Well Child Visit Handout - 5 Years

FIVE YEARS
 
Date of Visit:  ___________
Weight:           ___________
Height:            ___________
 
 
NORMAL DEVELOPMENT:      At this age your child may have the following characteristics:
 PHYSICAL:  
•  Permanent teeth starting to appear.
•  Begins to show handedness—left-handed or right-handed.
•  Builds elaborate structures.
•  Tires easily.
•  Eats, dresses, and toilets without help.
•  Enjoys playing games and movement.
•  Enjoys playing noisy rhythmic instruments.
•  Is curious about reproduction and birth.
•  May be able to skip.
 
 EMOTIONAL:
•  Begins to express more feelings in words.
•  Embarrasses easily and cannot yet laugh at self.
•  Feelings about death appear.
•  Shows guilt over misbehavior.
•  Likes independence.
•  Is serious and dependable.
 
 SOCIAL:
•  Submits to more rules and regulations.
•  May tattle, name-call, hit and shove at times.
•  Cooperates in simple group tasks.
•  Likes to please adults.
•  Takes turns during playing and speaking.
•  Gets along comfortably with other children.
•  Is keenly interested in family activities.
 
 MENTAL:
•  Begins to recognize a few letters and words.
•  Has a short attention span (about 10-15 minutes).
•  Has developed an overall image of self.
•  Craves facts.
 
NUTRITION:
•  Offer your child three regular meals per day plus nutritious snacks.   
•  Make mealtimes pleasant and companionable.  Encourage conversation.
 
ORAL HYGIENE:
•  Regular dental care and dental visits are important.  Teeth should be brushed twice daily with a fluoride toothpaste—once by a parent and once by your child.  Limit between meal sweets, candy, and soda.  Try not to use candy and sweets as rewards.
 
SAFETY:
•  Make sure your child is properly restrained in a car seat (if less than 40 lbs, 40 inches)  or a booster seat with a lap/shoulder belt.  Place the child safety seat in the backseat.
•  Keep car doors locked when traveling.
•  Never leave your child alone in the car or house.
•  Teach street safety.  Your child is too young to cross the streets alone!
•  Install smoke alarms on every floor and change batteries twice a year.
•  Show your child how to respond to clothes catching on fire:  “Stop-Drop-Roll.”
•  Supervise all swimming and water play.  Insist on life jacket use when in a boat or near the water.  Teach your child how to swim.   
•  All guns should be unloaded and put in a locked cabinet.
•  Caution children about unsafe hiding places, e.g., refrigerators, car trunks, clothes dryers.
•  Teach safety rules for interacting with strangers.
 
STIMULATION:
•  Toys that help develop muscle skills include roller skates, jungle gyms, bicycles with training wheels, large blocks, small tools, Tinker Tools, and jump rope.
•  Toys that tend to encourage imagination include household furniture, dishes, dress-up clothes, medical kits, empty food boxes, play money, playhouses, and tents.
•  Puzzles, dominoes, marking pens, modeling clay, blunt scissors, connect the dots, and coloring books are helpful in developing fine muscle skills.
•  Planting a garden, caring for a fish or hamster, baking cookies, preparing simple foods, baking bread or caring for a plant can be fun, rewarding, and begin to teach responsibility.
 
KINDERGARTEN
READINESS:  
•  School systems vary in their cut off date for beginning kindergarten.  Your school may offer screening for kindergarten readiness for those whose birthday falls close to the deadline.  Screening usually includes a team of professionals to check the child’s readiness skills.  Your child may be asked to perform tasks such as copy a design, remember story details, throw and catch a ball, tell a story in sequence and walk a balance beam.  Screening does not necessarily predict success in kindergarten, only readiness.
 •  Helping prepare your child for kindergarten involves learning readiness skills in small repetitive doses but without pressure.  A parental attitude will be communicated to your child—if you are hesitant, your child will be too.  So encourage your child.  Also play and talk with your child.  Say aloud the names of objects in your home and in books.  Compare things that are big and little, fast and slow, hot and cold.  Talk about colors and shapes.  Count simple objects and match shapes that are alike.  Make learning fun!  Help your child learn the letters of the alphabet and parts of the body.  The most important preparation is to instill a positive attitude about going to school and learning new things and meeting new friends.   
 
PARENTING:
•  Once your child enters school, your involvement in school activities and homework will be a big help in his/her success in learning.
•  Limit the amount and monitor the quality of television.  Watch shows with your child and discuss them.
•  Continue to read aloud to your child!
 
ANTICIPATORY GUIDANCE:  (Information credited to Brazelton’s Touchpoints)
•  Fears:  A new set of nightmares and fears may appear.  Five-year-olds begin to be afraid of more intangible things such as disease or violence.
•  Games:  Games with rules and directions become very important.  Fairness is also important at this age.
•  Moral awareness:  Moral begins to develop and they find themselves living with angry feelings.  Five-year-olds are also able to feel empathy for others.  The child becomes aware of the effect of his/her actions not only on the responses of others but also on his/her own feelings.
 •  Gender identity:  Gender identity is at its peak.  Five-year-olds have lots of questions about their bodies.  They may identify with one parent over another. 
•  Fantasy vs. reality:  Dreaming and wishing must now struggle to make way for reality.  They still may play dress-up games or have imaginary playmates, but they are now able to differentiate fantasy from reality.