Back-to-school time is a reminder for parents to check the annual physical off the list if you haven't already.
Your district will have specific guidelines as to when this is mandatory. It will also need proof of up-to-date immunizations before your child can enter certain grades.
Schedule a "well visit" rather than hoping for a full evaluation when your child is in for a sick call. Setting aside time for a general health assessment will allow the doctor to thoroughly assess both physical and psycho-social development and answer questions you or your child might have. Check your health insurance coverage for well visits.
The American Academy of Pediatrics emphasizes "the great importance of continuity of care in comprehensive health supervision and the need to avoid fragmentation of care." It recommends a physical at 5, 6, 8, 10 and then yearly through 21. The physical aspect of the exam should include assessment of spinal alignment to rule out scoliosis, a check of eyes, ears, nose, skin, mouth, fine and gross motor development, height, weight, blood pressure, heart rate and reflexes.
Children deemed at risk for lead poisoning or tuberculosis may be screened. Ensure that immunizations are up to date (tetanus boosters at 11 or 12, Hepatitis B series) and ask for a copy of the record so that you will have it when your school requests it. Sexually active teenagers should have checks for sexually transmitted diseases and females should have a pelvic exam.
Kids who are overweight or have a family history of obesity may have their cholesterol checked. The childhood obesity issue has become such an epidemic that most pediatricians will discuss diet and healthy exercise options. Besides having heart and blood pressure checks, your child may be tested for diabetes.
The psychological/behavioral aspect of the exam will be based on age. The doctor should review school performance, including achievements or difficulties and explore friendships and socialization. Injury prevention, such as wearing helmets or not touching firearms stored in the home, and making wise health decisions regarding drugs, alcohol and tobacco will be broached as each year goes on. Older children should be prepared for changes that begin at puberty.
As the summer begins to wind down, add "schedule checkups" to your to-do list for back to school:
• Prepare a list of questions or concerns to discuss with the pediatrician.
• Remind your doctor if your child is home-schooled so that screenings for vision or hearing problems will be included in the visit.
• Request age-appropriate nutrition counseling if there is a family history of heart disease, diabetes or obesity issues.
• Don't forget to bring your school's required physical forms as you will probably have to leave them to be filled out.
By maintaining a regular schedule of well visits, your child can develop a trusting relationship with the pediatrician. This will enhance continuity of care and the doctor will be able to assess conditions more readily since they will have a well-established baseline.