Pre-School Checkup: 4 Year Check Up

When your little one was a baby your pediatrician checked for different things as they reached certain developmental milestones and typically had a checkup every other month. After the first year, however regular check ups become less frequent and aside from scheduled immunizations, your child will typically only see the doctor for wellness checks at every year. At age 2 and 3 your pediatrician will go over some basic routine checks such as growth measurements, vitals, and address any health concerns. I decided to skip ahead to the 4 year check up because there will be a few new things your doctor will test your child on.

The Pre-school Checkup

By now your child should be up to date on their immunizations according to your child’s school requirements. At this stage, your child will undergo required screenings they will need to have prior to starting school. The purpose of this is to check for any concerns or problem areas that may need to be treated before they start school if they haven’t been already. The doctor or nurse check upwill recheck all or some of the following:

  • Growth measurements: weight and height
  • Vitals
  • Check eyes, ears, mouth and nose
  • Ask questions regarding child’s development
  • Skills assessment: give child instructions to perform simple age-appropriate activities

Screening Tests

Your doctor will perform the following screening tests on your child to check for any areas of concern:

  • Eye exam
  • Hearing test

eye examYour child’s doctor will check the eyes and ears at each check-up visit for any common concerns such as infections. If your child has had any previous conditions or there is a family history of eye problems (i.e., mom and dad both need glasses) they may have already had their eyes checked by an optometrist. It is recommended that your child receive their initial eye exam sometime between 3-5 years when they’re capable of recognizing common shapes or letters to perform the test. At the 4 year check up, your pediatrician will check your child’s vision using an eye chart which may consist of different characters such as letters, shapes, or animals while checking their eye movement and alignment.

Your doctor will also check your child’s ears at each routine visit to check for any signs of infections. Your baby will have their initial hearing test in the hospital at birth; at this check-up they will also screen for hearing. The doctor or nurse will place headphones on your child’s head and have them listen as they play sounds at various frequencies. They will instruct them to indicate when they hear the sound typically by raising their hand.

Your doctor will advise if a referral is needed to an optometrist or ophthalmologist to further address hearing and vision problems.

In addition to these tests, your doctor will also assess development and language skills by asking them to do some or all of the following:

  • drawingHop: with both feet, with one foot
  • Identify shapes
  • Draw a face
  • Understands instructions on prepositions: over, under, on, in, in front, behind, etc.

Your doctor may advise on activities for your child to help them achieve necessary skills needed before starting school. If you have any concerns regarding your child’s health or development be sure to address them with your doctor. Children develop at their own rate and while some may do all of the these things, others may need a little more time to master (such as hopping on one foot). A delay may be normal, but it could also indicate a problem which your doctor can diagnose and treat.

4 Year Shots

If you chose to have your child vaccinated or delayed vaccinations your doctor will administer any missed shots as well as the following as recommended by the CDC:

  • DTaP – 5th and final dose
  • IPV – fourth and final dose
  • MMR – 2nd dose
  • Varicella– 2nd and last dose

Your doctor or the nurse should go over the vaccines with you and provide papers on potential side effects, what to look for, and when you should call the doctor. If you have any questions or concerns regarding your child’s immunizations or other health questions don’t hesitate to discuss them with your doctor.

*This article serves to provide a guide on what you can expect at your child’s 4 year check up. We are not medical professionals and are no substitute for seeking the advise of a trained physician. The information provided in this article was brought to you by:
Centers for Disease Control and Prevention

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