Kindergarten is the first big step along the educational path for many children, and it’s important that your child be prepared physically and emotionally before she enters school. Although well-child visits usually begin within a few weeks after birth and continue throughout childhood, the kindergarten physical is an opportunity for your doctor to evaluate your child’s physical, social and emotional development as well as her immunization status. In addition, your doctor may want to perform screening tests to rule out potential health issues.
The Physical Exam
The physical examination serves to identify potential problems, many of which can be resolved with early intervention. The nurse will weigh and measure your child, check his blood pressure, pulse and other vital signs. In addition, your child will be asked to demonstrate his visual ability by identifying letters or shapes from a specified distance. A hearing test is another common part of the physical examination. Your doctor will perform a physical exam that may include testing reflexes, listening to your child’s lungs or palpating various places on his body. He may ask him to walk on tiptoes and balance on one foot.
In addition to the physical exam, the doctor will engage the child in conversation to determine how well she can express herself. She may be asked to identify colors or count on her fingers, or talk about her friends or daily experiences. Your doctor will also ask questions about your child’s interactions with other children and siblings as well as adults. Some of the developmental milestones that are common for this age include developing independence, showing guilt when she misbehaves and beginning to express her feelings in words.
Preventive health screening is another important part of the kindergarten physical. Your child may need to have a blood sample drawn to test for anemia or lead exposure. Other screening tests that may be performed include a urinalysis to check for diabetes, a blood test for hyperlipidemia, or elevated blood fats, and a tuberculosis skin test. Hyperlipidemia and tuberculosis testing are usually performed only in children who are likely to be at risk. If blood testing is necessary, a single blood sample is usually sufficient.
The pre-kindergarten visit is also the time to confirm that your child is up to date on his immunizations; be sure to bring his immunization record to the appointment. Communicable diseases are more likely to be spread in large groups, so updating immunizations is important. If your child is not already up to date, he may need DTaP – diphtheria, tetanus and whooping cough – polio, hepatitis, measles, mumps, rubella and chickenpox vaccines. Unfortunately, these cannot be combined, so several injections may be necessary.