09:22am Saturday 19 October 2019

Annual physical exams present opportunity for discussion between parents, children and family physicians

As the start of the school year approaches, many children will visit their family physician or pediatrician for their annual physical exam. While the primary function of these annual visits is to evaluate children’s physical health, University of Michigan family physicians and pediatricians urge that these visits be used as a time for conversation.

Parents should consider these appointments as a time for children and parents to engage in important discussions with their doctor, according to an article by Dr. Margaret Riley, M.D., Clinical Lecturer of Family Medicine at the U-M Medical School. The article was recently published in American Family Physician.

“For children between 5 and 12 years old, the counseling aspect of the annual physical is important because children in this age group are establishing patterns of behavior that may last a lifetime,” says Riley. “It’s important for children to be counseled on leading a healthy lifestyle by their parent or guardian as well as their regular physician.”

These types of discussions also help children develop a positive and trusting relationship with their doctor, Riley says.

Along with the routine physical exam, the report suggests that parents, physicians and children should talk about healthy lifestyle practices and accident prevention. This includes discussing the importance of eating a proper diet and getting regular exercise, limiting screen time, getting adequate sleep, and the dangers of high risk behaviors. Discussion of each topic varies according to children’s age, and should be tailored to the individual child’s needs.

• Dietary Counseling – annually.
Parents and physicians should take advantage of annual visits to remind children of the value of eating fruits and vegetables and limiting sugary beverages and processed foods.

“It’s important that children are educated early on about the importance of eating healthy food like lean meats, whole grains, low fat dairy, beans and fish,” Riley says. “Teaching children portion control will also help them to avoid becoming overweight.”

• Physical Activity – annually.
While it’s up to parents to ensure children get at least 60 minutes of physical activity every day, family physicians and pediatricians can encourage kids to stay active by offering a straightforward explanation of the benefits of exercise.

“Physicians can explain to children how different activities help keep their muscles, heart and bones strong,” Riley says. “Demonstrating to kids that even fun activities like playing tug-of-war and swimming help keep them healthy will encourage them to remain active.”

• Screen Time – annually.
“The more time children spend in front of a screen, the higher their risk of obesity,” Riley says. “This includes time spent watching television, playing video games or using the computer.”

While the average child spends 7.5 hours a day in front of a screen, the American Academy of Pediatrics recommends no more than one to two hours of quality programming each day for school-aged children.

“To minimize the risk of obesity, it’s critical that parents and physicians work together to encourage kids to cut down on time spent in front of a screen,” Riley adds.


• Sleep– annually
Inadequate sleep can lead to behavioral issues, difficulty concentrating at school, and has been linked with obesity.

“Children 5-12 years old need an average of 11 hours of sleep nightly, and getting enough sleep will help them feel their best,” Riley says.


• High-Risk Behaviors – annually, beginning at 11 years old
According to a 2007 survey of youth in the U.S., 24 percent of those younger than 13 had had their first drink of alcohol, 15 percent had smoked an entire cigarette and 8 percent had tried marijuana.

“Screening for high-risk behaviors should occur during annual visits for those 11 years and older,” Riley says. “Early screening reduces the risk of substance abuse related injuries, motor vehicle crashes and substance dependence in adulthood.”


• Safety – annually
Accidents are the leading cause of death in children ages 5-12, and many injuries are preventable and predictable.

“Motor vehicle accidents and drownings cause the majority of injuries in children. Families should be counseled on traffic safety including seat belts and bike helmets, and children ages 5 and up should be taught to swim,” adds Dr. Riley.

The suggestions published in the report are based on studies completed by the American Academy of Family Physicians, the American Academy of Pediatrics, the U.S. Preventative Services Task Force, and the Department of Health and Human Services.

# # #

Additional Resources:
American Academy of Pediatrics

U.S. Department of Health and Human Services Recommendations for
Physical Activity

Additional Authors: Amy B. Locke, M.D., Eric P. Skye, M.D.

Citation: Riley M, Locke AB, Skye EP. Health maintenance in
school-aged children. Part II: counseling recommendations.
Am Fam Physician. 2011;83(6):000-000.

Disclosures: None.

The University of Michigan C.S. Mott Children’s Hospital is consistently ranked as one of the best hospitals in the country. It was nationally ranked in all ten pediatric specialties in the U.S. News Media Group’s 2011 edition of “America’s Best Children’s Hospitals” including third in the country for heart and heart surgery. In November, the hospital moves to a new 1.1 million square feet, $754 million state-of-the-art facility that will be home to cutting-edge specialty services for newborns, children and women.

Written by Lauren McLeod

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