Well-child checks: What to expect and why they matter

There’s a lot of preparation that comes with back-to-school season, but it’s not just purchasing stationery, uniforms and a stylish backpack. 

It’s also important to make sure your child is prepared from an overall wellness perspective, as physical and mental health are crucial to their success in the classroom and beyond.

Before the start of school or during the first few weeks, an annual well-child check should be made to ensure kids are healthy, happy and fully positioned to thrive this academic year. Jose Alcala Villegas, MD, a family medicine practitioner at Saint Francis Center of Hope, breaks down what families can expect at this visit and why it’s so important.

“Well-child checks are essential because they bundle several proven preventative interventions—immunizations, developmental and health assessments, screening for treatable conditions and anticipatory guidance—into a single visit before they reenter a high-density, disease transmission environment,” says Dr. Alcala Villegas.

Key physical health aspects covered during a routine well-child check include:

• Hearing and vision screening: If a child’s vision isn’t 20/20 (ideal for all individuals) or there are signs of hearing impairment, both of which can drastically impede their ability to learn, they’ll be referred to an ophthalmologist or audiologist for further assessment.
• Growth: Height and weight will be measured to ensure the child is growing properly for their age and rule out obesity. Age-appropriate guidance on nutrition and activity levels, such as avoiding junk foods and soda, will be provided.
• Dental care: A pediatrician will assess for overall dental developmental milestones, check for early signs of tooth decay, and provide guidance on brushing and general dental care.

During well-child checks, providers also assess patients’ mental health in the following ways:

• GAD-7 (Generalized Anxiety Disorder-7): A brief, seven-item questionnaire to screen for generalized anxiety disorder in children starting at 8 years of age
• PHQ-9 (Patient Health Questionnaire-9): A nine-question tool used to screen for anxiety and depression starting at age 12
• Evaluating for attention deficit disorders and implementing early intervention
• Recommending best practices for mental health, including 8 to 10 hours of sleep nightly and limiting screen time to no more than two hours daily
• Monitoring bullying and other potentially stressful situations

“We try to identify these things early so that they can go back to school in the best shape possible,” says Dr. Alcala Villegas.

In addition to physical and mental health checks, young patients also receive mandated vaccinations at their well-child checks to help prevent future illness. These include:

• MMR: Protects against measles, mumps and rubella
• DTaP: Protects those under age 7 from diphtheria, tetanus and pertussis (whooping cough)
• Tdap: A booster shot for older kids and teens against diphtheria, tetanus and pertussis
• HPV: Important in adolescents to prevent oropharyngeal, anal and cervical cancers
• Meningitis: Recommended for teens going to college, especially if they’re living in dorms, with such close quarters significantly increasing risk of infection

“And, of course, the flu shot is also very important. Everyone should get that vaccine annually, as we’re about to enter flu season, which is from September until January,” says Dr. Alcala Villegas. “That’s recommended for everyone, regardless of age.”

For kids and teens involved in athletics, they’ll need to undergo a sports physical, which can either take place during their well-child check or as a separate appointment. This differs from a routine annual visit in that a full cardiac screening is completed.

A provider will check for chest pain or shortness of breath during exercise, heart murmurs and family history of heart conditions, especially unexpected cardiac-related deaths before age 50. They’ll also do a full physical exam to ensure there are no chronic conditions, such as asthma, that could impair their performance on the court/field. During this screening, if an abnormality is found, the patient will be referred to see a cardiologist or get an EKG.

“Sports physicals are meant to clear the patient for a specific sport as opposed to a well-child check, which is a more comprehensive approach,” says Dr. Alcala Villegas.

With the start of school fast approaching, Saint Francis Center of Hope is excited to welcome new patients, answer any questions, and make sure kids and teens throughout the community are at their physical and mental best this school year.

Learn more about family medicine services at Trinity Health Mid-Atlantic or make an appointment.