What questions should be asked during a 3-year-old well-child exam for a new patient?

Key Questions for a 3-Year-Old Well-Child Exam (New Patient)

For a comprehensive 3-year-old well-child exam for a new patient, healthcare providers should ask specific questions about development, behavior, safety, and family concerns to identify potential health issues early and provide appropriate interventions.

Medical and Developmental History

• Ask about birth history, past hospitalizations, surgeries, and any known medical conditions 1
• Inquire about current medications, allergies, and immunization status 1
• Ask parents: "Is there anything your child is not doing that you think he or she should be able to do?" to identify potential developmental concerns 2
• Ask: "Is there anything your child is doing that you are concerned about?" to identify potential coordination or movement issues 2
• Ask: "Is there anything your child used to be able to do that he or she can no longer do?" to identify potential regression of skills 2
• Inquire about the child's ability to follow objects with their eyes, maintain fixation, and visual tracking abilities 2

Family and Social History

• Ask about family composition, including who lives in the home and recent changes in family structure 3
• Inquire about family history of eye disorders or early childhood use of glasses in parents or siblings 2
• Ask: "Has anything scary or concerning happened to you or your child since the last visit?" to screen for potential trauma exposure 2
• Assess for family stressors that might impact the child's development and well-being 3

Vision and Hearing Assessment

• Ask parents about any observations regarding the quality of the child's vision and eye alignment 4
• Inquire about the child's response to sounds and language development 4
• Ask about any concerns regarding the child's ability to see or hear 2

Tobacco and Environmental Exposures

• Ask: "Does anyone who provides care for your child smoke?" 2
• Ask: "Does your child visit places where people smoke?" 2
• Ask: "Does anyone ever smoke in your home?" 2
• Ask: "Does anyone ever smoke in your car?" 2
• Ask: "Do you ever smell smoke from your neighbors in or near your home or apartment?" 2
• Inquire about potential exposure to electronic nicotine delivery systems (vaping) 2

Nutrition and Growth

• Ask about diet and nutrition patterns, including typical meals, snacks, food preferences, and any allergies or intolerances 3
• Inquire about feeding habits, including appetite, picky eating, and mealtime behaviors 1
• Ask about juice and sugar-sweetened beverage consumption, which should be limited in young children 1

Sleep Patterns

• Ask about sleep duration, bedtime routines, and any sleep disturbances 3
• Inquire about difficulties falling or staying asleep, snoring, or bedwetting 3

Behavior and Social Development

• Ask about the child's ability to communicate needs and wants 1
• Inquire about play behaviors, including imaginative play and interaction with other children 1
• Ask about toilet training status and any challenges 1
• Ask about behavior management challenges and discipline approaches 3

Safety Assessment

• Ask about home safety measures, including smoke detectors, carbon monoxide detectors, and gun safety if applicable 3
• Inquire about car safety seat use and positioning (should remain rear-facing until at least 2 years of age) 1
• Ask about supervision during bathing and around water 3
• Inquire about childproofing measures in the home 3

Screen Time and Media Use

• Ask about screen time habits, including television, computer, video games, and mobile devices 3
• Inquire about parental monitoring of media content 3

Dental Health

• Ask about dental care routines, including tooth brushing frequency and fluoride use 1
• Inquire about dental visits and any concerns about teeth or oral health 1

Special Considerations

• For children with chronic conditions, ask specific questions about symptom management and impact on daily activities 3
• Consider using standardized screening tools to identify potential developmental or behavioral concerns 2

Remember that a 3-year-old child should be able to engage in the examination process with appropriate preparation. Explaining procedures in simple, age-appropriate language and offering praise for cooperation will help facilitate a successful examination 2.