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Your Checkup Checklist: 3 Years Old

Your 3-year-old is becoming a self-determined individual. Whether getting dressed, climbing stairs or washing hands, they may prefer to do it "all by myself." Now that they can be understood most of the time, 3-year-olds can also negotiate. Don't be surprised if they tell you exactly what they want to eat or wear.

At this age, your child may talk more with other kids when they play together. Your 3-year-old is also beginning to develop a sense of right and wrong, and can follow simple rules. Imaginative play appears, along with the ability for simple games like matching things. Supervised playdates with other children and structured preschool will help them develop many skills.

Although 3-year-olds want to do more and can do more by themselves, supervision and rules are important. They have a strong urge to explore and learn, but have not yet developed a sense of good judgment.

What to expect at the 3-year well-child visit

At the 3-year-old checkup, your pediatrician will perform a complete physical exam and ask about your concerns. The doctor also will focus on reading and language development, healthy nutrition, and the prevention of safety risks like falls from windows, firearms and navigating street crossings and parking lots.

Here's what else to expect at this visit:

✅ Immunizations

Your child likely will be caught up with vaccinations, but any missed or delayed will be given at this visit. As always, your pediatrician will recommend the influenza (flu) vaccine during flu season, and talk about the latest COVID-19 guidelines. If your child needs a vaccine, the CDC offers tips to make it less stressful. See "Vaccines Your Child Needs by Age 6."

✅ Health Screenings

Your pediatrician will perform a full physical exam including a vision and oral health screening. The doctor will screen for risks like exposure to lead, which can be found in some water pipes, paint in homes built before 1978, and some toys. Because exposure affects IQ and development, the CDC has developed a program around lead poisoning prevention.

Also, pediatricians will take time during this visit to address possible needs around food security, child care, and safe living conditions. If needed, your doctor can provide community resources offering housing, food and social support.

Questions your pediatrician may ask

✅Developmental Screenings

If you child is not meeting CDC developmental milestones, or if there are things your child does or can't do that concerns you, bring those up during your visit. Don't wait out any concerns. Your child may need to see a specialists for more evaluation. Or, screenings and some intervention services may be available through your local elementary school.

Positive family interactions are extremely important at this age. This is a time to discipline by praising positive behaviors, and using time-outs for behaviors like hitting or biting. Your pediatrician may observe how you interact with your child. They may also ask how you reinforce limits and settle conflicts.

If they haven't already, your doctor will ask about preschool plans. If you choose not to enroll your child in child care or preschool, they can suggest other ways to build school readiness.

Questions your pediatrician may ask

  • Has anything changed at home since your last visit?

  • Is your child potty trained?

  • Can your child put on a piece of clothing like a jacket or shirt? Can your child pedal a tricycle?

  • Has your child lost any skills they once had?

  • When shown how to draw a circle, can your child draw one? Can they use scissors, a fork?

  • How does your child play with other children?

  • How much screen time is your child getting?

Questions you may have

❓ Did you know
A child's appetite often drops at this age because their growth rate is slower. Caregivers should offer nutritious foods, but let the child eat as much or as little as they want. Making substitute foods to entice a child to eat can encourage picky eating.

✅Feeding & Healthy Nutrition

It's not unusual for a child's appetite to drop at this age. Provide healthy options; then allow your child to decide how much to eat. Your child may eat one regular meal, and consume the rest of their calories in small meals and snacks. Your pediatrician may ask about what your child has to drink. Be aware that many drinks, other than milk, offer little nutritional value.

Questions your pediatrician may ask

  • Do you consider your child a healthy eater?

  • What do you do if your child doesn't eat what you've made?

  • What does your child drink each day? How much water and milk?

Questions you may have

✅Safety

Safety is a big concern for this age because the leading cause of death for young children is unintentional injury.

Questions your pediatrician may ask

  • Is your child still using a rear-facing car safety seat installed in the back seat of your car?

  • Are you still cutting up foods like grapes and hot dogs into small pieces?

  • Do you use window guards for windows on the second floor or higher?

  • Are there firearms in the home? If so, are they locked in a secure place?

  • How are you practicing pool and water safety?

Questions you may have

✅ Communication Tips

Your pediatrician's top priority is to attend to your concerns. Be sure to bring them to your doctor, who may refer you to care elsewhere if it is after hours or if a specialist is needed. Pediatricians also can refer you to resources available in your community.

More information

Last Updated
10/31/2022
Source
Adapted from Bright Futures, 4th Edition (American Academy of Pediatrics Copyright © 2022)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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