Standard check-ups for children and teenagers

Straight after birth:

• The baby’s heartbeat, complexion, reflexes, muscle tension and breathing are checked.
• The baby is checked for external deformities and any injuries possibly due to the delivery process.
• Blood is taken from the umbilical cord. The pH level is checked to determine whether there’s enough oxygen in the baby’s blood.
• With the parents' consent, the baby is given a vitamin K shot to prevent bleeding.

Between the third and tenth day after birth:

• A physical examination is done, mostly to identify any diseases or deformities.
• With the parents' consent, the baby is given a second dose of vitamin K.
• The blood is tested for various metabolic disorders.
• A special hearing test is carried out so that any hearing problems can be detected at an early stage.
• A test method known as pulse oximetry screening is used to identify certain types of heart defect that the baby might already have.

In the fourth to fifth week after birth:

• A physical examination is carried out.
• With the parents' consent, the baby is given another dose of vitamin K.
• Gross and fine motor skill tests are done. For instance, the doctor will check to see whether the baby can hold its head up briefly while lying on its stomach and whether it opens its hand spontaneously.
• The baby’s perceptual skills are tested. For instance, can it track an object with its eyes? Does it look at familiar people when they approach it?
• Do rocking, singing or talking to the baby have a calming effect? Does the baby react appropriately to loud noises, bright light and touch?
• An ultrasound scan is carried out to check whether the baby’s hip joints are correctly positioned.
• Initial advice on vaccinations is given.

At the age of three to four months:

• A physical examination is carried out.
• The doctor assesses the baby’s development by checking whether it can bend and stretch all of its limbs, can hold its head up for at least 30 seconds whilst seated, tracks faces with its eyes, turns its head to see where a noise came from, can spontaneously move its hands to the middle of its body, enjoys being shown affection and reacts when spoken to.
• The doctor checks to see whether the baby seems happy, whether it attempts to make eye contact with its parents and whether being shown affection has a calming effect on it. The doctor will also look at the facial expressions and gestures the parents use and how the baby reacts to them.
• The doctor will also ask whether there are any problems with breastfeeding or bottle feeding, and whether the baby is very restless or cries a lot.

At the age of six to seven months:

• A physical examination is carried out.
• The doctor assesses the baby’s development by checking whether it pushes itself up with its palms on the floor and arms stretched, reaches for toys, forms simple chains of syllables, and reacts appropriately when shown affection.
• Checks are also carried out to make sure that the baby seems happy and attentive, smiles and attempts to make eye contact when it’s spoken to, can be soothed by rocking or by being spoken to, and reacts appropriately to loud noises or touch.
• The doctor will also check whether the baby cries a lot or is very restless.

At the age of ten to twelve months (just before the baby’s first birthday):

• A physical examination is carried out.
• The doctor assesses the baby’s development by checking whether it can sit up and whether it can roll from its back to its stomach and back again on its own, gives its parents an object they ask for, understands simple words and requests, can form double syllables like “da-da” and longer chains of syllables, imitates sounds, and can drink from a bottle on its own.
• Checks are also carried out to make sure that the baby seems happy and attentive, attempts to make eye and physical contact with people it knows, shows an interest in playing with its mother or father (with toy blocks, for instance), and can control its feelings in an appropriate way for its age (e.g. cope with minor disappointments).

At the age of 21 to 24 months (just before the baby’s second birthday):

• A physical examination is carried out.
• The doctor assesses the baby’s development by checking whether it can walk confidently, unpack small objects, say single words and follow simple commands, point to objects it knows in picture books, and play on its own for a short time.
• The doctor will also ask whether the baby is a good sleeper or whether it has problems falling asleep or sleeping through the night.

At the age of 34 to 36 months (just before the child’s third birthday):

• A physical examination is carried out.
• The doctor assesses the child’s development by checking whether they can jump from a low step onto the ground without any problems and without losing their balance, grasps things with their thumb, index and middle fingers, speaks in sentences of at least three words, knows their own name, can listen and engage in concentrated play, can be apart from their parents for several hours without any problems, play with other children, and enjoy the playing.
• Checks are also carried out to make sure that the child independently seeks contact with others and makes eye contact.

At the age of 46 to 48 months (just before the child’s fourth birthday):

• A physical examination is carried out.
• The child’s hearing is tested.
• The doctor assesses the child’s development by checking whether they can confidently ride a “balance bike” (a special bike with no pedals, designed to train toddlers’ sense of balance), can hold a pen properly between their thumb, index and middle fingers, speak in sentences of at least six words, ask why/how/where questions, can get dressed and undressed on their own, and play with other children of the same age.
• The doctor also asks about the child’s emotional development. These questions cover aspects such as: Can the child cope with minor disappointments? Do they seem happy or are they often sad? Do they cry a lot or have temper tantrums? Can they cope with being separated from loved ones or do they get anxious?

At the age of 60 to 64 months (usually just after the child’s fifth birthday):

• A physical examination is carried out.
• The doctor assesses the child’s development by checking whether they can hop on one foot, can catch a relatively large ball, can copy pictures of circles or squares, can say most words properly, can name at least three colors, can take turns when playing with other children and engage in role play with other children.
• The doctor also asks about the child’s emotional development. These questions include: Does the child seem happy or do they have specific anxieties? Is the child particularly impulsive and prone to temper tantrums?

All health insurers reimburse the costs of the U1-U9 examinations. Most health insurers also pay for the U10 and U11 examinations and supply special booklets for the results because they’re not included in the standard booklet.

The main aim of the U10 examination, which takes place between the ages of seven and eight, is to identify any learning disorders. But the doctor also assesses the child’s motor skills, emotional development and behavior (checking for signs of ADHD, for example).

The U11 examination, which is conducted between the ages of nine and ten, is intended to identify any learning difficulties, antisocial behavior or mental health problems. It also includes a dental check-up and questions about any problems related to diet, exercise or media consumption.

When the child reaches adolescence, there is another examination (“J1”), which statutory health insurers pay for. It takes place between the ages of 12 and 14. J1 comprises a physical examination, questions about the child’s development and any physical or mental health problems. It also includes an assessment of their vaccination status.

Some health insurers also cover the costs of the J2 examination for 16 to 17-year-olds. Apart from a physical examination, J2 focuses on issues relating to puberty, sexuality, mental health and nicotine/alcohol/drug consumption. In addition, it covers topics such as career interests, friendships and diet. The doctor will also offer any booster shots that are needed.