Preventive Health Care Visits
Scheduled visits to the doctor provide parents with information about their child's growth and development. Such visits also give parents an opportunity to ask questions and seek advice. The American Academy of Pediatrics recommends that after the first year of life children see their doctor for preventive health care visits at 12, 15, 18, and 24 months of age and then yearly until age 6. It is then recommended that the child come for a visit at age 8 and again at age 10. Visits can be made more often based on the advice of the doctor or the needs of the family.
A variety of measurements, screening procedures, and vaccinations are performed (see Section 23, Chapter 263) at each visit. Height and weight are checked. Good growth is one indicator that the child is generally healthy. Head circumference is not routinely measured after the age of 18 months. Beginning at age 3, blood pressure is measured at each visit.
Preventive visits may include a check of vision and hearing. Some children may need to have their blood checked for anemia or an increased level of lead (see Section 24, Chapter 297). The age of the child and various other factors determine which tests are performed. Some doctors also recommend that the child's urine be checked, although the value of such testing has not been established.
The doctor also asks questions to see how the child has progressed intellectually since the last visit. For example, the doctor may want to know if an 18-month-old has begun to speak or if a 7-year-old has begun to read. In the same way, doctors often ask age-appropriate questions about the child's behavior. Does the 18-month-old child have tantrums? Does the 2-year-old sleep through the night? Does the 6-year-old wet the bed at night? Parents and doctors can discuss these types of behavioral and developmental issues during the preventive health care visits and together design approaches to any behavioral or developmental problems.
Child safety is discussed during preventive visits. Specific safety concerns are based on the age of the child. For a 6-month-old, the doctor may wish to talk about childproofing the house to prevent unintentional poisonings or injury. For a 5-year-old, the discussion might be focused on the potential hazards of guns in the home and gun safety. Parents should take the opportunity to bring up topics that are most relevant to their unique family situation. As the child gets older, he can be an active participant in these discussions.
Finally, the doctor performs a complete physical examination. In addition to examining the child from head to toe, including the heart, lungs, abdomen, genitals, and head and neck, the doctor may ask the child to perform some age-appropriate tasks. To check gross motor skills (such as walking and running), the doctor may ask a 4-year-old to hop on one foot. To check fine motor skills (manipulating small objects with the hands), the child may be asked to draw a picture or copy some shapes.
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