What questions should be asked during a 3-year-old well-child visit?

Key Questions for a 3-Year-Old Well-Child Visit

The most important questions to ask during a 3-year-old well-child visit should focus on development, behavior, safety, nutrition, and family dynamics to ensure optimal health outcomes and early identification of potential concerns.

Developmental Assessment

• Ask parents about any developmental concerns with questions like "Is there anything your child is not doing that you think he or she should be able to do?" to identify potential developmental delays 1
• Inquire about regression of skills with questions such as "Is there anything your child used to be able to do that he or she can no longer do?" to identify potential developmental regression 1
• Ask about language development, including vocabulary size, sentence formation, and ability to follow directions 1
• Assess fine and gross motor skills through questions about drawing, self-dressing abilities, climbing, and coordination 1

Behavioral and Social Development

• Ask about behavior management challenges and discipline approaches to understand parental strategies 1
• Inquire about social interactions with other children, sharing behaviors, and play preferences 1
• Ask about toilet training progress and any challenges or concerns 1
• Assess temperament, emotional regulation, and any concerning behaviors such as aggression or excessive tantrums 1

Family and Social Environment

• Ask about family composition, including who lives in the home and any recent changes in family structure 1
• Screen for potential trauma exposure by asking "Has anything scary or concerning happened to you or your child since the last visit?" 1
• Inquire about childcare arrangements and any concerns with daycare, preschool, or other caregivers 1
• Assess family stressors that might impact the child's well-being 1

Nutrition and Growth

• Ask about diet and nutrition patterns, including typical meals, snacks, food preferences, and any allergies or intolerances 1
• Inquire about appetite, picky eating behaviors, and mealtime routines 1
• Ask about milk and juice consumption, as limiting or avoiding juice may improve dental health 2
• Discuss transition from bottles to cups if not already completed, as weaning to a cup by 12 months of age may improve dental health 2

Sleep Patterns

• Ask about sleep duration, bedtime routines, and any sleep disturbances 1
• Inquire about difficulties falling or staying asleep, night waking, nightmares, or bedwetting 1
• Ask about napping patterns and any recent changes in sleep habits 1

Safety Assessment

• Inquire about home safety measures, including smoke detectors, carbon monoxide detectors, and gun safety if applicable 1
• Ask about supervision during bathing and around water to assess potential drowning risks 1
• Inquire about car seat use and positioning, as car seats should remain rear-facing until two years of age or until the height or weight limit for the seat is reached 2
• Ask about childproofing measures in the home to assess potential injury risks 1

Screen Time and Media Use

• Ask about screen time habits, including television, computer, video games, and mobile devices 1
• The American Academy of Pediatrics recommends limiting screen time to one hour per day for children 2-5 years of age 2
• Inquire about parental monitoring of media content 1

Vision and Hearing Assessment

• Ask about any concerns regarding the child's ability to see or hear 1
• Inquire about the child's response to sounds and language development to assess auditory function 1
• Ask parents about any observations regarding the quality of the child's vision and eye alignment 1

Dental Health

• Ask about dental care routines, including tooth brushing frequency and fluoride use 2
• Inquire about dental visits and any concerns about teeth or oral health 2
• Ask about bottle or sippy cup use, especially at bedtime 2

Environmental Exposures

• Ask about tobacco exposure, including "Does anyone who provides care for your child smoke?" 1
• Inquire about potential exposure to electronic nicotine delivery systems (vaping) 1
• Ask about potential exposure to environmental hazards, including lead, mold, or other toxins 1

Common Pitfalls and Caveats

• Avoid closed-ended questions that can be answered with yes/no, as they may not elicit complete information about developmental concerns 3
• Remember that parents may not volunteer information about developmental concerns unless specifically asked 3
• Be aware that the average well-child visit lasts about 20 minutes, so prioritizing questions based on individual child needs is essential 4
• Consider using standardized screening tools to supplement parent interviews for more comprehensive assessment 1
• Recognize that children with special health care needs may require more time and additional targeted questions 4