Well Child Exams: Not Just For "Shots" Anymore!

It’s time to address a common misconception: that children don’t need to go to the doctor unless they are sick or need immunizations. That’s an attitude that was commonly held by parents (and pediatricians) at one time, but approaches to preventive care during childhood and adolescence have changed greatly in recent years.

Today’s children and teens face a variety of challenges: media/technology bombardment, obesity risks, bullying at school, mental health problems, overwork/exhaustion. These are all issues that we, as pediatricians, want to help you identify in order to help your children. We also know now that many children deal with subtle developmental issues that can be better helped if detected earlier. And with budget cuts to schools, a visit to the doctor’s office is often your child’s only opportunity to have their vision and hearing screened.

The American Academy of Pediatrics recommends frequent well child exams in the first two years of life and yearly thereafter. If you have an infant or toddler, we should be seeing that little one at two weeks of age, two months, four months, six months, nine months, twelve months, eighteen months, and two years of age. Some higher-risk toddlers will need a visit at 15 months and/or 30 months. Then we should see your preschooler at age three years, four years, and five years.

We perform formal developmental screening with the Ages and Stages tool at nine months and three years, and any other time it seems warranted. We also use the M-CHAT tool to screen for autism at 18 months and at two years.  Your four- and five-year-olds can expect us to test their hearing and vision, and we start monitoring BMI (body mass index) at age two.

After age five, we should see your child every one to two years for preventive care. Some insurances still only pay for checkups every two years in that age group, but we encourage you to get feisty with your insurance over this and ask to have it changed! The AAP recommends that children over the age of five continue to be seen yearly, and we would like to see them. In the elementary-school-aged child, we perform vision screening (and hearing if needed or not done previously) as well as any catch-up immunizations.

In middle school, we also begin to screen for problems such as mood disorders, substance use, and school issues. High school youth can expect a detailed questionnaire covering issues such as safety, substance use, risky sexual behaviors, and mental health issues… in addition to some immunizations that come due in the teenage years! Of course, if your youth is participating in a school sport, he or she will be required by the school to have a physical every two years anyway.

To provide the best care for your child or adolescent, it’s important that we have these opportunities for preventive care. We can’t in good conscience just serve as an urgent care or shot clinic for your child. We’ll take every opportunity to remind you of this need when you call or come in for other reasons. So study the schedule above, and if you’ve got a little one (or a not-so-little one) who is in need of a checkup, give us a call! Or better yet, use your Secure Patient Portal Account and request an appointment online, without even having to pick up the phone.