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Ages & Stages

Your Checkup Checklist: 6 Years Old

By age 6, most kids will begin to have deeper thoughts and emotions. They may begin to think about the future and ask questions about what it could look like. This is an important time for your child's curiosity to develop.

Activities such as school bring children this age into regular contact with the larger world. A 6-year-old likely has attended kindergarten and is entering first grade. If you live in a state where full-day kindergarten is not mandatory, then this could be the first time your child will be in school for over 6 to 8 hours at a time. Make sure to talk with them about what their school days will look like and listen to any concerns they may have.

What to expect at the 6-year well-child visit

Like last year's visit, your pediatrician will ask your child questions directly. The doctor may ask about their experience in kindergarten and how they are They may also ask your child what they do with their friends or at home. This helps show your child's social and emotional development.

Here's what else to expect at this visit:

✅ Immunizations

By 6 years old, your child will need several booster shots. They will receive the fifth dose of the DTaP (diphtheria, tetanus, and acellular pertussis), fourth dose of the polio, second dose of the MMR (measles, mumps, and rubella) and second dose of the varicella (chickenpox) vaccines. These are usually given between the 4th and 6th birthdays. Your pediatrician will recommend the influenza (flu) vaccine during flu season and discuss the latest COVID-19 guidelines.

Schools typically require proof of vaccination, and your child's pediatrician can give you this record. Some states may require additional vaccines, so check with your child's school to confirm what they will need. If your child is beginning a new school after kindergarten, make sure to check if they require additional vaccinations. You can use these tips to make getting a shot less stressful.

✅ Health Screening

Your child's pediatrician will perform a full physical exam for your child which includes hearing and vision screenings. Your child may also be screened for lead exposure, dyslipidemia (lipid profile), and other health conditions if they are at risk. If your child does not see a dentist, then your child's pediatrician will perform an oral health exam.

Your pediatrician will also ask about your child's safety in your neighborhood, at extracurricular activities, and at school. They may ask if you know their friends, teachers, and other adults in your child's life. They want to make sure your child is safe in your neighborhood and in other spaces. If needed, your doctor can provide community resources that discuss housing, food, and social support.

Questions your pediatrician may ask you

  • Has your child received any specialty or emergency care since the last visit? Has your child or anyone in the family developed a new health condition?

  • Do you have any worries about your child's development or learning? What concerns you about your child's academics?

  • Do you feel safe in your home? Has your child said they do not feel safe at home or in school?

  • Are you concerned about anyone in your home drinking, smoking, or using drugs?

Questions your pediatrician may ask your child

  • What is something you are good at in school? What is one thing you are good at outside of school?

  • Do you have any questions about your health today?

✅ Developmental Screenings

At 6 years old, your child will feel more confident in their movement, speech and play. This is evidence of their growth and developmental. Kids this age can typically balance on one foot, hop and skip around. If they are involved in sports, you may see improvement in their movement and skills. Most children this age will also be able to tell stories using full sentences with appropriate tenses and pronouns.

The doctor will also focus on your child's progress in school during the visit. They will ask about their experience in kindergarten, if they can follow directions from teachers, and play in a respectful way with others. If your child received a report card or evaluation, your doctor may ask what areas they scored high in and where they struggled.

Your child can have big feelings about school, and you should bring these up to their pediatrician. It is also important to talk with your child's teachers about their education progress. Some children will struggle in school; if your child seems to be falling behind in school, bring up concerns to your pediatrician. They may suggest screening for attention-deficit/hyperactivity disorder (ADHD) or other learning differences.

To learn more about your child's developmental milestones, try using our motor skills tool. Make sure to share any concerns with your pediatrician. They can offer next steps and referrals for further testing. Early intervention is key to getting your child the assistance they may need.

Questions your pediatrician may ask you

  • Do you know your child's friends and their families?

  • Does your child use kindness when playing with other kids? How does your child interact with adults in their life?

  • Can your child get themselves dressed?

  • Does your child spend time with friends outside of school?

  • Does your child set any goals for themselves?

Questions your pediatrician may ask your child

  • What is your favorite thing you have learned in school?

  • Do you do any sports, clubs or other activities outside of school?

Questions you may have

  • Should I limit screen time for my child?

  • My child is acting out during school, how can I help?

  • What can I do with my child at this age?

Did you know: Even though 6-year-olds are in school, they still learn a great deal of emotional skills from their first role models: their parents. Setting a good example of patience and kindness can help your child deal with new feelings.

✅Feeding & Healthy Nutrition

6-year-old kids will spend a great deal of their time in school and outside the home. This means that they may be expected to make their own choices about meals and snacks. If your child receives breakfast and lunch from their school, it is important that they know what eating choices are healthy. With nutritious eating practices put in place at home, kids can learn how to make healthy choices.

If you pack your child lunch or snacks for school, it is important to provide them with balanced options and nutritious food. Providing your children with choices in their own lunch will give them more control over their eating patterns. It will also help them learn how to make these healthy choices on their own.

Questions your pediatrician may ask you

  • Does your child eat school lunch? Do you know what they serve?

  • Do you pack your child's lunch? What options do you provide them?

  • How active is your child?

  • Does your family eat together? It is important for mealtimes to be social, without cell phones and TV competing for attention.

  • How much screen time does your child get? Do you have a family media plan?

Questions your pediatrician may ask your child

  • Do you eat breakfast before school? It helps you learn more during the day.

  • What is your favorite healthy food you eat at school? What about at home?

  • Do you ever help make meals or snacks at home?

Questions you may have

  • What can I do if my child is a picky eater?

  • What snacks can I give my child?

  • My child won't drink milk. What should I do?

  • How can I make sure my child gets all their vitamins?

✅ Safety

Injuries are the greatest threat to the health of your child, but you can help prevent most major injuries. Your 6-year-old is becoming more independent and is able to do more things that are dangerous. As your child spends more time with friends and at school, it is important they know basic safety rules.

At this age, your child will try to prove that they are a grown up, but it is important to set boundaries with them. Parents must teach street safety, basic swimming skills, and car safety. 6-year-olds will also begin to use a booster seat, and parents must always check to be sure he or she is buckled in the seat correctly.

Children in homes where firearms are present are in more danger of being shot by themselves, family or friends than by an intruder. If you have a gun in the house, keep it unloaded and in a locked place with the ammunition locked separately. It is also important to ask if homes where your child visits have guns and how they are stored.

Questions your pediatrician may ask you

Questions your pediatrician may ask your child

  • How do you typically cross the street?

  • What seat do you sit in when riding in the car?

  • Do you know your family's address and phone numbers?

Questions you may have

✅ Communication Tips

Your pediatrician's top priority is to attend to your concerns. They can refer you elsewhere if specialty care is needed or if it is after hours. Pediatricians can also refer you to resources available in your community.

More information

Last Updated
American Academy of Pediatrics (Copyright @ 2023)
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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