Well-Child Visit: 8 Years

What to Expect During This Visit

Your doctor and/or nurse will probably:

1. Check your child's weight and height, calculate body mass index (BMI), and plot the measurements on a growth chart.

2. Check your child's blood pressure, vision, and hearing using standard testing equipment.

3. Ask questions, address concerns, and offer advice about your child's:

Eating. Schedule 3 meals and 1–2 healthy snacks a day. Serve your child a balanced diet that includes lean protein, whole grains, fruits and vegetables, and low-fat dairy. Kids this age should get 2½ cups (600 ml) of low-fat milk daily (or other low-fat dairy products or fortified soy milk). Limit foods and drinks that are high in sugar, salt, and fat. Don't give more than 4–6 ounces (120–180 ml) of 100% juice per day.

Bathroom habits.Bedwetting is more common in boys and deep sleepers, and in most cases it ends on its own. But talk to your doctor if it continues to be a problem.

Sleeping. Kids this age need about 9-12 hours of sleep per night. Lack of sleep can make it hard to pay attention at school. Set a regular bedtime that allows for enough sleep and encourage your child to follow a relaxing bedtime routine. Keep TVs and digital devices, like smartphones and tablets, out of your child's bedroom.

Physical activity. Kids this age should get at least 60 minutes of physical activity per day. Set limits on screen time, including TV, video games, smartphones, tablets, and computers.

Growth and development. By 8 years, it's common for many kids to:

• show more independence from parents and family members
• have a group of friends, usually of the same gender
• look up to role models, such as professional athletes, actors, or superheroes
• know the difference between right and wrong
• enjoy reading
• solve simple math problems
• have longer attention spans and cooperate more
• problem solve in a more organized and logical way
• do more coordinated tasks, like shoot a basketball

4. Do anexam. This will include listening to the heart and lungs, checking teeth for cavities, and watching your child walk. Because some children start to show signs of puberty as early as age 7, your pediatrician will check pubertal development. A parent or caregiver should be present during this exam.

5. Update immunizations.Immunizations can protect kids from serious childhood illnesses, so it's important that your child get them on time. Immunization schedules can vary from office to office, so talk to your doctor about what to expect.

6. Order tests. Your doctor may check for anemia, high cholesterol, and tuberculosis and order tests, if needed.

Looking Ahead

Here are some things to keep in mind until your child's next checkup at 9 years:

School

1. Encourage your child to participate in a variety of activities, including music, arts and crafts, sports, after-school clubs, and other activities of interest.
2. Praise accomplishments and provide support in areas where your child struggles.
3. Struggling in school could be a sign of a learning disability, attention problems, or of being bullied. Talk to the teacher about your concerns so that your child can get the help needed to succeed.

Self

1. Explain to your child that their body will change and that this is normal. Teach the proper names for body parts and explain what they do. Let your child know that it's never OK for an adult to ask them to keep a secret from you. No one should look at or touch your child's private parts, or ask them to look at or touch theirs.
2. Make sure your child brushes their teeth twice daily, flosses once a day, and sees a dentist once every 6 months.
3. Set fair and consistent consequences for breaking the rules. Do not spank or hit your child.
4. Give your child a sense of responsibility by letting them do simple chores, like making their bed and setting the table.

Safety

1. Your child should continue to ride in the back seat of the car and use a belt-positioning booster seat until they're 4 feet 9 inches (150 cm) tall. Kids usually reach this height when they're 8–12 years old.
2. Make sure your child wears a helmet while riding a bike, skateboard, or scooter, and the right safety equipment, like mouth guards and pads, when playing sports.
3. Teach your child how to cross the street independently (looking both ways, listening for cars), but continue to help your child cross the street until age 10.
4. Teach your child what to do in case of an emergency, including how and when to call 911.
5. Teach your child to swim, but do not allow swimming unless an adult is watching.
6. Apply sunscreen of SPF 30 or higher at least 15 minutes before your child goes outside to play and reapply about every 2 hours.
7. Protect your child from secondhand smoke.
8. Explain to your child why they should never try cigarettes or othertobacco products, e-cigarettes, drugs, oralcohol.
9. Monitor your child's Internet use. Keep the family computer in a place where you can watch what your child is doing. Install safety filters and check the browser history to see which websites your child visits. Teach your child not to share personal information.
10. Protect your child from gun injuries by not keeping a gun in the home. If you do have a gun, keep it unloaded and locked away. Ammunition should be locked up separately. Make sure kids can't get to the keys.
11. Talk to your doctor if you're concerned about your living situation. Do you have the things that you need to take care of your child? Do you have enough food, a safe place to live, and health insurance? Your doctor can tell you about community resources or refer you to a social worker.

These checkup sheets are consistent with the American Academy of Pediatrics (AAP)/Bright Futures guidelines.