Making the Annual Pediatric Evaluation More Relevant to the Needs of the Child

Abstract

Techniques and maneuvers of physical diagnosis being taught and practiced in well-child care require little participation by the child-patient. During the first three years of life, the stresses of physical growth require frequent application of traditional examination techniques, as auscultation, palpation, and manipulation. Defects previously occult, made manifest by growth, must be identified. But after age three, “appropriate endpoints now consist of determining the child's competence to perform under the physiologically stressful conditions imposed by new social and learning situations.” As illustration, the authors describe in detail, an annual health examination being given to well children in private practice. Especial emphasis is placed on hearing problems in their relation to poor work in school.