4 Little Checks

GOAL - Children are on optimum developmental pathways.

Access to health and early year’s information and trusting relationships between services and parents are important to support access to health and well-being services. Community feedback supported the need for a collective approach to enhanced early intervention and child health in Kwinana and Cockburn.

The 4 Little Checks Action Team was formed around the time the Community Child Health program updated the health and development assessments and screening schedule.  The action team focused on increasing awareness of child development milestones,  implementing early intervention initiatives and working with primary healthcare professionals to roll-out early intervention rapid trials for hearing and developmental assessments.

Me at 2 Passport

The Me at 2 Passport aims to ensure 2 year old children in the community are meeting their developmental milestones through play-based activities. It acts as a starting point for parents to see how their child is growing and developing and to teach them new skills. It will highlight any areas for concern which you can then speak to your Child Health Nurse about.

The passport is a booklet divided into:

  • Gross Motor Skills
  • Fine Motor Skills
  • Communication Skills
  • Personal / Social Skills
  • Problem Solving

Under each skill are ideas of fun  activities you can do with your 2 year old to see if their development in this area is age appropriate. Once your 2 year old has successfully completed the activity you can check it off in the passport.

This initiative originated from the Me at 3 program developed by Peel Early Years Collective, Wanslea and the City of Mandurah. The program was developed to aid a child’s development prior to starting Kindy with the overall goal of improving outcomes for children in the Peel region after data identified that children were starting school before meeting their developmental milestones, and there was a distinct lack of connections to services that can provide developmental information.

Due to COVID-19 we are unable to provide any hard copy passports at the moment but once restrictions are lifted we are happy to provide you with a passport.

We also have the Me at 2 Toolkit for  groups, community and services who are encouraged to contact us for bulk passports to use within their centres and at events.

The Me at 2 Passport is supported by the City of Cockburn, Wanslea Early Learning and Development  and the Peel Early Years Collective.


About the initiative

In a partnership between Connecting Community for Kids, Earbus Foundation of WA, Goodstart Early Learning, NursePrac Australia and The Smith Family a community model for ear screening and surveillance is being designed and rolled out. This will provide more access points for universal ear checks for children in Kwinana and Cockburn areas aged 0 – 5 years before they commence school.

Non-health professionals have been trained by Earbus Foundation to provide ear screening for children. These screeners have all their results reviewed by Audiologists from Earbus and are required to take Competencies every 6 months to ensure a standard of care across screeners and sites. They will deliver these ear screens in childcare and community settings and support parents with accessing treatment pathways and provide ongoing surveillance.

The screens will:

  • Detect any potential abnormalities in the external ear canal
  • Make sure there are no perforations of the ear drum
  • Detect evidence of potential ear infections or disease (Otitis Media)
  • Check for any blockages in the external ear canal or fluid in the middle ear
  • Check the overall function of the middle ear
  • Be tracked over time and onward referral initiated as appropriate

 Why ear screening is important

  • Early detection and intervention is key to providing a better outcome  
  • If not diagnosed and treated,  middle ear infections can have serious developmental consequences
  • Good ear health is important for early childhood development as ear infections can lead to hearing loss and consequently falling behind at school
  • Ear infections lead to repeat illnesses and absences from school
  • Poor ear health can lead to delayed speech and language skills

 How the checks are conducted

The checks involve a 15-20 minute appointment, where parents will firstly complete a milestone checklist. Following this a trained educator will conduct two tests on the children’s ears.

  • Use an otoscope to look into the child’s ear for a general ear exam
  • Perform a tympanogram, a test which will rule out the presence of fluid in the middle ear, a middle ear infection, perforation of the ear drum or Eustachian tube dysfunction.

 Services taking part

  • Goodstart Early Learning (Success, Bertram, Atwell, Cockburn Central),
  • Bright Futures
  • Babbingur Mia

Rapid Trial
In 2018 we worked with four early learning centres, Nurse Prac Australia and Telethon Speech and Hearing to provide health, development and ear checks for young children.  The familiar environment and involvement of early learning educators made the experience a positive one for children.  Significantly, we found 59% of children screened were recommended for a second hearing screen in 4-6 week’s time.  The importance of ear health and hearing on a child’s development has been a continued focus of the Action Team.

Working with Goodstart Early Learning, NursePrac Australia, The Smith Family and Earbus Foundation of Western Australia, we are exploring training non-health professionals to provide ear screening for children in community settings.

Downloadable Resources