Well-Child Checkup: 11 to 13 Years
Well-Child Checkup: 11 to 13 Years
Between ages 11 and 13, your child will grow and change a lot. It’s
important to keep having yearly checkups so the healthcare provider can track this
progress. As your child enters puberty, he or she may become more embarrassed about
a checkup. Reassure your child that the exam is normal and necessary. Be aware that
healthcare provider may ask to talk with the child without you in the exam room.
School and social issues
Here are some topics you, your
child, and the healthcare provider may want to discuss during this visit:
School performance. How is
your child doing in school? Is homework finished on time? Does your child stay
organized? These are skills you can help with. Keep in mind that a drop in school
performance can be a sign of other problems.
Friendships. Do you like your
child’s friends? Do the friendships seem healthy? Make sure to talk to your child
about who his or her friends are and how they spend time together. This is the age
when peer pressure can start to be a problem.
Life at home. How is your
child’s behavior? Does he or she get along with others in the family? Is he or she
respectful of you, other adults, and authority? Does your child participate in
family events, or does he or she withdraw from other family members?
Risky behaviors. It’s not too
early to start talking to your child about drugs, alcohol, smoking, and sex. Make
sure your child understands that these are not activities he or she should do,
even if friends are. Answer your child’s questions, and don’t be afraid to ask
questions of your own. Make sure your child knows he or she can always come to you
for help. If you’re not sure how to approach these topics, talk to the healthcare
provider for advice.
Puberty is the stage when a child
begins to develop sexually into an adult. It usually starts between 9 and 14 for girls,
and between 12 and 16 for boys. Here is some of what you can expect when puberty
Acne and body odor. Hormones
that increase during puberty can cause acne (pimples) on the face and body.
Hormones can also increase sweating and cause a stronger body odor. At this age,
your child should begin to shower or bathe daily. Encourage your child to use
deodorant and acne products as needed.
Body changes in girls. Early
in puberty, breasts begin to develop. One breast often starts to grow before the
other. This is normal. Hair begins to grow in the pubic area, under the arms, and
on the legs. Around 2 years after breasts begin to grow, a girl will start having
monthly periods (menstruation). To help prepare your daughter for this change,
talk to her about periods, what to expect, and how to use feminine products.
Body changes in boys. At the
start of puberty, the testicles drop lower and the scrotum darkens and becomes
looser. Hair begins to grow in the pubic area, under the arms, and on the legs,
chest, and face. The voice changes, becoming lower and deeper. As the penis grows
and matures, erections and “wet dreams” begin to happen. Reassure your son that
this is normal.
Emotional changes. Along with
these physical changes, you’ll likely notice changes in your child’s personality.
You may notice your child developing an interest in dating and becoming “more than
friends” with others. Also, many kids become moody and develop an attitude around
puberty. This can be frustrating, but it is very normal. Try to be patient and
consistent. Encourage conversations, even when your child doesn’t seem to want to
talk. No matter how your child acts, he or she still needs a parent.
Nutrition and exercise tips
Today, kids are less active and eat
more junk food than ever before. Your child is starting to make choices about what
eat and how active to be. You can’t always have the final say, but you can help your
child develop healthy habits. Here are some tips:
Help your child get at least
30 to 60
minutes of activity every day. The time can be broken up throughout the day. If
the weather’s bad or you’re worried about safety, find supervised indoor
Limit “screen time” to
1 hour each
day. This includes time spent watching TV, playing video games, using the
computer, and texting. If your child has a TV, computer, or video game console in
the bedroom, consider replacing it with a music player. For many kids, dancing and
singing are fun ways to get moving.
Limit sugary drinks. Soda,
juice, and sports drinks lead to unhealthy weight gain and tooth decay. Water and
low-fat or nonfat milk are best to drink. In moderation (no more than 8 to 12
ounces daily), 100% fruit juice is OK. Save soda and other sugary drinks for
Have at least one family meal
together each day. Busy schedules often limit time for sitting and talking.
Sitting and eating together allows for family time. It also lets you see what and
how your child eats.
Pay attention to portions.
Serve portions that make sense for your kids. Let them stop eating when they’re
full—don’t make them clean their plates. Be aware that many kids’ appetites
increase during puberty. If your child is still hungry after a meal, offer seconds
of vegetables or fruit.
Serve and encourage healthy
foods. Your child is making more food decisions on his or her own. All foods have
a place in a balanced diet. Fruits, vegetables, lean meats, and whole grains
should be eaten every day. Save less healthy foods—like french fries, candy, and
chips—for a special occasion. When your child does choose to eat junk food,
consider making the child buy it with his or her own money. Ask your child to tell
you when he or she buys junk food or swaps food with friends.
Bring your child to the
dentist at least twice a year for teeth cleaning and a checkup.
At this age, your child needs about
10 hours of
sleep each night. Here are some tips:
Set a bedtime and make sure
your child follows it each night.
TV, computer, and video games
can agitate a child and make it hard to calm down for the night. Turn them off at
least an hour before bed. Instead, encourage your child to read before bed.
If your child has a cell
phone, make sure it’s turned off at night.
Don’t let your child go to
sleep very late or sleep in on weekends. This can disrupt sleep patterns and make
it harder to sleep on school nights.
Remind your child to brush
and floss his or her teeth before bed. Briefly supervise your child's dental
self-care once a week to make sure of proper technique.
Recommendations for keeping your
child safe include the following:
When riding a bike,
roller-skating, or using a scooter or skateboard, your child should wear a helmet
with the strap fastened. When using roller skates, a scooter, or a skateboard, it
is also a good idea for your child to wear wrist guards, elbow pads, and knee
In the car, all children
younger than 13 should sit in the back seat. Children shorter than 4'9" (57
inches) should continue to use a booster seat to properly position the seat
If your child has a cell
phone or portable music player, make sure these are used safely and responsibly.
Do not allow your child to talk on the phone, text, or listen to music with
headphones while he or she is riding a bike or walking outdoors. Remind your child
to pay special attention when crossing the street.
Constant loud music can cause
hearing damage, so monitor the volume on your child’s music player. Many players
let you set a limit for how loud the volume can be turned up. Check the directions
At this age, kids may start
taking risks that could be dangerous to their health or well-being. Sometimes bad
decisions stem from peer pressure. Other times, kids just don’t think ahead about
what could happen. Teach your child the importance of making good decisions. Talk
about how to recognize peer pressure and come up with strategies for coping with
Sudden changes in your
child’s mood, behavior, friendships, or activities can be warning signs of
problems at school or in other aspects of your child’s life. If you notice signs
like these, talk to your child and to the staff at your child’s school. The
healthcare provider may also be able to offer advice.
Based on recommendations from the
American Association of Pediatrics, at this visit your child may receive the following
Human papillomavirus (HPV)
(ages 11 to 12)
Influenza (flu), annually
Meningococcal (ages 11 to
Tetanus, diphtheria, and
pertussis (ages 11 to 12)
Stay on top of social media
In this wired age, kids are much
more “connected” with friends—possibly some they’ve never met in person. To teach
child how to use social media responsibly:
Set limits for the use of
cell phones, the computer, and the Internet. Remind your child that you can check
the web browser history and cell phone logs to know how these devices are being
used. Use parental controls and passwords to block access to inappropriate
websites. Use privacy settings on websites so only your child’s friends can view
his or her profile.
Explain to your child the
dangers of giving out personal information online. Teach your child not to share
his or her phone number, address, picture, or other personal details with online
friends without your permission.
Make sure your child
understands that things he or she “says” on the Internet are never private. Posts
made on websites like Facebook, Myspace, and Twitter can be seen by people they
weren’t intended for. Posts can easily be misunderstood and can even cause trouble
for you or your child. Supervise your child’s use of social networks, chat rooms,
Online Medical Reviewer: Liora C Adler MD
Online Medical Reviewer: Pat F Bass MD MPH
Online Medical Reviewer: Heather Trevino
Date Last Reviewed:
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