Regular assessments to ensure the health of children would begin before birth and continue until age eight, under a proposal to create the first national program for early childhood health.
The schedule - to include a home visit for every newborn - is intended to address concerns that developmental problems in children may not be identified soon enough for treatment to be effective. It powerfully acknowledges the link between the wellbeing of mothers and the physical and mental health of their children.
While the precise timing of check-ups has not yet been determined, these would be, "weighted towards the first three years of life", says the interim report of the National Health and Hospitals Reform Commission, released this week.
Marie-Paule Austin, the St John of God chairwoman of Perinatal and Women's Health at the University of NSW, said: "We strongly believe the infant's mental health outcome will be impacted by whether the mother's well or not well. Even from pregnancy the mother is developing an attachment to the foetus."
Severe or prolonged mental illness in a mother could disrupt the relationship with her baby, setting up a risk for mental illness in the child, Professor Austin said.
Frank Oberklaid, director of the Centre for Community Child Health at the Royal Children's Hospital, Melbourne, said: "Any system to keep young children and families in touch [with health services] can only be a good thing.
"The problem is between 18 months and school entry. Attendance [at well-child clinics] drops off very rapidly beyond 12 months... and the next time somebody sees them is when they start school in trouble. There's a whole lot of competencies that develop or don't develop during that time, in language and social development."
Professor Oberklaid said it would be critical to ensure the timing and content of assessments were based on sound science. While it was "intuitive" that screening all children for developmental milestones would be effective, in practice questions remained: "What do you screen for? What's the expertise of the person doing a check? Even if you had [tests that were] 100 per cent reliable, where do you refer the child afterwards?"
At 2, Bonnie Bradley's little world is expanding rapidly. She runs, tumbles and bounces, and her brain is working as energetically as her body. "Her talking has progressed a lot in the last half year," said her mother, Katy. "She seems to understand everything we say to her. Doing things 'by myself' - that's a big one." Bonnie's last well-child visit was a year ago, but Mrs Bradley believes she would quickly notice if anything were amiss. Toddler dance classes and playgroups offer the opportunity to notice other children's progress.
Bonnie's baby sister Alice just had her eight-week check, where her reflexes were tested, along with her reaction to noise and ability to focus her eyes.
Mrs Bradley said the assessments were a chance to look ahead. "All those visits set you up with a pretty good idea what can happen up to school age." She welcomed an expanded program, which could provide dietary advice and first-aid.
The Federal Government has said it will respond to the proposals after the reform commission's final report is completed later this year.
