Healthy Kids

Expect to see doctors refer to the 2000 CDC Growth Charts to assess kids' nutritional status and general health as they get older. To see more information about the charts and to figure out your child's body-mass index, go to cdc.gov/growthcharts/ .

ELEMENTARY-SCHOOL AGE
Typically at the 5-year checkup, kids get any remaining immunizations that their state requires for school entry. (Click here for a chart of your state's requirements.) In June, the Advisory Committee on Immunization Practices (ACIP) to the CDC voted to also recommend a second dose of chickenpox vaccine to kids who are 4 to 6.) Elementary-school kids often go for checkups every year, though pediatricians say it's acceptable if healthy kids only go at 6, 8 and 10. Doctors will ask kids for urine specimens to look for protein and blood—symptoms of kidney disease. (Contrary to popular belief, they are not using the urine specimen to screen for diabetes.)

TWEENS
Most kids enter puberty healthy; the annual physical helps keep it that way. The 2006 Childhood and Adolescent Immunization Schedule—released earlier this year by the CDC, the American Academy of Pediatrics and the American Academy of Family Physicians—includes several additions for 11 and 12-year-olds. They should get the meningococcal conjugate vaccine to reduce the incidence of a rare but potentially lethal bacterial infection, as well as the new tetanus, diphtheria and acellular pertussis "booster" to protect against whooping cough. Adolescents who haven't received all three doses of hepatitis B vaccine should start or complete the series. (Leave at least four months between the first and third doses.) Check whether your insurance carrier is already covering the human papilloma virus (HPV) vaccine, which the Centers for Disease Control recommended in June and which costs $360 for a series of three shots given over six months.  A CDC advisory panel has recommended it for girls aged 11 to 12 and for 13- to 26-year-old women who have not yet received or completed the vaccine series.

At their checkups, tweens may want to talk to their doctors about why they have pimples or when they will get "grown-up bodies," says Robie Harris, author of "It's Perfectly Normal"  (Candlewick; 2004). Doctors can explain what hormones are and may also talk to tweens about delaying sex and about getting pregnant or contracting a sexually transmitted disease.

Many doctors like time alone with children, starting at age 11 or 12, to ask confidential questions. Some also want time alone with parents, who may not want to talk about their concerns about drug use or sex in front of their children. "Everyone has to agree that we have some ground rules for confidentiality," says Dr. John Knight, director of the Center for Adolescent Substance Abuse Research at Children's Hospital Boston. "I'm going to keep their responses private unless there's a safety issue."

Many doctors also use written questionnaires to gather information in a nonjudgmental way.