What are appropriate well‑child exam questions for a 9‑year‑old female?

Well-Child Exam Questions for a 9-Year-Old Female

For a 9-year-old female well-child exam, focus your questioning on developmental milestones, psychosocial screening using the HEADSSS framework, trauma exposure, vision and hearing concerns, pubertal development, allergic conditions, safety, and family dynamics.

Medical and Developmental History

• Ask parents directly: "Is there anything your child is not doing that you think she should be able to do?" to identify potential developmental delays 1
• Inquire about skill regression: "Is there anything your child used to be able to do that she can no longer do?" as regression warrants immediate evaluation 1, 2
• Screen for coordination or movement concerns: "Is there anything about your child's movement or coordination that concerns you?" to detect motor skill issues 2

Trauma and Psychosocial Screening

• Begin trauma screening with: "Has anything scary or concerning happened to you or your child since the last visit?" This question should be asked at every visit 1, 3
• Use the HEADSSS framework for age-appropriate psychosocial assessment covering Home environment, Education, Activities, Drugs, Sexuality (age-appropriate), Suicide/depression, and Safety 1, 3
• Ask about school performance and peer relationships to identify learning difficulties or social challenges 3

Vision and Hearing Assessment

• Ask: "Have you noticed any problems with your child's vision or the way her eyes look or move?" to screen for visual concerns 1, 2
• Inquire about family history of early childhood glasses use or eye disorders in parents or siblings to assess genetic risk 2
• Ask about hearing concerns and response to sounds to identify potential auditory issues 2

Pubertal Development and Gynecologic Screening

• Discuss pubertal changes and menstrual education proactively, as this age represents early puberty for many girls 1, 3
• Ask: "Have you noticed any changes in your body, such as breast development or body hair?" to assess pubertal stage 3
• Screen for cyclical abdominal pain, as this may indicate imperforate hymen or other anatomic concerns 3

Allergic Conditions Screening

• Ask specifically about history of asthma, eczema, hay fever, and food allergies, as allergic conditions are highly prevalent in school-age children and may correlate with developmental concerns 4, 5, 6
• Inquire: "Does your child have any allergies to foods, medications, or environmental triggers?" 5, 6
• Note that girls with earlier pubertal development may have increased risk of allergic conditions, particularly allergies and asthma 7

Family and Social History

• Ask about family composition: "Who lives in your home? Have there been any recent changes in your family?" to assess social support and potential stressors 1, 2, 3
• Screen for family history of diabetes, cardiovascular disease, mental illness, and substance abuse 3
• Inquire about intimate partner violence or substance abuse in the household 3

Safety Assessment

• Ask about home safety: "Do you have working smoke detectors and carbon monoxide detectors? If there are guns in the home, are they locked and stored separately from ammunition?" 2
• Screen for seatbelt use, helmet use during biking/skating, and water safety practices 3
• Assess supervision during activities and childproofing measures 2

Environmental Exposures

• Ask: "Does anyone who provides care for your child smoke cigarettes or use vaping products?" to assess tobacco and electronic nicotine exposure 1, 2

Nutrition, Sleep, and Screen Time

• Inquire about typical meals, snacks, food preferences, and any dietary restrictions or allergies 2
• Ask about sleep duration, bedtime routines, difficulties falling asleep, snoring, or bedwetting 2
• Screen for screen time: "How much time does your child spend on television, computers, video games, and mobile devices daily?" 2
• Ask about parental monitoring of media content 2

Behavioral and Emotional Health

• Inquire about behavior management challenges and discipline approaches used at home 2
• Screen for anxiety, mood changes, or emotional concerns 1, 3

Common Pitfalls to Avoid

• Do not skip confidential time alone with the patient, as 9-year-olds may begin to have concerns they won't share with parents present 3
• Do not dismiss parental concerns about development or behavior, as parents are often first to recognize problems 8
• Do not overlook the connection between allergic conditions and developmental or behavioral concerns, particularly ADHD and autism spectrum disorder 4