Well Child Care
> Well child care: 7-12 Years
Well child care: 7-12 Years
Information regarding developmental goals, safety, immunizations, and nutrition information.
Athletic Heart Screens
We are commonly asked if we think the athletic heart screens offered through our schools are recommended. The answer is complex but Dr Stuppy discusses it in Heart Screenings for Athletes - Are they worth it?
What to expect at your visit:
School aged children should be able to answer many of the health related questions asked of them at the visit. If the doctor or nurse asks your child a question, please resist the urge to answer for him or her. It is important to let kids become more comfortable in the medical setting, and we want them to develop this confidence over the years. For more on this topic, please read Developing healthcare responsibility in your child
If you need to discuss something out of earshot of your child, please contact the provider before the visit. It makes kids anxious if we discuss things privately at their visit. For more on this, please see Talking About Your Child Privately
During the tween and teen years many children desire more privacy and it will be offered for parents to leave the room for part of the visit. Not all children want their parents to leave, but if yours does, please be respectful of this normal developmental stage.
It is recommended that depression is screened yearly for all adolescents. We begin this screening at 12 year well visits. Please allow your child to answer as independently as possible, but you can help clarify questions as needed.
Discuss with your child that doctors and other healthcare providers need to know what is going on with their patients. It is important to answer questions as completely and honestly as they can. We talk about things that are not polite dinner conversation (like poop quantity and quality) and that's okay. Our questions help us understand how their body is working inside and out.
We will need to examine their body. We do allow kids to keep on their clothes at this age, but must move clothing around or remove it during parts of the exam. Review that it is only okay for people who have permission from you (and any other specific adult, such as another parent) to examine their bodies (especially in the swimsuit or underwear area). You should be clear that you only give permission if a person needs to help keep them clean (if they need help with toileting or bathing) or if they need to keep them healthy (as in a doctor's office). We will not force any child to undress completely if it is against their wishes because that sets the precedent that an adult can force a child to do something that makes them feel uncomfortable and they aren't in control of their body, but if there is a concern with the body part they won't let us examine it will make it more difficult for us to make a good assessment of the issue.
- The middle years of childhood are a time of enormous social and intellectual growth.
- Tweens are better able to reason and solve problems.
- Sports can contribute to physical fitness, develop basic motor skills, boost self-confidence, and teach teamwork. Don’t push winning, but rather teamwork and good efforts. Avoid early sports burnout.
- Children now prefer same-sex playmates.
- Puberty can begin as early as 7 for girls and 9 for boys.
- The first physical sign in girls is usually breast budding between 7 and 13 years. Menstruation usually starts 2 years after the onset of breast changes.
- Boys’ first physical change is enlarging testicles between 9 and 14 years. Growth in height and weight is very rapid just before and during puberty. Growth typically stops about 2 years after girls begin menstruating.
- Begin talking with your child about body changes now, before it’s too late!
- Encourage proper sleep for normal growth, development and behavior.
- Click here to learn about sleep problems, such as bedwetting, snoring, and insomnia.
- This is a great video explaining erections. We recommend you watch it and decide if it is appropriate for your son: The Science of Morning Wood.
- Dr Stuppy has several blogs that help answer common questions related to this age group:
There are many books on the topics of puberty, sex, and talking with children. A great place to start is Amazon because you can read reviews and also check similar suggested books to find the one you think is best for your child. Books on puberty issues:
- For girls: The Care & Keeping of YOU: The Body Book for Girls by Valerie Lee Schaefer (Also found on Amazon and other sites for less than $10.) There are two books in this series. Book 1 is best to read before puberty. It is very simple but explains what young girls need to understand before changes start. Book 2 is best for girls further along in puberty (but not older teens who already understand their cycles). It goes into more details on the physical and emotional changes of puberty as well as some practical aspects, such as how to insert a tampon. Many girls need to use a tampon early on (and even their first period) so this can be helpful to read before their period starts, but after changes have started.
- For boys: The Boys Body Book: Everything You Need To Know For Growing up YOU by Kelli Dunham (Also found on Amazon and other sites for less than $10.)
- New for boys: Guy Stuff: The Body Book for Boys (from the author of The Care & Keeping of You: The Body Book for Girls)
- For every parent (it's not too early!): The Talk: What Your Kids Need to Hear from You About Sex by Sharon Maxwell.
- Children need a balanced diet of fruits, vegetables, lean meats or other form of protein, and limited fats and simple sugars. Encourage a plant (fruit or vegetable) plus a protein with each meal and snack. The plants help them get to the recommended 5 a day fruits + vegetables, and the protein helps give lasting energy. Most kids get more than enough carbs.
- Vitamin supplementation may help round out the nutrients your child misses through the diet, but still encourage healthy eating.
- The American Academy of Pediatrics recommends all children take a vitamin D and iron supplement daily.
- Limit "pop", juice, and pre-packaged snack foods with high fat and calories.
- Juice offers little nutrition and has a lot of sugar! See Dr. Stuppy's summary of the AAP Juice Guidelines for more information.
- Great snack suggestions:
- Apple slices (or banana) with peanut butter
- Yogurt with fruits or veggies
- Carrots or sugar snap peas with hummus
- Almonds and fruit
- Fruit and cheese
- Pre-wash (and cut) fruits and vegetables and put them in individual containers for kids to grab them quickly. You can add lemon juice to apple slices to prevent browning.
- Eating as a family at home has been shown to improve not only nutrition, but also family bonds.
- See our Nutrition page for more topics, such as fish oil, vitamin D, sports nutrition, weight loss and gaining tips, and more!
- Let your child know what the house rules are.
- Be consistent with discipline among all categories.
- Learn to talk with your child -- but listen more than talk!
- Model behaviors for your child.
- Teach how to make good decisions. Less explanation and more learning from natural consequences works best.
- Remember that professional help is available if problems become too intense or cause other problems such as decline in school performance, increased family stress or serious emotional problems.
- Family meetings are a good way to bring the family together, improve communication, recognize and reward progress, and to determine family member’s feelings. Each member should be allowed to speak without criticism, to share thoughts, achievements, and hopes. Parents can serve as discussion leaders.
- Screen time:
- Some television programs promote learning, but many have detrimental messages. Violence is common and leads to aggression among kids. Children do not understand the claims of commercials and may base their choice of food or toys on what they see.
- Watch television with your child. Discuss what you see. Keep television, computers, cell phones, and other screens out of your children’s bedrooms!!
- Turn television and other screens off during mealtime.
- Monitor computer/Internet use. Learn how to block objective content. Click here for more on Internet safety.
- Talk to your kids about what they're watching on tv and doing online. Discuss how what they see applies to situations in their own lives.
- Talk to your kids about being respectful in person and online. Monitor your children's screen time and online history.
- There are no longer specific screen time recommendations, but it should be limited so there's time for exercise, sleep, homework, and other activities.
- Common Sense Media is a website that has reviews of tv, movies, and video games for discerning parents. Get familiar with what your kids are watching and playing - ideally before they start!
- The AAP offers a tool to help make a family Media Use Plan.
- See our discipline page for more information.
- Use a booster seat until your child is 80 pounds, 4 feet 9 inches or at least 8 years old. Most kids are 10-12 years old before they're safe without a booster.
- Never place a child under 13 years in front of an airbag. Remember: You must be a teen to sit in front!
- Children learn by example: Adults should wear helmets and seat belts. Never smoke in front of your child. Never drink alcohol to excess in front of your child.
- Avoid motorized vehicles such as mopeds, mini-bikes, snowmobiles, or all-terrain vehicles.
- Use bike helmets for biking, rollerblading, skateboarding, and down-hill sledding.
- Learn swim safety.
- Teach first aid.
- Talk about tobacco, alcohol, sex, and drugs in a way your child can understand. Remember they hear about these from television and friends, so you must tell them your beliefs too.
- If you own a gun, keep it unloaded and locked. Keep the ammunition locked separately.
- Many children (mostly 11-16 years of age) have died from a game that they play to get a brief high. This game goes by many names, including the choking game, blackout, dream game, and others. See this article to learn the signs to watch for in your child. Learn about the dangers of this game, and teach your children how dangerous it is.
- See our page on how to safely dispose of medications in an earth friendly way.
- If you are looking for more safety information check out our safety and injuries section.
- Hearing loss is becoming more common in kids - up to 15% of 6-18 year olds have some hearing loss. Prevention is key! Read more in Hearing Loss.
- Tdap, Meningoccal, and HPV vaccines are recommended at 11 years (older kids can catch up if not yet given). Please check our vaccine page for more information.
- If you are worried about the safety of vaccines, please read:
- Flu vaccine is recommended each Fall.
Please bring any required health forms
to your well visits!
WIC (Women, Infant, and Children) provides nutrition counseling, breastfeeding support, and food to families who have needs. For more information click here
Review your insurance contract to see who is responsible for payment of specific things within your well visit. Many companies do not require a co pay for well care visits, but if additional topics are discussed (such as ill topics or refills of medications) they might require a payment from you. They might also require you to pay for all or part of any labs or testing done at well visits.
New rules allow us to not bill insurance if your child requires a sports physical only and has already had a well visit in the past year. We are now able to charge cash like many school sports physical clinics and urgent cares (who don't know your child) do.
If you have questions about how your insurance handles codes performed at the time of well visits, please visit our insurance pages on patient responsibility with billing
and Why am I being billed? I have insurance!