Time for Back to School Check-Ups

by: Dan Florell, Ph.D.

As the start of the school year comes, it is time for children and adolescents to get their annual check-ups. Most families make the trip to their pediatrician prior to school to get sports physicals or various vaccinations that schools require.

The benefits of annual well-child check-ups go beyond meeting school’s requirements. The check-up is part of establishing a medical home for the child or adolescent. The medical home is a place where all of a child or adolescent’s medical care can be coordinated. The check-up allows pediatricians an opportunity to check in with families at least once a year to keep records updated and monitor any issues that may be of concern or need additional follow-up.

An advantage of setting aside time to have an annual well-child check-up is that it gives parents a chance to bring up concerns that ordinarily would not warrant a visit to the doctor’s office. This could include concerns about a child’s eating, sleeping, or social difficulties. For example, a child may have started waking up in the middle of the night and complaining about being tired in the morning. While it has not seemed to affect the child’s behavior at home during the day, it might be a sign of some underlying issue that needs to be addressed.

Another advantage of meeting with the pediatrician annually is the relationship with the child or adolescent can be maintained. For healthy children, the annual check-up may be the only time they see their pediatrician in a given year. The importance of having a continued relationship with the doctor can mean the difference for an adolescent feeling comfortable enough with his pediatrician to confide about health issues that he may not be able to talk about with his parents.

Prior to meeting with the pediatrician for a well-child check-up, parents should talk with other adults that the child spend significant time around like grandparents or other care providers to see if they have noticed anything that is of concern. Sometimes children will mention problems to other adults or they may be displaying troubling behaviors in one setting but not another.

In addition to having a well-child check-up annually for physical health, there is a growing interest in having children receive a mental health check-up. The incidence of mental health issues in children and adolescents ranges from 13 to 20% in a given year. This means that one out of five children and adolescents are likely to need help for mental health problems and yet many do not.

Typically, parents become aware of a mental health problem with their child or adolescent when the school year is underway. School requires children and adolescents to be in a structured setting where they are required to do tasks that many students prefer to not do. This situation can cause misbehavior in the classroom and result in teachers contacting the parents about the issue.

School is also the time that children and adolescents feel additional stress as there is more pressure to complete assignments and perform at a higher level. Further stress can occur from social relationships ranging from disagreements between friends to bullying. This stress can cause anxiety and depression in children and adolescents.

Many children and adolescents may have shown signs of having mental health difficulties at the end of the past school year. However when the stress and demands of school were lifted during the summer, the difficulties diminished. This does not mean the problem has gone away.

A mental health check-up for children and adolescents can provide a baseline for how they behave when they are in the more relaxed environment of summer. This way if problems do arise, the psychologist can see how the children or adolescents typically behave and whether there is a need for further intervention.

Mental health check-ups are particularly important for children and adolescents who have had mental health difficulties in the past. Even when everything appears to be going smoothly, there could be relapses and it is helpful for those children and adolescents to maintain their relationships with the psychologist.

As the school year is getting ready to start up, it is important for parents to remember to have their children or adolescents get their annual check-up. The check-up should involve the children or adolescent’s physical as well as mental health. This type of prevention will make it easier for pediatricians and psychologists to catch a problem early on.

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