HomeArticlesBack-to-school physicals: What parents need to know

Back-to-school physicals: What parents need to know

Parents should know what to ask before, during and after their child’s annual school physical and wellness check.

With a new academic year starting, parents likely have their kids’ school physicals at the top of to-do lists. What do you need to ask before, during and after you visit the pediatrician’s office? We asked two local Valley pediatricians what parents should know about their child’s physical, mental and emotional health.

Matthew Barcellona, a community pediatrician with North Scottsdale Pediatrics, and Amy Rampley, a native Arizonan and pediatrician who has worked at Desert Sun Pediatrics in Phoenix for the last 13 years, offer tips.

When is the best time to schedule a school physical? 

With work duties, a busy household and managing school schedules and extra-curricular activities for their children, parents don’t always get wellness checks scheduled on or near each child’s birthday.

“A yearly physical doesn’t have to be exactly on a child’s birthday, but (at) a consistent time of the year,” says Barcellona.

Both Barcellona and Rampley agree it’s best to avoid waiting-room crowds during winter months, when viral illnesses are prevalent during cold and flu season.

Is there a difference between a well check and a school physical?

“A well check is a comprehensive exam that addresses all parts of a child’s health — physical, emotional and mental health,” says Barcellona. Such checks are about “maintaining a child’s overall health” and a physical is only part of this exam.

Rampley says an athlete’s physical might include an extra component, such as “assessing cardiac risks, measuring muscle, joint, shoulder and upper body strength — and for boys, a hernia check.”

Both agree that a well check is the only way for a child to receive a full evaluation of his or her health.

What vaccinations does my child need?

Parents may want to prepare children ahead of time if vaccinations will be part of a wellness visit. Guidelines are listed on websites for the American Academy of Pediatrics and the Centers for Disease Control and Prevention. If parents want to stagger the timing of vaccinations rather than having several given at once, they should discuss that with their pediatrician.

Where should my child’s body mass index fall, and how much activity does my child need?

When a child’s body mass index, or BMI, is greater than 85 percent, he or she is considered overweight. If a BMI is greater than 95 percent, a child is considered obese. (How to calculate BMI.)

Rampley says talking about weight is a “tricky subject,” but urges parents to take the initiative to discuss this with their pediatrician. Barcellona thinks it is important to consider a “child’s genetics, body type and trends over time,” when having a discussion about BMI. Both agree that extremes (below 5 percent or above 85 percent) indicate a need to look at nutritional health.

Children should exercise (or enjoy physical activity or play) for at least an hour daily. Exercise “also offers a way to de-stress,” says Barcellona.

Rampley encourages parents to find activities that appeal to their children and to tailor physical activities to their interests.

What signs should parents watch in terms of emotional development?

In younger children, pay careful attention to sleeping patterns and interaction with others. If a child is withdrawn, “not engaging with others, having mood swings and separating themselves,” parents should address these issues with their physician, says Barcellona.

One of the best ways to know how a child is doing emotionally is to ask open-ended questions, says Ramply. In her own family, Rampley employs a weekly dinner tradition that includes going around the table and asking, “What’s one good thing (that) happened to you today?”

She urges protecting children’s emotional health by offering them plenty of down time and not over-scheduling organized activities.

How much screen time is appropriate for my child? 

Barcellona describes a mnemonic device that is easy for parents and kids to remember regarding all aspects of wellness, including screen time: 5-2-1-0. Every day, he says, a child should have five or more fruits and vegetables, two hours or less of screen time, one hour of aerobic activity and zero servings of fruit juice or soda.

Rampley adopts a policy of “no electronics in the bedroom at night,” citing research studies that indicate looking at the phone at night can cause sleep disturbances and increase anxiety. “We are in the technology age, but we need to unplug because our kids need to have human relationships,” she says.

What do pediatricians wish parents would ask?

Barcellona wishes more parents would ask about after-hours emergency care and the best places to call or go when unexpected situations arise.

Rampley wants parents to dig deeper when it comes to prescriptions for their children. She encourages parents to ask, “Why is (my) child is taking a particular medicine? Is it necessary, and can we try something else?”

She also wants parents to educate themselves on fevers. She says we live in a “fever phobic” society, and adds when evaluating a temperature, it is important to consider the overall symptoms of a child and how he or she is acting.

Editor’s note: This story was first published in July 2107. Links and resources have been rechecked and verified. 

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