child’s medical booklet (Kinderpass) to check the last preventive health check-ups (U8 and U9). – The doctor reviews the child’s vaccination booklet to ensure the child has all the necessary vaccinations. – Weight and height measurement – Testing eyesight (vision) and hearing – Examining the overall development of your child (e.g., linguistic, mental, physical, social) | – The pediatrician checks the medical history and development of the child. – Examining linguistic, intellectual, and psychosocial development – If necessary, a physical/neurological exam is done |
NOTE: The exam scope and requirements for school entry health checks vary for each state. You can contact your local health office or check their online website for specific requirements
Why is the health check-up before starting school necessary?
School entry medical examinations (Einschulunguntersuchung) are legally required for all children in Germany. However, you should do it for the following reasons.
- You are unsure whether your child should start school, especially if your child is younger than the other children in the group. School entry health checks are another decision-making aid for parents.
- The health check-up examines whether your child is physically, mentally, and socially fit for school. If the pediatrician finds anything abnormal during the check-up, they recommend measures to ensure that your child has a smooth school start. Common recommendations include:
- Glasses for vision problems
- Exercises or therapies to improve motor skills
- Vaccination consultation if immunizations are incomplete
When do the school entry health checks (Einschulunguntersuchung) take place?
The school entry medical check-up takes place two years before admission to primary/elementary school. Your local health authorities (Gesundheitsamtes) will send you a medical examination invitation.
If you don’t receive the invitation, contact your local health authorities. Your child must take the school entry health check on time for two reasons.
- You’ll have enough time to work with your child to improve their health and development.
- It’s a prerequisite for school enrolment in Germany.
Who examines the child during school entry health checks?
- Part 1, the school entrance medical screening (Schuleingangsscreening), is carried out by pediatric nurses.
- Part 2, the school medical examination (Schulärztliche Untersuchung), is carried out by a pediatrician. They are also called Schularzt.
The school entry medical check-up occurs in the kindergarten or health department (Gesundheitsamt). Parents are requested to be present during the health check for the following reasons.
- The child feels more comfortable when you (parents) are present during the medical examination.
- You can answer the doctor’s questions, if any.
- The doctor can share their observations/results of the examination straight away.
What happens after the school entry health checkup?
Use this Visualization: You may use this image for free with proper attribution to GermanPedia (i.e., by linking back to GermanPedia).
- The doctor explains and discusses the health check results with the parents. The health department also informs the parents what data they will share with whom.
- You will receive a confirmation of your child’s participation in the school entry health checkup. Make sure to keep it, as it will be required during your child’s school enrolment.
- The medical check-up results are sent to the state’s health department. Of course, your child’s personal data, such as name and address, is not shared. The health department uses the data to statistically evaluate the health status of children in a given year group.
- The medical examination results are also shared with the school. However, the results are shared only if they are important for the child’s successful integration into school. This may include:
- Chronic conditions such as asthma, heart defects, diabetes, metabolic disorders, or allergies.
- Special support needs. For example, kids who need wheelchair support or who have severe visual or hearing impairments.
- The health department also informs the school if the child must attend a preparatory German course. This is helpful for children of expats living in Germany.
Sharing the health checkup information with the school is essential for the best integration of the children.
FAQ
The school entry medical examination is free in Germany. The local health department organizes it.
It depends on the federal state you live in. However, in most German states, parents decide when their children attend school.
Kindergarten teachers, school entry health checkers, and primary school teachers can only make recommendations.
If you want your child to attend school early or one year later, you must write to the school administration.
NOTE: The school has the right to decide which students to accept. So, even if you want to send your child early, the school may reject the admission.
You do not have to prepare your child for a health checkup. Remember, the medical examination is to help you and your child get ready for school.
Just inform your child about the checkup and what will happen. This way, your child won’t be surprised when they meet the doctor.
It can take around 30 to 60 minutes.
You must bring the following documents to the school entry health check.
– Child’s medical history book (Kinderpass or Kinderuntersuchungheft)
– Vaccination booklet
– If you received a questionnaire with the invitation letter, you must complete it and bring it to the health check.
Yes, you receive a questionnaire with the medical check invitation letter, or it’s handed out during the checkup.
The questionnaire contains general questions about your child’s physical, social, and emotional health. The questions vary from one federal state to another.
Moreover, in some federal states, it’s mandatory to fill it out.
The doctor will suggest possible support measures on how you can prepare your child better for school (e.g., therapy, learning activities).
In some cases, parents can choose to postpone enrollment after consulting with the pediatrician and the school. However, schooling is compulsory in Germany. Thus, the tendency is always to ensure that a child of school age is enrolled with proper support.
Remember, this health checkup is not a pass or fail test. It is an assessment of your child’s school readiness. The goal is to identify areas where your child may need extra support, not to disbar them from schooling.
Yes, but you should first contact your child’s school to discuss the possibility of early enrollment. Regulations for early school entry vary for each federal state. However, as a general rule, your child must be at least five years old to be considered.
Starting school early comes with advantages and disadvantages (e.g., performance pressure, social isolation). Make sure that you also have an age-appropriate discussion with your child to understand how they feel about it.
More topics
References
- https://www.lgl.bayern.de/gesundheit/praevention/kindergesundheit/schuleingangsuntersuchung/index.htm
- https://familienportal.nrw/3-bis-6-jahre/gesundheit-kind/schuleingangsuntersuchung
- https://www.landkreis-landshut.de/hostedmedia/22073/sg71_schuleingangsuntersuchung_englisch_flyer_092024.pdf
- https://stadt.muenchen.de/service/info/sg-schulgesundheit/10278765
- https://www.deine-gesundheitswelt.de/schwangerschaft-geburt/schuleingangsuntersuchung
