Originally created 07/31/00

Make sure your child gets a healthy start



Before a child starts the school year, it's important for him or her to have a complete physical examination and be updated on vaccinations.

The Center for Disease Control recommends that children have three Hepatitis B shots, five Ditheria, Tentanus and Pertissis shots, three H. Influenzae type B shots, four polio vaccinations, two measles, mumps and rubella shots and one varicella shot by the time they are six years old. Vaccinations can be obtained from regular pediatricians or local health departments.

Eye exams

According to Michael X. Repka, M.D., a Hopkins pediatric ophthalmologist, many school-age children have vision problems that can result in educational difficulties. A comprehensive eye exam by a professional can help ensure a child's eyes are ready for the school year. All children should have their eyes examined at six months of age and again by age 4 for visual acuity, presence of cataracts, alignment problems, and eye diseases.

The standard Snellen "E" chart has been widely used and is well accepted for preschoolers, Repka says. Children under 5 should read the 20/40 (next to smallest) line with both eyes. If there is a two-line difference in vision between eyes, children should be referred to an eye doctor for examination.

Children who are 5 or older should have their eyes examined regularly during pediatric visits or between visits if they complain of vision problems. Repka encourages additional screening by school and other volunteer organizations.

Head lice

Head lice can be avoided if parents and teachers work together, said Alain Joffe, M.D., director of adolescent medicine at the Children's Center.

Lice are most often transferred by head-to-head contact. But it is also possible for a child to get them by using another child's towel, brush, comb or hat. Lice look like dandruff, but the small, white creatures adhere to the hairs rather than the scalp. They are most often located behind the ears or near the nape of the neck.

"A child with lice must be removed from school immediately. He or she can then return the morning after completing the treatment," Joffe said.

Parents of the child's classmates should be alerted so they can check their children for infestation.

Head lice are no cause for shame; they don't result from poor hygiene. Effective shampoo treatments are available over the counter and by prescription.

School phobias

For children who have had problems in previous school years, returning to the classroom can be a traumatic experience. For more information about how to handle school phobia's, click here.

-- Information from the Johns Hopkins Children's Center