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What is a Well-Child Exam?

Tricia Christensen
Tricia Christensen
Tricia Christensen
Tricia Christensen

A well-child exam is a physical and medical assessment of a child that is usually performed by pediatricians, general practitioners, doctors of osteopathy, or nurse practitioners. These exams are scheduled frequently during the first year of life, and then generally after a child turns two, he or she has one once a year. Many things occur during a well-child exam, and here is a brief list of some things parents can expect at one:

  • Assessment of vision via vision screenings
  • Examination of the child’s body
  • Height/Weight Measurements
  • Routine Vaccinations
  • Assessment of developmental milestones
  • Questions about diet
  • Age specific education regarding a child
A well-child exam is commonly an annual checkup for children 2 and over.
A well-child exam is commonly an annual checkup for children 2 and over.

Essentially, the well-child exam is a form of preventative medicine, meant to catch any potential problems in a child’s physical or developmental health. It also gives parents an opportunity to ask any questions regarding any physical or developmental changes they have noted in their child. Each exam is usually tailored to the individual child and to the child’s age. For instance, doctors might make sure that parents are safety-proofing homes for active toddlers, and warn them about the dangers of accidental ingestion of dangerous substances.

Doctors often assess a child's growth at a well-child exam.
Doctors often assess a child's growth at a well-child exam.

Another important aspect of these examinations is making sure that children stay current on vaccinations. Though there are some parents who refuse these vaccinations, most physicians feel that these are important in order to prevent contraction of very dangerous and life-threatening diseases like polio. Vaccinations are usually given at specific ages when they are thought most efficacious, and children might also have preventative tests to rule out things like exposure to tuberculosis. Some schools, especially at kindergarten admission, require proof of these vaccinations or ask parents to sign waivers if they choose not to vaccinate their kids.

Vision screenings are part of a well-child exam.
Vision screenings are part of a well-child exam.

Equally valuable is determining if children are growing appropriately and reaching certain developmental milestones. While each child is different, children who are not progressing in a number of areas may require special support or help in order to catch up with peers, or failure to meet milestones could suggest serious illness. Usually lack of one or two developmental milestones is not of great concern, but if at a certain point, a child is not reaching most of them, this can suggest significant needs.

During well-child exams, physicians often test the child's vision to diagnose any problems.
During well-child exams, physicians often test the child's vision to diagnose any problems.

Doctors also act in a supervisory role during a well-child exam to make certain that children are having basic needs met. Physicians usually ask questions about behavior, diet, home safety, and they may comment on any examination results that might suggest potential problems for the child. For instance, with great concern about childhood obesity, a child with a high weight and low height might be scrutinized more carefully, and a physician could give advice on modifying diet, or order additional tests to rule out things like childhood diabetes.

A well-child exam is a physical and medical assessment of a child performed by a pediatrician.
A well-child exam is a physical and medical assessment of a child performed by a pediatrician.

As a child grows, the well-child exam can begin to include education for the child. Some doctors even ask parents to step out of the room when they’re examining teens to question them regarding potential drug use and any sexual behavior, though this isn’t true of every exam. However, for each age, doctors attempt to cover the major pitfalls and health issues, so that a child (or parent) gets the best preventative advice and medical care until the next exam.

Some schools, particularly at kindergarten admission, require proof of a child’s vaccinations.
Some schools, particularly at kindergarten admission, require proof of a child’s vaccinations.

Especially in early years, parents may spend a lot more time at the doctor than just during well-child exam visits. Kids gets colds, flus, bronchitis and infections, which may necessitate many visits. One question parents may ask is whether a sick child should attend a well-child exam. This may be up to the discretion of the treating physician.

A child with a high weight and a low height may be scrutinized more carefully than kids of average weight and height during a well-child exam.
A child with a high weight and a low height may be scrutinized more carefully than kids of average weight and height during a well-child exam.

Some doctors may still want to see the child for the exam but might delay things like giving routine vaccinations until a child is feeling better. A child that is really feeling unwell may not be able to fully participate in an exam, and might skew results, especially of things like vision tests or developmental tests. Many parents find it works better to reschedule these exams for when a child is fully healthy.

Tricia Christensen
Tricia Christensen

Tricia has a Literature degree from Sonoma State University and has been a frequent WiseGEEK contributor for many years. She is especially passionate about reading and writing, although her other interests include medicine, art, film, history, politics, ethics, and religion. Tricia lives in Northern California and is currently working on her first novel.

Learn more...
Tricia Christensen
Tricia Christensen

Tricia has a Literature degree from Sonoma State University and has been a frequent WiseGEEK contributor for many years. She is especially passionate about reading and writing, although her other interests include medicine, art, film, history, politics, ethics, and religion. Tricia lives in Northern California and is currently working on her first novel.

Learn more...

Discussion Comments

christensen

In most states a child can seek birth control and sexual advice well before he or she is 18, without parental permission. A pediatrician unaware of the whole health of the child is not doing that kid or her parents any favors.

As uncomfortable as it is, it is legal for children to obtain all kinds of health advice, including prescriptions for things like the pill, from early ages on.

I would rather step out and make sure my kids get the most comprehensive treatment they can, than make an issue of it and have the doctor miss something really important.

SauteePan

@Suntan12: I know I used to hate the shots too. I have to say that my daughter loves seeing her doctor.

I think that she has a crush on him because she melts every time he talks to her. He really has such a nice bedside manner and is friendly. The only thing that I hate is the wait. It is a very busy practice and I normally have to spend an hour and a half every time I take my kids to the doctor.

suntan12

@Sunshine31: You could do that if you feel comfortable or discuss it with the doctor before the checkup.

I wanted to say that I remember when my kids were babies and I had to take them in for their well baby exam. I remember how I would dread when they had to have any immunizations because my daughter would scream and cry so much that it broke my heart.

I really like that the doctor gives me the growth and development percentiles so that I could see how they are growing with respect to other children. This always made me feel good because they were always on track.

sunshine31

@Moldova: I understand how you feel but I also thought that maybe the child would be more candid without the parent present. This would help the doctor get more information. Although a drug test could be ordered to determine if the teen were using drugs and with an exam the doctor could be able to tell if the teen engaged in sexual intercourse, I do think that it is better to try to get the information from the teen directly because a doctor has a certain level of trust with a patient and this relationship should continue.

It is a really difficult area to discuss because parents have certain beliefs and this may go against what a doctor has to do to do his or her job. I think that if your child has had the same doctor all their life you should have a certain comfort level with the doctor and trust that he will gain the information necessary in order to help your teen.

If you have any objections or questions then you could ask the doctor privately.

Moldova

I just wanted to say that as a parent I would be a little uncomfortable if my children’s doctor told me to step out of the room so that they could talk to them about any sexual behavior. While I understand that if the teenager were an adult that would be standard protocol but with a younger teen I would be upset about this because I think that the parents should be involved.

At least the parent should be asked if this is okay with them before a doctor asks if they could speak to their minor child alone. That is just my opinion.

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    • A well-child exam is commonly an annual checkup for children 2 and over.
      By: Thomas Perkins
      A well-child exam is commonly an annual checkup for children 2 and over.
    • Doctors often assess a child's growth at a well-child exam.
      By: WavebreakmediaMicro
      Doctors often assess a child's growth at a well-child exam.
    • Vision screenings are part of a well-child exam.
      By: Kelpfish
      Vision screenings are part of a well-child exam.
    • During well-child exams, physicians often test the child's vision to diagnose any problems.
      By: imagedb.com
      During well-child exams, physicians often test the child's vision to diagnose any problems.
    • A well-child exam is a physical and medical assessment of a child performed by a pediatrician.
      By: WavebreakMediaMicro
      A well-child exam is a physical and medical assessment of a child performed by a pediatrician.
    • Some schools, particularly at kindergarten admission, require proof of a child’s vaccinations.
      By: Petro Feketa
      Some schools, particularly at kindergarten admission, require proof of a child’s vaccinations.
    • A child with a high weight and a low height may be scrutinized more carefully than kids of average weight and height during a well-child exam.
      By: olegmalyshev
      A child with a high weight and a low height may be scrutinized more carefully than kids of average weight and height during a well-child exam.