What To Expect In Your Child’s Routine Checkup

By the time your toddler is two years old —

Growth is rapid, and the developmental changes are exciting. At your child’s annual exam, your provider may:

Measure your toddler’s height and weight to ensure healthy growth.
Take a measurement of the head to track brain growth.
Examine the eyes and ears.
Perform an autism spectrum disorder checkup (ASD). Early detection and intensive treatment before age three can change the underlying brain development and activity and help most children who show signs of ASD.
Give your child age-appropriate immunizations.
Check your child’s heart rate and breathing. It’s not uncommon to perform a blood pressure screening for children as young as three.
Screen for anemia and lead poisoning with a blood test.
Watch your child walk to assess gait and coordination.

When your child five years old —

Your provider will weigh and measure your child to make sure he or she is growing at a healthy, steady rate. Blood pressure, heart rate and breathing will also be checked.

After consulting your child’s immunization record, your provider will administer any vaccines that are new or have been missed. Your provider will also provide the shots your child needs to start school, including the DTaP, MMR, chicken pox, polio and hepatitis A vaccines.

Tests might include:

A tuberculosis test
A hearing screening using headphones and sounds played at different frequencies to look for early signs of a hearing problem
An eye exam to look for signs of congenital eye conditions and to check the structure and alignment of your child’s eyes and her ability to move them correctly

By age five, most children are speaking in full sentences. Your provider may also inquire about school and friends to gauge how your child is adapting to new experiences and to determine the development of appropriate social skills and peer relationships.

When your child is a preteen —

Annual wellness exams help your growing child move through the challenging preteen years with good health habits and an empowered sense of responsibility for his or her well-being. Prior to the start of the school year is the perfect time to schedule a well-child visit.

Yearly checkups for 10- to 12-year-olds might include:

•Routine examination of heart, lungs, skin, internal organs and reflexes
•Vision and hearing screenings
•Blood cholesterol test to help assess your child’s risk of future heart disease
•Urinalysis to check for infection, kidney problems and diabetes
•Hemoglobin blood test to check for anemia
•Scoliosis exam to check for curvature of the spine

The Centers for Disease Control and Prevention recommend that all boys and girls ages 11 or 12 be vaccinated for HPV, the most common sexually transmitted infection. “Nearly 80 million people—about one in four—are currently infected in the United States. About 14 million people, including teens, become infected with HPV each year,” reports the CDC. Talk with your child’s physician about any other vaccinations that are recommended.

This is also a good time to discuss the importance of healthy lifestyle habits with your developing child. I’ll try to assess their vulnerability for risky behaviors. Questions may include:

•Do you have any questions about puberty or your bodily changes?
•For girls: Have you had your first menstrual cycle? Do cramps prevent you from being active?
•Have you ever used tobacco? Do your friends smoke?
•Do you drink alcohol or get high using other substances?

Your provider may look for signs of emotional or psychological distress and ask questions such as:

How is school going for you? Do you like your classmates and teachers? Are you being bullied or treated poorly by peers?
How are relationships at home? Has any major change happened to your family in the last year, such as illness or separation?

You might discuss nutrition with your child’s physician during a routine checkup too. Children age 12 need between 1,600 to 2,500 calories each day, and active children need even more. Dietary questions include:

Is your child a vegetarian? If so, are they eating iron-rich foods like soybeans, tofu and spinach?
Do they eat fiber-rich fruits and vegetables daily?
Are they getting enough calcium and vitamin D from dairy products?

Preteens need at least 9 hours of sleep each night on a regular basis. Your provider may bring up your child’s sleeping habits to determine if emotional stress or environmental factors are interfering with his or her ability to obtain adequate rest.

As you move through the years together —

Remember that your family medicine provider can act as an advocate for you in an often-complex health care system. Your collaborative relationship thrives on effective interpersonal communication. Let your provider know whenever your child sees a new specialist or receives care in an emergency situation. Although electronic health records can often convey this information automatically, it’s a good policy to always request that a record of recent care be sent to your family doctor. This allows your child’s physician to coordinate your care with other providers and subspecialists when needed to ensure all of your medical needs are met.