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Q. Does my child really need a wellness exam before kindergarten?
March, 2006
A: Yes, a wellness exam before kindergarten really is a good idea. Your question also brings up why childhood wellness exams are recommended at all. I will answer both parts as they are so closely related.
The purpose of childhood wellness exams is two fold: to identify and treat health problems before they become serious, and to promote wellness and injury prevention. Equally as important, these visits with your child's health care provider are an opportunity for you as a parent to ask questions about your child, not just around physical concerns, but around issues such as sleep, behavior, or any other worries you might have. With the frequency of visits, a rapport can be developed between your family and your provider, and most importantly, your child will become comfortable in the health care setting and learn to trust his or her health care provider. This is important particularly when your child is ill and as your child grows and becomes more involved in their visits. By bringing your child to your health care provider for wellness visits, you are setting up good habits that your child can continue through their adult life.
At each of the recommended visits your provider will check to see if you have any questions or concerns, or if your child does. Your provider may ask questions about eating, sleeping, temperament, and recent illnesses; ask about vision and hearing and test those as your child is ready; discuss dental care and visits, and do a thorough physical exam. Your child's height and weight will be plotted on a graph, another indicator of health. Immunization recommendations will be made to protect against preventable disease. Sometimes blood needs to be taken to test for anemia. Your provider will talk to you about what you can anticipate in your child before the next visit, for example, your baby will be ready to start solid foods when.... Or he can move to a booster seat in the car when...We refer to that as anticipatory guidance. Even if you have parented before, recommendations change and remember, each child is different!
As a provider I look forward to the pre-kindergarten visit, usually around age 5 or so. Somehow the kids always know that this is a special visit too. In addition to what I already mentioned before, this is the time to review school readiness. We may talk about your child's ability to separate from you and if it is a worry, strategies to help ease the transition for you and your child. Vision and hearing will be tested which is so important for success in school. How independent is your child in dressing, i.e. boots, coats, or, does he need practice? Does your child know his phone number? Sometimes I have kids draw a self portrait. That tells me about their fine motor skills. I may ask about pedaling a bike or physical activities they participate in. I will ask about friends. All of this relates to their school readiness. Of course, if your child has difficulty or concerns in any of these areas, it doesn't mean they can't attend kindergarten. It may mean that we develop a plan together to work on different skills, to ensure their successful transition to kindergarten.
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