My children, who are in kindergarten and third grade, were born at the very end of the summer, so their annual well visits always dovetail nicely with back-to-school checkups. But because I was late to book their appointments this year, and because Saturday-morning slots are hard to come by, we have to wait until mid-October to see the pediatrician. I definitely know two topics I want to bring up. Is my younger daughter's constant "What?"s just a habit she's gotten into, or is anything wrong with her hearing? (She seems to hear me fine when she's in the way-back seat of our car and I'm whispering something to my husband that I'd rather my kids not hear...) And is my older daughter's vision okay, even if she puts on my glasses and says she sees "much better"? (I only question it because she freely admits she prefers how she looks with glasses.)
I really wish I could've had these matters resolved before school started. In our September issue we ran a story called "Is Your Child Ready to Learn?" that thoroughly outlined all of the ways that a child's health and ability to learn are entwined. The story was a part of a partnership we have with a wonderful organization, Children's Health Fund, which is dedicated to providing top-quality healthcare to children who don't have access to it. The experts at CHF gave us a list of the most crucial questions every parent should ask--and bring up with the pediatrician if there's any concern.
1. How well can my child see? I was really surprised to learn that between 5 and 10 percent of preschoolers and 25 percent of school-age children have a vision problem, according to the American Optometric Association. But less than a third of children have their vision tested before they start school. By age 4, your child should be screened annually. Definitely mention it to your doctor if you notice that your child holds books really close to his face or sits super close to the TV or computer screen or squints even when the light isn't bright.
2. Could she have a hearing problem? Children who've gotten frequent ear infections are especially vulnerable to temporary hearing loss, which can last three months or longer. As with vision screens, your child should be checked each year starting by age 4 at latest. If your child has any kind of speech delay, or if she seems to ignore you when you call her name, or turns the volume way up, or says her ears hurt or that she hears noises, these are all red flags worthy of your doctor's attention.
3. Is he overly stressed? You may not think to bring up issues like anxiety with your pediatrician, especially in the course of a typical 15-minute checkup. But your doctor needs to know if there's anything worrying you about your child's mental health. Perhaps you're not even sure if your child's stressed. Some possible physical signs are frequent headaches, stomachaches, nail biting, hair-pulling, and bedwetting.
4. What does she eat? Not surprisingly, children who don't get enough to eat are at high risk for poor school performance, since they're just too distracted by their hunger to concentrate well. But children who are overweight or obese (which is a third of all kids in this country) are also at risk because if they don't get proper nutrition, their brain simply won't function the way it should. Even a child with no weight or hunger issues can be affected by poor nutrition if she doesn't get enough fruits or veggies or if she refuses to eat entire food groups. If you suspect your child's diet isn't adequate, tell your doctor so you can work together on strategies to improve it.
5. How's he sleeping? It's no shock that there's a direct link between how much sleep a child gets and how well he does in school. Research has proven that sleep-deprived kids have more behavior problems: They're easily distracted, often argumentative, frequently overactive (a way to help them stay awake), and may be misdiagnosed with ADHD. Tell your pediatrician if your 5- to 11-year-old doesn't get at least 10 hours of sleep each night, or if you notice any other red flags, including snoring, restless sleep with sweating, or mouth breathing.
6. Could she have asthma? This is the most common chronic disease in childhood and often develops before a child turns 5. One misconception about asthma is that it causes a child to wheeze. That's not always true. For many kids, the only symptom is a chronic cough--either at night, or when the weather is cold, or as a result of exercise. Let your doctor know if you notice any of these signs, particularly if there's a family history of asthma or if your child had eczema as a baby (which is often a sign that asthma will come later).