Graceful Health: Is your child developing normally?

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It might seem like just another chore on the back-to-school task list, but there are plenty of good reasons why your child's required yearly physical is a wise investment.

Children with chronic health challenges like asthma, allergies, or diabetes obviously need to be watched closely for any changes in their conditions, but "well" kids need watching too. The yearly physical provides a structure for regular check-ups to ensure that your child is developing normally.

What is normal? That's a good question, one to be asked at each year's physical. Answering that question thoroughly is a good reason for having a regular primary care provider. Someone who knows your child's unique health history is better prepared to ask the right questions so that any abnormalities are noticed as soon as they arise.

The yearly physical is also an opportunity for you as the parent to receive guidance and support. It is wonderfully affirming to have someone assure you that your child is developing normally and that you are doing a good job!

Having a regular pediatrician or primary care provider for your child also means that someone is helping you keep track of immunizations and is making sure that records are submitted to the state-wide database. Immunizations are recorded in this database so that the information is readily available if your child goes to the ER or to another pediatrician.

It's important to know that, as of July 1, the exemption from immunizations for philosophic reasons is no longer an option. Only exemptions for medical and religious reasons are allowed, and the proper paperwork must be filed to claim these exemptions. This means a catch-up schedule, or at least a plan, is necessary before school starts this fall for children who were not fully, or ever, immunized. This is a big adjustment for families who have opted out of shots in the past, so don't hesitate to request information and have discussions with your child's medical providers and to check with schools and the Vermont Department of Health regarding what is required. You can find information and forms at the Vermont Department of Health's website, using the search term "school entry immunizations."

Having an ongoing relationship with a medical provider also helps to build trust, so that there is a safe place to discuss private concerns. In this atmosphere, the provider can ask frank questions, especially as the child grows into adolescence. A provider who knows your child well has better intuition and is more likely to notice emerging problems with depression, sleeping, eating disorders, illicit behavior, and social interaction.

School physicals are an important time to check on a child's physical growth and development. In addition, the provider assesses whether the child is at a healthy weight, and if not, advises the child about nutritional habits that can either increase or decrease weight.

According to the American Heart Association, approximately one in three of America's children is overweight or obese, and that prevalence has increased steadily over the last forty years. Obesity often causes diabetes, high blood pressure and high cholesterol, and it can also have a huge impact on self-esteem, so this is cause for major concern.

The National Association for Sport and Physical Education has reported another sobering statistic about our children's health: only one in three kids are physically active every day.

We adults could do a better job of mentoring healthy exercise habits. This same organization says that adult statistics match that of kids. Less than five percent of us engage in the recommended 30 minutes of physical activity each day, so one of the best things we could do for our children's health is to take a walk together.

Of course, there are plenty of kids who are involved in sports. They may be getting enough exercise, but they also need check-ups. Sports physicals are required so that a provider can assess the function of heart, lungs, nerve reflexes, range of motion, flexibility, balance, and gait. If the child has a history of concussions or has had recent sprains, fractures, or other injuries, the progress of healing, the risk factors, and the safest approaches to conditioning will be discussed.

Time passes so quickly, and it's easy to forget how long it's been since the last check-up. With all of the benefits of regular yearly physicals in mind, the arrival of the school health form can be a welcome reminder, rather than another item on your to-do list.

It won't be long before the routine of school and sports begins all over again. There's no time like the present for setting up your appointment!

Natalie Harding is a Physician's Assistant practicing at Grace Cottage Family Health in Townshend. Natalie earned her Master of Physician Assistant Studies from Franklin Pierce College in New Hampshire. She worked in Greenfield, Mass., before joining Grace Cottage Hospital in 2014.


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