By the time your child reaches his or her fifth birthday, he or she will have undergone a total of ten U examinations; the U8 examination is already the ninth in this series. Therefore, you and your child are probably already quite experienced in terms of the timing and organization of a checkup for children.

Perhaps your child will be especially excited before the appointment because he or she has so many tasks to accomplish. Talk to your child in advance about what to expect at the pediatrician’s office. Also, motivate your child not to refuse to do the tasks. After all, the pediatrician wants to know exactly what your child can already do – and where he or she might still need some help.

In this article you can read about the age at which the U8 examination is carried out, how it works and what your child should be able to do. You will also learn how you can practice with your child in advance and what questions the pediatrician will ask you.

How To Find The Best Time For The U8 Examination

Ideally, you should have completed the U8 examination with your child at the pediatrician between the 46th and 48th month of life. At this point, your child is about to celebrate his or her fourth birthday or has already celebrated it.

Now this period is quite tight, especially in view of the fact that many pediatrician’s offices are already overloaded. For this reason, you can generally have the U8 performed between the 43rd and 50th months of your child’s life.

Many pediatricians advise that preventive examinations should be carried out as late as possible. After all, the U8 examination, as well as every other preventive examination for children, takes a close look at what your child can already do and what he or she cannot yet do.

Since children develop at different speeds and can master some things earlier or later, a later appointment makes more sense. At this time, it is highly likely that your child will be able to cope with all the demands made on him or her at the U8 examination.

Compulsory Or Not? Here You Will Find The Answer

In principle, there is no legal obligation to have U examinations such as U8 actually performed. Nevertheless, the screenings are mandatory in most federal states.

The authorities are interested in ensuring that every child grows up healthy and, if necessary, receives the support it needs. The following list shows whether the U8 examination is mandatory in your state:

• Baden-Württemberg: mandatory.
• Bavaria: obligatory, will be checked at the start of school.
• Berlin: mandatory.
• Brandenburg: mandatory.
• Bremen: mandatory.
• Hamburg: not obligatory, but must be verified at the latest at the start of school.
• Hesse: mandatory.
• Mecklenburg-Western Pomerania: mandatory.
• Lower Saxony: mandatory.
• North Rhine-Westphalia: mandatory.
• Rhineland-Palatinate: mandatory.
• Saarland: obligatory.
• Saxony: mandatory.
• Saxony-Anhalt: not mandatory.
• Schleswig-Holstein: mandatory.
• Thuringia: mandatory.

It can often be read on the Internet that U examinations are only mandatory in Baden-Württemberg, Bavaria, and Hesse. However, this is not correct, as almost every federal state ensures compliance with every single preventive examination for children, including the U8 examination.

In almost all federal states, families who fail to comply with these examinations are reported to the health authorities by the pediatrician. To ensure that no one misses U examinations such as the important U8, reminders are also sent out in many places – often by the health insurance companies or the local authorities.

What Happens If You Don’t Go To The U-examination?

Of course, in the stress of everyday life, despite reminders or notes on the kitchen wall, it can happen that you forget the U8 examination. Sometimes the pediatrician’s receptionist can’t find a free appointment in the period in question.

To avoid the latter, you should make an appointment for the U8 examination as early as possible. The best time to make an appointment is right after the last U8 examination, before you and your child leave the doctor’s office. Many pediatricians ask that you make an appointment for the U8 examination at least six months before it is due so that scheduling difficulties can be avoided.

However, what happens if you miss the U8 examination despite everything? In this case, it depends on which federal state you live in: In Bavaria or Hamburg, nothing happens for the time being, but you must be able to present the missed U examination by the time of the school entry examination at the latest. Before school enrollment, the responsible public health officer will check whether all preventive examinations have been completed.

In other federal states (e.g. Mecklenburg-Western Pomerania), your pediatrician reports the U8 examination to the regional authorities. As a rule, this is the public health department. If there is no response two months before the deadline, the office will send a reminder to your family.

Now you have to react: Make an appointment for the U8 examination with your pediatrician and inform the health department in writing. If this does not happen, or the appointment for the U8 is not kept, then again a report is made to the Youth Welfare Office – which will again pay you and your family a home visit. Of course, it does not have to come to that.

What Your Child Should Be Able To Do By The U8 Examination

At the U8 examination, the pediatrician will check your child’s language, motor, and social skills. For this purpose, you must also fill out a parent questionnaire, in which about 35 questions are asked about the various developmental areas. In addition, your child will be asked at U8 to:

• Draw and color a circle.
• Draw a person.
• Cut something out with scissors.
• Stand on one leg without holding on for at least three seconds.
• Jump forward at least 20 centimeters with closed legs.
• Tell a short story or experience.

If your child can’t draw a person yet: Don’t worry, he doesn’t have to yet. The pediatrician just wants to see if his mental development is appropriate for his age.

Most four-year-olds can draw a stick figure or a head and a belly with arms and legs on it without any problems. If your child draws five fingers on each hand, the picture is perfect.

Your child’s language ability is tested by asking a nurse or the pediatrician to describe a scene from a picture book or tell about an experience (such as your last trip to the zoo). Your child should use different adjectives and connect his sentences “with and then”.

In addition, your pediatrician will check the correct pronunciation of the words, which of course does not have to be perfect at this age. However, some children have a pronounced lisp or are not yet able to articulate certain sounds. This is how you can support your child in speaking.

Optimally Prepared: How To Help Your Child Pass The U8 Examination

You can prepare your child for this part of the U8 examination at home by practicing these skills with him or her:

• Cutting out different shapes (circles, triangles, squares) with scissors.
• Drawing shapes and people (make sure the pencil is held correctly!).
• Telling a story (e.g., about a scene from a favorite picture book).
• Tell about an experience (e.g., a visit to the zoo, a sleepover at Grandma’s).
• Standing on one leg (always alternating left and right).
• To hop with both legs.

Repeat these exercises over and over and incorporate them into your daily routine in a playful way. For example, let your child tell you about his day in kindergarten and ask him open-ended questions (where a “yes” or “no” answer is not enough).

Do not correct any mistakes, but repeat your child’s statements using correct grammar and words. You can make cutting and drawing more exciting by practicing the little men and shapes, perhaps as part of a craft project.

Many boys don’t like to craft or draw. However, they quickly catch fire when they get to create their favorite characters or toys themselves.

Don’t Be Afraid Of The U8 Examination: What The Doctor Does

As with other U examinations, your child will first be measured: Body length, weight, and head circumference give the pediatrician information about whether your child is developing according to age. In addition, these measurements provide information about whether your child is still within his or her percentile.

Major deviations from the growth curve sometimes indicate hidden diseases or developmental problems. As with other U examinations, a urine sample must be taken at U8 to rule out possible kidney problems or cystitis.

On this occasion, your pediatrician will also ask whether your child is already dry and when (or if) he or she might still need a diaper. Occasional defecation or wetting are still perfectly normal at this age, as is nighttime diapering.

When your child’s blood pressure is measured, which is also obligatory, it should be around 90/60 mmHg. The pediatrician will then give your child a thorough physical examination. The U8 examination checks whether:

• The internal organs are healthy and working properly.
• The skeleton is healthy and the spine does not show any curvature.
• The feet have a normal arch and there are no deformities.
• Your child walks on the whole foot and not only on the tips of the toes.
• When walking, the foot rolls.
• Your child keeps his back straight and can make it round.
• The sexual organs are developed according to age and are healthy.
• There is no undescended testicle or narrowing of the foreskin in boys.
• There are abnormalities in the skin, such as a rash or special sensitivities.

In addition, the pediatrician performs an eye test and a hearing test at the U8 examination to rule out any visual defects or hearing problems. Vision is tested at U8 with the help of a board on which your child has to recognize and name certain symbols or pictures.

The hearing test, on the other hand, is carried out at many U examinations with the help of headphones. If both tests are not done, please talk to your pediatrician and ask why.

Perhaps he routinely sends his patients to the ophthalmologist as well as to the ear, nose, and throat specialist and therefore does not perform the tests himself. Also essential to the U8 examination is a check of the child’s dentition or a referral to the dentist.

Allow Plenty Of Time For The U8 Examination

Compared to the previous U examinations, you will have to plan quite a lot of time for the U8 examination: it takes around one and a half to two hours with all the tests and examinations. For this reason, you should take your child for the U8 examination in the morning, if possible, when he or she has had a good night’s sleep and breakfast.

Some pediatricians split the U8 examination into two appointments, usually one for the physical examinations and one for the speech and motor tests.

U8 Examination: Vaccination Or Not?

According to plan, no vaccination is scheduled for the U8 examination. However, it may happen that any missed vaccinations have to be made up.

Failed The U8 Examination? This Is What Happens Now

Don’t worry: There is no such thing as a failed U8 examination. It doesn’t matter if your child can’t do some things yet or not so well. In the case of abnormalities or a need for support, the pediatrician will probably recommend that you go to an orthopedist.

• Going to the orthopedist (for shoe inserts, for example).
• Make an appointment with the eye doctor.
• Going to the dentist every six months.
• If the child has speech defects or a speech development delay, take the child to speech therapy.
• To go to occupational therapy for (fine) motor development or social deficits.

No one is obligated to actually follow these recommendations. However, it is in your child’s best interest to follow the advice of your pediatrician. Many a later school problem could have been solved by early visits to a speech therapist or an occupational therapist.