Acing Your Child’s Back-to-School Well Visit

Here's everything parents need to know—by age and stage—about their kids' back-to-school doctor's appointment.

Medically reviewed by Lyndsey Garbi, MD

When it comes to back-to-school, you probably have a laundry list of things to do. From buying school supplies to getting new shoes and haircuts, there can be a lot to accomplish before that first school bell rings. But don’t forget to add a visit with a healthcare provider to that list, too. They can perform your child’s annual wellness exam and even do a sports physical if they need one.

“Well visits are important to keep your child as healthy as possible,” says Dane Snyder, MD, the section chief of Primary Care Pediatrics at Nationwide Children’s Hospital and an associate professor of pediatrics at The Ohio State University College of Medicine.  “Completing these visits helps catch problems early and leads to fewer emergency [room] visits overall.”

It is also important to see the same primary care provider at each visit if you can, Dr. Snyder says, noting that “having continuity between the patient and the primary care provider is important so they can get to know your child and family better.”

If you don’t have a pediatrician yet, you might want to find one that you trust. In fact, the American Academy of Pediatrics recommends that every child receive continuous medical care over a long period of time at one medical home. Doing so allows one physician to monitor your child’s growth and development and build their medical history in one place.

But even if you don’t have a pediatrician, schedule a visit for your child with a healthcare provider in your area. They can make sure your child is up to date on vaccines, screen their hearing and eyesight, and so much more. Here is everything you need to know about your child’s back-to-school exam.

Related: 8 Important Questions to Ask Your Pediatrician

What Is the Purpose of the Well Child Visit?

Your child’s annual wellness exam is a comprehensive visit to keep them healthy, Dr. Snyder says. The visit will include a review of your child’s growth and development as well as their lifestyle habits like sleeping, eating, and exercising. You can even discuss your child’s school performance with your pediatrician.

“These visits promote the health of your child physically, mentally, socially, and emotionally,” says Patty Sabey, MD, a board-certified pediatrician at Altos Pediatric Associates at Stanford Medicine Children’s Health. “Your child receives preventative care, including vaccines and screenings for vision, hearing, dental, and cardiovascular health.”

If you have an older child in sports, they also will undergo a comprehensive evaluation for sports clearance. And they typically will have an opportunity to privately address confidential issues with their pediatricians, Dr. Sabey adds.

Pediatricians also check for tuberculosis and lead exposure. And, if your family has travel plans, your pediatrician will provide travel counseling as well as any additional vaccines your child needs, she says. Some examples include Hepatitis A and typhoid vaccines and prophylactic medication for malaria if applicable.

This is also a good time to go over any behavioral issues or developmental delays, Dr. Sabey says. “Early intervention ensures your child receives optimal resources to improve their prognosis for things like autism, ADHD, and learning differences.”

Age-By-Age Guide to the Well Visit

One of the great things about annual wellness visits is that they address gaps in care that can negatively impact your child’s health, such as inadequate dental or sleep hygiene, excessive screen time, and inadequate dietary habits, Dr. Sabey explains.

These visits also are based on your child’s age and what milestones they should be achieving as well as what type of preventative care they might need. Here is your age-by-age guide of what to expect at a wellness visit based on your child’s age.

Pre-Kindergarten

This visit is focused primarily on your child’s growth and development, Dr. Snyder says. “We want to assess if a child is on track to be ready for kindergarten through their speech, toilet training, and writing skills, along with other developmental milestones. We also focus a lot on reading as well as a proper sleep schedule, along with healthy eating and activity habits.”

A child should also have some basic safety knowledge, such as knowing a caregiver’s phone number, how to dial 911, and some guidelines on safety around others, Dr. Sabey adds. By this age, your child should be able to identify colors and opposites, carry out a simple conversation, tell what’s next in a familiar story or event, and interact well with others. They can even help with simple household chores at this age.

Also around pre-K, your child should receive the MMR (measles, mumps and rubella), varicella (chicken pox), DTaP (diphtheria, tetanus and whooping cough), and Polio vaccinations, Dr. Snyder says. You also may be asked if you would like for your child to get the influenza vaccine.

Kindergarten

While this visit focuses on many of the same things as a pre-K visit, pediatricians are more concerned about your being ready for kindergarten at that time, Dr. Snyder says. They will also make sure your child is reaching the appropriate milestones for this age like counting to 10, writing some letters in their name, and naming some letters; and make sure they are caught up on their vaccinations.

“At this age, your child can participate in simple household chores, such as cleaning up books and toys, helping with food preparation. They can get along with other children, can follow rules, and can be interested in reading for pleasure,” Dr. Sabey says.

First and Second Grade

Once a child starts first grade, much of the focus of the well-child visit turns toward school performance, both academically and socially, Dr. Snyder says. “We continue to discuss healthy lifestyle habits such as proper sleep, diet, and exercise—and continue this through early school years.”

Unless your child has missed a dose of a previous vaccine, they likely will not be due for any immunizations. That said, you will likely be offered the influenza vaccine.

Third and Fourth Grade

Once your child enters third grade, they will begin being introduced to the concept of puberty, both in school and at their pediatrician’s office. Pediatricians also will touch base with you and your child about school performance, any behavior concerns, and will find out if there are any areas where your child might need additional support, Dr. Sabey says.

“At age 9, we recommend the first HPV vaccination, which protects against a virus that causes some types of cancer and genital warts,” Dr. Snyder says. “The second (and last) of these vaccinations is recommended at least six months later. We often give this second dose at the following year’s well visit.”

Middle School (Fifth Through Eighth Grade)

During these annual well exams for your middle schooler, your pediatrician will likely continue to monitor and discuss puberty. They also will discuss school performance, behavior concerns, and ask about any need for additional support. Social dynamics with peers and extracurricular activities also become a more important topic at this age.

“As children get older, we continue to focus on everything that we did at earlier visits, but add evaluations around the patient’s mental health and sports participation, if applicable,” Dr. Snyder says.

Kids 10 years of age and older who are at increased risk for meningococcal B disease are recommended to routinely receive a MenB series. And before your child can start seventh grade, both the Tdap (diphtheria, tetanus and whooping cough) booster and meningitis vaccines are typically required for school, Dr. Snyder says. “We are able to offer this vaccination once a child turns 11 years old.” Individuals 10 years of age and older who are at increased risk for meningococcal B disease are recommended to routinely receive a MenB series (ACIP Category A recommendation).

If your child plans to participate in a sport, they also may need a physical and a form filled out by a healthcare provider in order to play. They also may receive a confidential interview with the pediatrician to assess their mental health and counsel them on high-risk behavior prevention, Dr. Sabey says.

Related: Sex Education 101: The Conversations You Should Be Having With Your Kids

High School

Like in middle school, your high school-bound child will need a physical and a form filled out by a healthcare provider if they plan to participate in a sport. If they are older than 16, a second meningitis vaccination is recommended, Dr. Snyder says. You also may be asked about the influenza vaccine.

“At these visits, in addition to everything we complete at visits for younger children, we also will ask to spend some time speaking with the adolescent alone, to ensure there are no questions they feel more comfortable asking confidentially,” Dr. Snyder says. “We also will screen for sexual activity and alcohol, tobacco and other drug use.”

Other things that may be discussed include puberty, driver safety, and plans for next steps. Your pediatrician may also talk to your teen about transitioning to adulthood and offer tips on self care.

Related: The Most Important Vaccines for Children: An A-Z List for Parents

What About a Mental Health Check?

A mental health screening can be a great addition to the back to school check up, especially if you have any particular concerns, says Stacy Doumas, MD, a child psychiatrist at Jersey Shore Medical Center (part of the Hackensack Meridian Health System) in New Jersey.

"Routine behavioral heath screenings may be done by their pediatrician or their school, and can also be scheduled with a therapist or psychiatrist," Dr. Doumas says. "Such providers can explore symptoms of ADHD, depression, anxiety, substance abuse, and trauma to identify areas that may need treatment. Routine screening reduces stigma and enhances early diagnosis and intervention for mental health conditions."

Pediatricians are often the first line for mental health screenings and a great place for parents and caregivers to start, especially if they are not sure what they are seeing or there are only mild symptoms of concern, Dr. Doumas adds. "But it's never too early to start behavioral health screening. Early identification of developmental, behavioral, or mental health concerns can lead to early intervention and improved diagnosis."

How to Prepare

You can prepare for your child’s annual wellness exam by being ready to discuss your child’s development, nutrition, sleep, travel history, and social changes. You also should share any changes in your family medical history because these could be a factor in their health risks, Dr. Sabey says.

“It also helps to discuss the visit ahead of time with your child and let them know that they are going to get a complete examination, including likely having their genitals checked,” says Shipra Sharma, DO, a pediatrician at Cook County Health’s Sengstacke Health Center. “It helps to reassure your child that this is a normal and expected part of the checkup.”

Note any changes in health or behavior and bring along any medications your child takes, adds Freda Singletary, MD, a pediatrician with Rainbow Pediatrics of Fayetteville, North Carolina. If there are school-related issues, bring those up too and provide input you have received from teachers, coaches, and tutors.

“These check-ups are a way for us pediatricians to ensure your child's overall health and growth is on track, they're up-to-date with vaccinations, and to catch any health concerns early when they're easier to manage,” Dr. Singletary says. “Identifying these things early helps with providing appropriate support and accommodations to provide students with all they need to learn effectively.”

For more Parents news, make sure to sign up for our newsletter!

Read the original article on Parents.