With the busiest time of year upon us, do you really have to find time to fit in an annual physical for your child? The answer is yes!

Summit Health Pediatrician and Adolescent Medicine specialist Dr. Daniel Hermann is here with a reminder that if  you didn’t get around to scheduling your child’s annual well visit before the school year started, it’s not too late. “Even if your child seems healthy now,” says Dr. Hermann, “it’s still important to schedule them for an annual physical not only to stay on top of their health and development, but also their social milestones or any unexplained issues. And this is more important than ever given the ongoing COVID-19 pandemic. Plus, the better the doctor knows your child, the quicker they can determine when something is wrong.”

In the below Q&A, Dr. Hermann touches on the wide range of benefits annual check-ups offer, what a typical check-up visit is like, and what parents should pay close attention to.

Why are physicals important for everyone, especially children?

Physicals are important for everyone, especially children, as they give both parents and children an opportunity to assess growth and development. Physicals give the pediatrician insight into family dynamics and the environment in which the child is growing and learning. They also allow parents to ask questions about raising their children in a safe and healthy way.

Does my child need a physical every year, even if they seem healthy?
Yes, because children change so much over a year, both physically and psychologically. We have seen that the pandemic has affected children (and adults) in different ways, and it is important to discuss how the child is being affected at each visit.

Children grow and develop very rapidly over short periods of time. Thus, we see infants shortly after birth, then at two weeks and again at one month of age. Once a child is 2months, we see them every two months until they reach six months of age. After that, we see them every three months until they reach 18 months. Then, every six months until the child is three years old and annually thereafter. What parents do, with guidance from their pediatrician, helps mold the children into strong, healthy, young adults.  

How can I prepare my child for a physical?

Talk to your child about what to expect at the physical. They will be weighed, and their height will be measured. Their vision and hearing will be checked as well. Let them know, you, the parent will be right there with them for the exam. Address any concerns the child may have about the physical. For instance, they may be scared about getting vaccines.

You can contact your pediatrician before the visit to review what the visit entails. This way you will be fully informed and can pass that information along, as you see fit, to your child.

What does a typical child physical consist of?

For infants and toddlers up to 2 1/2 years of age, their length/height, weight, and head circumference will be checked and documented in the electronic health record (EHR).  Starting at 3 years old, their height, weight, and blood pressure will be documented. The pediatrician will check vision and hearing starting at 4 years of age and do a thorough head-to-toe physical exam. They will show the parents and child patients their growth trend and discuss proper growth and point out everything found during the exam, normal or not. They will also inquire about all types of development (social, gross, and fine motor skills, speech, etc.), nutrition, and sleep habits. “For school-aged children, I find it helpful to know about any academic achievements, and if the child is having difficulties. I ask about what is going on socially with their relationships, both within the family (i.e., moving, a new sibling, etc.) and outside of it with friends, especially any instances of bullying,” says Dr. Hermann. “I ask about sleep, hygiene, and nutrition as well since those are key factors in a child's growth and development. And I always review expected developmental milestones at the visit and advise what I expect at the next physical exam visit.”

The next step is to review vaccination status. The pediatrician will review vaccination status in order to make sure their child is fully protected against many serious bacterial and viral infections. They follow the standards set forth by the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC).

Should I expect any differences at a physical during the COVID-19 pandemic?

Routine physicals and sick visits have been conducted throughout the pandemic; however, parents and children may notice additional safety precautions, such as all staff wearing face masks and all clinical staff wearing face masks and gloves. Additionally, all rooms are thoroughly cleaned before, between, and after each visit. 

What numbers are particularly important to pay attention to?

For infants, length, weight, and head circumference are important in giving clues as to how a baby is growing and developing. For children, height, weight, blood pressure, vision, and hearing are checked.

Is there a difference between a regular physical exam and a sports physical?

The American Academy of Pediatrics (AAP) recommends both an annual physical exam (PE) and a sports physical, or Pre-Participation Exam (PPE). The sports physical, or PPE, concentrates on things that can impact participation in sports. Due to insurance restrictions, this is usually addressed at the annual PE. For health care continuity purposes, the AAP recommends that the sports PEs be done at your pediatrician's office rather than at a clinic or school.