Regular well-child examinations by your child's doctor are essential to keep your child healthy and up-to-date on immunizations against many dangerous childhood diseases. A checkup also gives your child's doctor an opportunity to talk to you about developmental and safety issues and gives you an opportunity to ask any questions you might have about your child's overall health.
What Happens at the Doctor's Office?
At a typical yearly examination at this age, your child's doctor will weigh and measure your child to make sure she is progressing along a normal pattern of growth. The doctor will take a medical and family history and perform a complete physical examination. During the visit, your child will be screened for high blood pressure and you'll be asked about your child's history of lead exposure and your family's history of cardiovascular disease and hyperlipidemia (an excess of fat and cholesterol and/or other fats in the blood).
Your child's doctor will check your child's immunization record to see if any vaccinations are needed. Booster doses of DTaP, IPV, and MMR (measles, mumps, and rubella) are usually given between your child's 4th birthday and school entry. A tuberculin skin test (PPD) may be done to check for exposure to tuberculosis.
Your child's doctor will check for crossed eyes and any vision and hearing problems.
Your child's doctor will also check your child's teeth for tooth decay, abnormal tooth development, malocclusion (abnormal bite), dental injuries, and other problems. In addition to the doctor's evaluation of your child's mouth, your child should be making regular visits to the dentist.
During this exam, your child's doctor will also check your child's development in both physical, behavioral, and social areas. Your child's doctor will ask a series of questions to see whether your child's everyday behavior is age appropriate, how well she operates in social situations, and how well she can communicate and understand directions.
Developmental milestones for 4-year-olds include being able to:
- help with household tasks
- play cooperatively with other children
- understand the concept of gender
- identify colors
Developmental milestones for 5-year-olds include being able to:
- dress independently and tie shoes
- recall address and phone number
- draw a body
- print first name
Your child's doctor will also check physical milestones: Can your 4-year-old hop or jump on one foot? Has your 5-year-old mastered skipping?
Child safety is another topic of paramount concern. Your child's doctor will reinforce the importance of using age-appropriate car seats, closely supervising children around swimming pools, using bicycle helmets and other protective gear, not smoking around children, using sunscreen, and protecting children against exposed wires, outlets, and heat sources. In homes with firearms, guns and ammunition should be stored separately and kept locked at all times.
What Should I Do if I Suspect a Medical Problem?
Although parents often can tell by their child's appearance if they are ill, there are certain symptoms that warrant a call to a doctor. Although the symptoms may represent a minor illness such as a cold or ear infection, they can also signal a more serious infection or a chronic condition, such as asthma. These include:
- changes in weight or eating habits
- changes in behavior or sleep patterns
- failure to grow in height as expected
- temperature over 102 degrees Fahrenheit (38.9 degrees Celsius) that persists or recurs
- persistent vomiting or diarrhea
- inability to hold down liquids
- signs of a skin infection or persistent rash
- frequent sore throats
- persistent cough, wheezing, or other breathing difficulties
- localized pain, such as an ear infection
Typical Medical Problems
Problems often found in this age group include enuresis (bedwetting) and sleep disturbances, such as nightmares. Children may also experience growing pains in their calves at night. Your doctor's office is frequently asked questions about these and other common concerns and can be a helpful resource and support.
Reviewed by: Barbara Homeier, MD
Date reviewed: January 2005
Originally reviewed by: Steven Dowshen, MD
