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The 4 Year Well Visit

All is Well Wednesday Week 13: 4 Years Old

Lucas is all smiles. He must know that the four year visit is a fun visit! They are full of personality and curious about what we are doing. You never know what they will say! 


  • Pure Tone Hearing


Your nurse will use a device similar to this that emits sounds across the speech spectrum (500-4000 Hz) to check the child’s hearing. Each ear is assessed individually. Cooperation by the patient varies. :)

  • Visual Acuity0315770001605728947.jpg

Visual acuity is assessed using a shapes chart. The child will be asked to stand 10 feet from the chart and “read” the lines. Vision is measured for right, left, and both eyes. 


Seasonal influenza Children 6 months and older may get a flu vaccine if appropriate age and season. If this is the first year your child received the flu vaccine, he/she will need a second one in 1 month. The seasonal flu vaccine covers four strains of the flu predicted to be circulated each year. All of our injections are preservative free. Children 2 years and up may also get the nasal flu vaccine, FluMist, if available and appropriate.  

Patient Portal/ Surveys: 

As of September 1, 2020, Summit Medical Group transitioned to a new electronic health record  and therefore a new patient portal. Your account information will need to be reestablished.  If you as the parent/guardian see a Summit Medical Group provider, your patient portal will be linked to your children. If you have not already set up your new account, please call the office.  Once your child is over the age of 13 they may wish to have their own patient portal account. Your new patient portal account has many interactive features including self-check in which will allow you to update information prior to your appointment and avoid excessive paperwork. You will be able to view upcoming appointments, outstanding bills, care summaries and send us secure healthcare messages! For more information about the new patient portal and online features, please see our website www.shultspediatrics.com.  Thank you for your patience during this transition. 

We also utilize a program called CHADIS. If you are a returning patient you may recall completing “surveys” that were linked to your patient portal account. This is the same program but runs independently from your new patient portal account. You will receive an email invitation from CHADIS to set up your account for your children and complete the needed questionnaires. The invitation email will allow you to register your account to receive reminders should you wish in the form of email or text alerts. When screeners have been assigned to your child by their provider you will receive an email/text from CHADIS reminding you to complete them prior to arriving for your appointment. Make sure to click the button “Send I’m Done” so that the answers can be loaded into your child’s chart and reviewed during their appointment. 

Ages & Stages, 48 months

The Ages & Stages Questionnaire (ASQ) is a developmental screening tool used to assess your child’s development periodically through 5 years old. The parent completes the age specific questionnaire before the visit to help the pediatrician gauge the child’s development in five domains: Communication, Fine Motor, Gross Motor, Personal-Social and Problem-solving. Please, allow 15-20 minutes to complete the survey. It is helpful to have your child with you when completing to better answer some of the questions.

If your child has not mastered all the skills in the survey (and most have not), don’t worry. The survey is designed to check for a range of development.


Next routine well visit: 5  years old. This is generally a BIG visit as your child is getting ready for kindergarten entry!

As always, take care and remember we are here if you need us!

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