Back to School Part I: The School Physical

Every school year parents and kids alike look forward to summer.  However, a few weeks in to summer and it’s time to talk about going back to school.  Besides getting all of the necessary clothing and supplies, one of the first things you need to think about is getting a physical scheduled with your child’s doctor.  Many offices fill up quickly so don’t hesitate to drop everything and call now. (Ok you can read this first)

Why, you may ask, is a physical so important to the back to school process?   As with all physicals, the back to school check will assess your child’s overall health.  As pediatricians, we evaluate growth, development, nutrition and update vaccines.  Furthermore, we will talk with you and your child about ways to stay safe and healthy.  Going back to school is also a good time to talk about any ongoing illnesses and how they will affect school performance.  It is also a good opportunity to discuss behavior or academic concerns so they can be addressed before they become a problem.

What to expect

Before the doctor sees your child, a nurse or assistant will likely measure their height, weight and blood pressure and may even do hearing and vision testing.  Sometimes problems with any of these measurements can go unnoticed.  Having yearly physicals helps us to know that your child is having appropriate height gain, is at a healthy weight and can see/hear.  Elevated blood pressure is not unusual if your child is nervous so you may be asked to bring your child back for further measurements if needed.

Once the doctor comes in, you and your child will be asked lots of questions.  Evaluating your child’s overall health, as well as school/sports readiness, involves reviewing  physical health, emotional health and academic health.  Some kids think it’s strange for the doctor to ask about school performance or peer relations.  Yet these things are vital to your child’s health and well-being.  Frequently learning problems, or even bullying, may not be realized until the physical.  For kindergartners, the doctor will likely assess readiness for school.  This may include questions about colors and letters your child knows, behavior and listening skills, ability to get along with others and independence with skills like going to the bathroom.  For teens, it is important that their pediatrician can talk with them privately in order to gain confidence and get a good interview about high risk behaviors.  This may involve asking about smoking/drinking/drug use or sexual health.

For children playing sports, it will be important for the doctor to obtain a thorough history about their past medical history with regards to breathing, their heart, past concussions or past fractures.  We will also ask about family history of heart conditions. Special forms may need to be filled out by the parent before we can sign off on sports clearance.

For children with chronic illnesses, like asthma, this is a great time to make sure all referrals are done and all care is coordinated.  This is also a good time to get refills on medications that may be needed at school like EpiPens and inhalers.

After all of the questions, the doctor will need to perform a physical exam.  Yes, that means looking at the private parts.  Parents, please respect your teens privacy and be prepared to leave the room if asked.  Furthermore, make sure they know in advance that a look at the privates is likely to happen.

Time for the shots

Vaccines are generally required at kindergarten entry and 7th grade.  Here is what is required for kindergarten:

• 5 Dtap (diphtheria, tetanus, pertussis/whooping cough)
• 3 Hep B
• 4 Polio
• 2 MMR (measles, mumps, rubella)
• 2 Varicella (chicken pox)

Here is what is required for 7th grade:

• TdaP (whooping cough booster)
• Meningitis will be offered but (in California) is not required for school entry
• HPV will be offered but (in California) is not required for school entry

What to bring

Here is a list of things not to forget.  Not only will this help the visit go more smoothly but will save you and the doctor time in the long run.

• Any past records if new to the office
• Immunization card
• School entry form
• Sports participation form
• Medication use at school form
• List of all current medications and doses if new to the office

In order to ensure a successful visit, be sure to have all of the items listed above, arrive early enough to fill out paperwork and allow extra time to make sure the full history, physical and vaccinations can be done.  For more on preparing to see the doctor for parents of younger kids, click here.  For more on why your doctor might run behind, click here.