Regular preventive pediatric examination: fourth year

Your child is learning quickly. His/her vocabulary is constantly expanding, he/she probably uses sentences of 4-5 words, learns songs by heart. Peers' company is important to him/her and he is beginning to play group games (hide-and-seek). He/she likes pretend games, and don't be surprised if he/she has an imaginary friend (imagination can do wonders). He/she is learning to follow the rules and thus developing self-control. He/she is aware of his/her emotions, which he/she expresses intensely, but also quickly changes his/her mood. He/she is more and more agile and can stand on one foot.

Preparing for the visit 

  • Check if you have any new medical documentation for your child and take it with you to be reviewed by the pediatrician.  
  • Always bring a toy your child likes or a children's book so that he/she can enjoy playing or reading while waiting.   

Contents of the preventive visit

Growth monitoring

With a warm word or two, the nurse will measure your child in his/her underwear and enter the body height and body weight measurements in the growth charts (graphs).

Introductory interview

A visit to the pediatrician always begins with an appropriate conversation. He/she will check how the child has grown since the previous visit, how he/she eats, how physically active he/she is, how he/she sleeps, how he/she likes to play most, whether there have been any changes in the family environment in the meantime, whether he/she attends kindergarten, etc.  

Pediatric examination and developmental assessment

  • The pediatrician will perform a regular examination of your child, in the order you are already familiar with. He/she will examine: skin, head, nose, mouth, neck, nodes in the neck, then he/she will listen to the heart and lungs, palpate the abdomen, check the genital region if necessary, check the condition of the skeletal system, posture. He/she will measure blood pressure.
  • You have learned to follow your child's development more precisely, so you can share your observations about the child's development and behavior with the pediatrician and seek advice if necessary.   

Additional examinations

  • Since your child already communicates well enough, his/her visual acuity can be determined at this age, so the pediatrician will refer him to an ophthalmologist. He/she will also be referred to a speech therapist to check speech development and, if necessary, to a physiatrist to detect and address the most common bone- and joint-related problems of the feet and spine in a timely manner. He/she will remind you to visit a dentist. 
  • If necessary, the pediatrician will refer the child to other specialists or health associates (in the development counseling unit), depending on the assessed condition. 
  • He/she will order a complete blood count for your child.   

Vaccination

There is no planned vaccination at this age, but the child's vaccination status is checked and, in case a vaccination is missed, it will be administered on this occasion.

Final opinion

At the end of the examination, the pediatrician will inform you of his/her findings from the preventive examination and will summarize the next steps. You may receive some written material to support your child's further development. He/she will inform you about the next preventive visit.

A preventive examination in the fourth year of life is another opportunity to assess in more detail the growth and development of your child; this is a time when it is still possible to catch up on any milestones missed or remedy or alleviate an observed delay. Take this opportunity!