What to Expect From a Well Exam for Your Preschooler

As an infant, your child's visits to the pediatrician for well checkups may seem commonplace. As they get into the preschool years, these visits will become more infrequent. The American Academy of Pediatrics recommends yearly well checkups by the age of 2. With the longer lapses between well-visits it’s important to know what to relay, ask and expect from your pediatrician, as well as how to prepare your preschooler for these less common, potentially more anxiety-provoking visits. Following are some tips on what to expect and how to prepare for your preschooler’s next pediatrician well visit.

What will the exam entail?

1. Your preschooler’s growth will be assessed. Is your preschooler growing at a normal rate for a 3, 4 or 5 year old?

2. Weight will be assessed similarly to make sure they are not under or overweight.

3. A stethoscope to listen to the heart and lungs will be used to detect heart rhythms and breathing problems.

4. The ears will be evaluated with an otoscope to make sure there is no fluid or infection in the ear canals.

5. The eyes will be evaluated with a bright light using an ophthalmoscope to make sure the optic nerves and surrounding tissues are
healthy. Since your preschooler is more verbal now, a screening vision test with an eye chart will be performed.

6. Blood pressure is taken to make sure there are no abnormalities.

7. The mouth will be evaluated to check for infection or teeth problems.

8. The abdomen will be pressed on to make sure the organs aren't enlarged and no masses are present.

9. By age 4 and 5 immunizations are given (the DTaP for diphtheria/tetanus/pertussis, IPV for polio, MMR boosters for measles/mumps/rubella, and Varicella for chickenpox)

10. Your pediatrician should ask about things you’ve observed in your child developmentally.

11. Advice on diet, oral health, and safety should be discussed for continued healthy development.

What preschooler parents should do at the exam?

 Your pediatrician is a resource. The well checkups are a chance for you to ask questions and have answers met. Asking questions beyond the purely medical is appropriate and should be encouraged. Is your preschooler very clingy? Are you concerned that your child still wets the bed? Are your preschooler’s sleep patterns abnormal to you? Ask your pediatrician about these things. They have expertise on general child care issues, too.

Some Preschool Pre-Well Checkup Tips

Before your preschooler’s next well check up exam make a list of the questions you’d liked answered, as well as a list of behaviors or other things you’ve noticed in your child you think may be important.

With longer stretches between pediatrician visits and increased cognitive awareness of having to see the doctor, prepare your preschooler for the visit. Talking to them about how the otoscope may tickle the ear when it’s inserted and how the stethoscope will feel cold on their skin are little preparations to help your child feel less afraid. Playing with mini toy doctor kits at home may even be a helpful. You can ask your preschooler to identify the medical tools the pediatrician uses when they’re at the visit. When your preschooler is actively involved during a visit, the fear may dissipate as the focus is on something else rather than what the doctor is doing.

For the fear that comes with getting shots, distracting your preschooler may be helpful. Singing a song while the shot is being given or using a distracting toy may work for your child. Additionally, your anxiety about your child's fears should be kept under check. Your preschooler will notice if you are nervous, so modeling confident and courageous behavior will help. Let your child become involved by asking them which arm they want injected and instead of saying it won't hurt, say something about it feeling prickly to the count of 5. Rewards are always good too.

By: Pia Chaparro

References:

1. American Academy of Pediatrics. Retrieved from http://www.aap.org on January 2, 2008.