WASHINGTON -- This is the time of year when many parents struggle with long back- to-school lists.
For many families, a trip to the pediatrician is the top priority. Doctors' offices are packed with children who need health updates before returning to their respective classrooms this fall.
Dr. Toni Thompson-Chittams, with TLC Pediatrics in Bowie, Maryland, says the goal is to ensure students are healthy and up to date with immunizations.
"You want to make sure they are growing and developing well," she says. That requires checking everything from their ears to their posture.
It also means doctors should ask lots of questions and offer guidance on everything -- from how many hours of sleep children should get on school nights to the need to cut back on sugary sodas.
All those questions and all that counseling are just as important -- perhaps more so -- when elementary school children morph into teenagers.
"The need is sometimes even stronger for our teenagers," says Dr. Kirsten Hawkins, chief of adolescent medicine at MedStar Georgetown University Hospital.
At that age, the conversation shifts to covering preventive health issues, ranging from wearing sunscreen to using a helmet when biking or snowboarding.
And there's no denying the onset of puberty becomes a big part of the doctor- patient-parent discussion.
"A lot of what we do in our practice is ... preparation and talking about it," Hawkins says.
She says the staff in her teen clinic tries to prepare families for what lies ahead; as teenagers move from dependence to independence, they start making decisions that have a lifelong impact.
Doctors are keeping an eye on the growth of hypertension and type-2 diabetes in teenagers. Those screenings have been added to the typical wellness visit for that age group.
"We really want to prevent these adult conditions from starting in our teenage years," Hawkins says.
In the District of Columbia, all public school students, regardless of age, are required to have one wellness visit with a doctor every 365 days. It doesn't have to be during the rush to go back to school, but it often happens that way.
Maryland and Virginia do not require annual wellness exams, although, as in D.C., medical clearance from a doctor is needed before a student can participate in school sports.
The local jurisdictions are fairly consistent when it comes to immunization requirements for pre-school and elementary school-aged children, all of which can be found on the official Maryland, Virginia and D.C. government websites.
There are some variations in requirements for tweens and teens.
D.C. requires the HPV vaccine for middle school girls and boys, giving parents the option to opt out. Virginia requires it only for girls, with a similar opt out provision.
Maryland does not yet require it at all.
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