Developmental follow-up and well-child checks are a vital component of ensuring a healthy, happy childhood leading to a healthy, happy life in which children reach their full potential.
They serve three main purposes:
1. To ensure children are growing and developing as expected
2. To pick up problems that need intervention or support
3. To provide guidance and health information on what to be mindful of at each stage of life
Well-child visits, along with vaccinations and other preventive care, form an important part of an effective programme of healthcare to ensure that children develop and thrive. What’s more, when well-child checks are missed, children end up with a significantly higher rate of being hospitalised unnecessarily and that rate goes up the more checks are missed. They are extremely important.
Vaccines and plotting growth are a vital part of ensuring your child thrives, but these visits go much further, allowing parents to discuss any concerns, including nutrition, sleeping issues and social problems. They also allow paediatricians to provide advice on what to look for in the next phase of development. If a paediatrician only sees a child when unwell, there usually isn’t time to properly discuss development. Furthermore, the presence of sickness (e.g. flu) means this isn’t the best time to assess the longer-term aspects of wellness and development. Separate checks work best.
An important benefit of a well-child visit is developmental monitoring. Paediatricians use their interactions with children to spot problems with playing, speaking or interacting. These signs may allude to autism, hyperactivity disorders or a learning disability, where early support is vital. It can also make the difference between mainstream school versus needing special educational support, which is scarce in Cayman.
Cayman has no set schedule of well-child checks but most paediatricians across the Island will see your child at: 2 to 5 days old, 1 week, 2 months, 4 months, 6 months, 9 months, 12 months, 18 months, 24 months, 36 months and annually thereafter to age 21.
Each developmental check is different. For instance, the 18-month check contains the first screening for autism, using a distinct behavioural check list coupled to family information and experiences. Prior to this, it is quite difficult to pick up. However, when identified at this early stage, really valuable behavioural and relationship interventions lead to improved IQ, language ability and social interaction, all things with life-long benefits.
By four years of age, language and motor skills are developing rapidly and certain types of play become much more important for social development. Children are becoming more independent. Picking up developmental issues here means children can receive support, such as speech and language therapy, the availability of which in Cayman surpasses that of the UK.
No two timepoints are the same and so it isn’t surprising that children tend to have more problems downstream, the more development and well-child checks are missed.
All good paediatricians conduct well-child checks. Some have skills in more advanced developmental follow-up e.g. from caring for pre-term infants. Using the same paediatrician over time helps too. Contact your paediatrician and tell them you’d like an appointment for a well-child check.
The emergence of Covid-19 onto the world’s stage has led to confusion over how and whether to engage in routine healthcare such as well-child checks. However, there is now a group of children with late diagnosed problems as a result of rest-in-place arrangements in various countries. This reinforces both the importance of well-child checks and their time-sensitive nature.
It is far more preferable to conduct a well-child consultation by video conference or ‘telehealth’ than not at all. Most paediatric practices have put systems in place in order to do this. However, it is also important to appreciate the challenges of physical assessment by video conference. Paediatricians will compensate for this through something called safety-netting – a process of giving you a series signs or symptoms that you need to watch out for as parents, the appearance of which warrants contact with your paediatrician.
Well-child checks, and especially ones conducted remotely, are not designed to replace the everyday vigilance of parents in helping to spot emerging issues. There are few health issues that aren’t best addressed through early identification and so if you are at all concerned about the health, behaviour or social interaction of your child, it’s a good idea to contact your paediatrician.
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