Articles and Topics
Pre-K Medical Check-Up (Part 1)
There are many things parents do to help our children get ready for kindergarten: we teach them to get along with others; we encourage their interest in books and learning their letters and numbers; we take them to the school to become familiar with how to get there, the facility, teachers, and other students; we buy them a backpack, lunchbox or new outfit; and we talk with them about how this is a big, exciting step in their life. Remember, we must also prepare our children for school health-wise.

School Health Forms
When you register your child for school, the school will give you important health forms. The health forms include a record of your child's pre-kindergarten medical check-up, immunizations, and explanation of any special needs your child may have. The forms also include information about your health insurance, doctor and dentist, and emergency contact information. You and your child's doctor will need to complete these forms.

Remember that the pre-kindergarten medical check-up and immunizations are required for admission to kindergarten. It is also advisable to have a check-up with the dentist.

The Medical Visit
Just as the beginning of kindergarten is a big step for your child, the pre-kindergarten medical check-up is also a big one. Plan to spend at least an hour at the medical office. During this medical visit, the doctor and/or nurse will do the following:

1. Ask you questions.
They will ask about your child's development, behavior, nutrition, and health. They will also ask if you have any questions or concerns. You should feel open to discuss your child's development, behavior, nutrition, health, and safety, as well as any family problems that may affect your child. Encourage your child to ask any questions he may have.

2. Do a complete physical examination of your child.
Your child should be undressed down to her underwear to ensure a thorough exam:
  • Height and weight
  • Blood pressure
  • Examination of your child's eyes, ears, nose, throat, neck, chest, abdomen, genitals, and limbs. The doctor will use a variety of medical equipment: a sphygmomanometer to measure your child's blood pressure; an oto-ophthalmoscope to look in your child's eyes, ears, nose, and throat; a stethoscope to listen to her breathing, heart and abdomen; and a hammer to check her reflexes.
  • Developmental exam: The doctor might ask your child some questions, have her draw, and check her physical coordination.

3. Do other tests:
  • Vision test: Your child will be asked to stand at a distance from a wall chart and identify letters, numbers or pictures, covering one eye at a time.
  • Hearing test: Your child will wear headphones and be asked to signal when he hears the sounds.
  • Urine test: Your child will be asked to give a sample of urine in a cup.
  • Other possible tests: Tuberculin test, a needle prick on the arm to check for exposure to tuberculosis; and blood tests for anemia, cholesterol or lead.

4. Give your child the necessary immunizations.
Between 4 and 6 years of age, children are typically due for 3 booster shots to protect them against 7 different diseases: DTP (diphtheria, tetanus and pertussis), polio, and MMR (measles, mumps and rubella). These recommendations may change as combination vaccines and new vaccines against different diseases are developed. The doctor may also recommend immunizations against other diseases, depending on your child's needs. Studies have shown that it is safe to get several shots at once.

5. Discuss with you key issues about your child's development and health.
You may also be given written materials or videotapes. Topics may include:
  • Your child's special needs: If your child has been diagnosed with special developmental needs (e.g., developmental delay, speech problem) or health conditions (e.g., allergy, asthma), the doctor will give you referrals for any additional assessment or services that may be necessary. In addition, you need a clear plan for how to meet your child's needs at home and at school. Ask your doctor to complete a written Care Plan that you can give your child's teacher and school nurse—this should address any classroom adaptations and precautions your child may need, her schedule for medications, signs of potential problems to look out for, and emergency instructions. Make sure the doctor prescribes an extra supply of any medications or equipment that the school may need for your child, and be sure to review the plan with the teacher and school nurse.
  • Healthy habits: Key health issues for young children include eating nutritious meals and snacks, following good hygiene and toothbrushing, engaging in regular physical activity, using sunscreen, avoiding tobacco smoke, ensuring adequate sleep, and limiting television.
  • Relationships: You can promote your child's emotional and social development by helping him express his feelings, get along with others, follow rules, and learn self-discipline.
  • Safety: Key safety issues for young children include installing smoke detectors and locking up poisons and guns at home, following traffic safety rules, wearing seat belts and bicycle helmets, following water safety rules, and protecting themselves from strangers.
  • Getting ready for school: Some good ideas for preparing your child for kindergarten include touring the school and meeting the teachers and other children in advance, and getting yourself and your child involved in school activities.

6. The doctor or nurse will complete the school forms.
Karen Sokal-Gutierrez M.D., M.P.H. Pediatrician