Back to School Physicals

By Tanya Remer Altmann, MD, FAAP

Back to school checklist: books, paper, pencils, clothes, sneakers….physical! September means back to school, and just as important as new school supplies, a back-to-school physical will help prepare your child or teen for the year ahead.

Athletes are often required to have a sports physical every year. Children entering kindergarten, middle school or high school may need a health form filled out. But even if not required, all children and adolescents should have annual check-ups.

School requirements have changed over the last few years, now recommending or requiring 29 immunizations prior to entering kindergarten and another 5 before entering middle school. Don’t worry, some are combined to make less pokes for your little one. But each vaccination is necessary to protect your child and teen from harmful and potentially deadly disease. In addition, the flu vaccine is recommended yearly–either as a shot or nasal spray.

As well as catching up on missed immunizations, a yearly physical exam may detect something as serious as a heart murmur or as simple as acne. While clearing up teen acne may seem insignificant to you, it can improve your 15 year-olds life and she’ll forever thank you for it!

At every complete check up your physician should calculate and plot your child’s Body Mass Index (BMI)—a ratio of weight to height. With the dramatic rise in child and adolescent obesity, nutrition and exercise counseling is vital. Overweight children not only suffer from diabetes, high cholesterol and heart disease, but they also have higher rates of depression, school failure and lower self-esteem. And yes, we can approximate how tall she’ll be by looking at her growth curve and physical development.

If your child has asthma or another chronic illness, frequent follow up with review of their medications is crucial. Now that he’s older he may need a higher dose or he may have outgrown his condition. Don’t forget to get a second set of medications for use during school, along with a written plan for your child, teacher or school nurse.

In addition to disease and illness, there are other critical issues such as sleep troubles, behavior problems, school failure and injury prevention that can affect your child’s health and should be discussed with his doctor on a regular basis. We can help or refer you to a specialist if needed.

If your child had difficulty in school last year, don’t wait until he gets behind this year. Plan ahead. Your pediatrician can determine if there is an underlying condition such as ADHD (Attention Deficit Hyperactivity Disorder) that if left untreated can hinder your child’s academic performance. School success might be as simple as a tutor for math or after school time set aside for homework. And don’t forget to limit TV, video game and computer time!

So you’ve made the appointment and taken the morning off work. How do you get your anxious child or unwilling teen to the doctor’s office? Role-play at home with your younger ones. Teach him where his heart, ears and stomach are. Allow your teen to take some responsibility for her own health care and give her the opportunity to talk to her pediatrician alone. Children learn from example, so make doctor’s visits a positive experience. If they hear you complain every time you see your physician, they will too.

Although we can squeeze your child or teen in that day for an ear infection or cold, a complete physical exam takes much longer and needs to be booked in advance. Get the school year off to a good start and schedule a back-to-school check up as soon as possible.