The Preteen Physical
The onset of puberty signals the need for a more grown-up approach to your child’s health-care needs. As a parent, you’ve been your child’s primary caregiver since birth. You’ve healed boo-boos with kisses, wiped tears after sports mishaps and washed sheets at 3a.m. after a losing round with the stomach bug. But as your child teeters on the brink of puberty, her health-care needs are changing.
In their preteen formative years, children need one-on-one time with their doctors so they can ask and answer their questions openly. This also gives physicians an opportunity to cultivate what hopefully will be a trusting doctor-patient relationship in the years to come. Starting around age 9, you and your child should notice a difference in how well-care visits are conducted. In addition to private time with the doctor, questions previously directed to you, as parent and caregiver, will be directed to your maturing child. The goal is to get your preteen comfortable handling all aspects of her healthcare – from making an appointment, to verbalizing concerns, to filling prescriptions – by the time she’s 18.
This shift in doctor-patient dynamics should be gradual. Experts recommend that physician practices either send letters or call parents in advance of this appointment to let them know how their child’s upcoming visit will differ from previous ones. The heads-up provides you with an opportunity to prepare your child for the changes. It also gives you time to prepare a list of questions and concerns. If you haven’t gotten that letter or phone call yet, this article will help you prepare you for the ways in which your preteen’s medical visits will change.
A Complete Physical
Your preteen should receive a comprehensive exam, including blood work to measure cholesterol and blood sugar levels, body mass indexing, blood pressure, height and weight. According to the American Medical Association’s (AMA) Guidelines for Adolescent Preventive Services, this type of exam should be performed at least once while your child is in the preadolescence stage. The AMA recommends these tests be repeated when your child reaches middle (ages 15 to 17) and late (ages 18 to 21) adolescence.
Puberty tends to occur in a series of five developmental stages that begin within the ages of 8 to 13 for girls and 9 to 14 for boys. The sexual maturation ratings scale (SMR), also known as Tanner staging, is used by doctors to determine where you child’s development falls within these stages. If there are no signs of puberty, your preadolescent will be rated SMR1; a child who displays the first signs of puberty is considered to be at the second SMR level; someone who has completed puberty is rated SMR 5. By checking these indicators and charting your child’s maturing body every two years, doctors can ensure development is on track. Large deviations from the norm require further evaluation.
Although it’s normal for kids going through puberty to feel uncomfortable being examined by a member of the opposite sex, experts advise against switching doctors solely due to gender. Your child might be slightly embarrassed at first, but a skilled doctor will ease your child’s concerns. If the situation makes you or your child extremely uncomfortable, however, ask if your child can be seen by another physician in the same practice.
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