Please note that this is a rough translation and that from what I can tell with friends kids, each Dr. does the examinations a little differently, some focusing on one particular aspect than others. The list however can give you an overview of what you might expect from each U Screening.
The German U Screenings are developmental checkups for babies and children that begin shortly after birth and continue up until a child's 14th year. They are intended to look at the development of each child and to spot any signs of extra help a child may need such as discovering poor hearing, poor eyesight, balance issues etc.
How do the U Screenings works?
U Screenings should be booked (where possible) a couple of months before they are due as Berlin paediatricians have limited time and it can be tough to book last minute appointments. You can work out when each U Screening is due for your child based on the periods highlighted in bold at the top of each explanation below. My son's doctor always recommended booking the screening for nearer the end of the time period, as for some children, an extra month or even weeks can make a huge difference in their development. It gives them a bit of extra time to catch up on some skills and find their own pace.
What should I bring to an U Screening?
Obviously the child in question is vital, but on top of that, you should bring…
- Child's health insurance card
- Yellow Health Book (das Gelbe Heft)
For babies & toddlers also...
- A spare nappy (diaper)
- Portable baby changing mat (not always necessary, but can be useful)
- Spare clothes (often the babies and toddlers will have a small period of nappy/diaper-free time, so it's good to be prepared in case of accidents (my youngest wee'd on the doctor at his U3 Screening)
- For those of you who are bottle feeding, it can be useful to be able to feed post-checkup should your baby have had an immunisation injection or is unhappy at being naked for a while so having the option may be good.
and some paediatricians ask for a towel and other such items, but mine never has.
What should I do if I miss one of the U Screening time periods?
You can contact your paediatrician and ask if it would be possible to do the appointment with them at a different date. Alternatively, I have been told you can contact your local Bezirksamt and explain the situation and they can organise a screening elsewhere.
Here are the breakdowns of the 'U Screenings' as best as I can manage...
The midwife or doctor checks the baby's skin color, breathing, heart activity, muscle tone and reflexes.
U2: within first week after birth
If you have a hospital birth and stay in for a few days post-birth then this will usually be carried out in the hospital. If you have a non-hospital birth or leave the hospital within a day or so post-birth then this will need to be done at s Kinderarzt's (pediatrician's).
The pediatrician checks the reflexes and whether the skeleton is in order. The baby will also have a metabolic blood test.
U3: 4 to 6 Week after birth
The doctor measures the head circumference, which reflects the development of the child and whether the fontanelles (skull openings) are still open. He spreads the baby's legs bent to examine if the hips are ok.
U4: 3 to 4 Months after birth
In this examination, the Dr will test to see if the baby can hold its head, how it responds to sounds and it's motor development. Should there be some obvious developemental issues, the Dr's will often be able to give advice at this point on how to work on the issues such as physio (Milo had physio for his neck at this age) or physical exercises.
U5: 6 to 7 Months after birth
Here the Dr's start to use simple games to study your child's development, looking for eye contact and whether or not the baby can hold its upper body erect easily hold his balance or not.
U6: 10 to 12 Months after birth
This examination focuses alot on physical development. Here the Dr. will see if the baby can crawl, pull itself up on furniture, how it plays etc.
U7: 21 to 24 Months after birth
This exam is about mental as well as physical development, looking at your child's speech, whether or not it can climb stairs, hold on to railings and checking for skills such as an ability to eat with a spoon.
U7a: 34 to 36 Months after birth
At this examination your Dr.'s will check the status of your child's vaccination's as well as checking its eyes, ears, stomach, feet etc. Linguistic development is particularly focused on and there'll be a few little tests like a simple puzzle in which your child has to match pictures and jumping off a step. . At this age, the Dr's will start considering recommending therapies/specialists for any physical or mental difficulties the child may be having.
U8: 3 to 4 years after birth
A full physical test will be performed including sight and hearing tests. A big focus of this screening is on the child's behaviour. How does it play with other children? Is it ok being separated from its mother? How long does it play alone? The Dr. will also ask about whether or not the child is 'dry' (ie. doesn't wear a nappy/diaper any more. A urine sample will also be taken during this examination to look for any possible urinary tract infection.
U9: 5 to 6 years after birth
Fine motor skills, language development and coordination will be studied. The Dr. will check if the child has good body position, whether it has enough muscle strength, whether it can count to 10, if it can estimate distances to roughly gauge whether it has an approximate sense of time, whether it knows its own name and address, and whether it can remember the names of friends.
U10: 7 to 8 years after birth
This screening is an 'extra' screening and can be taken by the choice of the parents, but isn't a necessity. Because of this, the screening isn't covered by the health insurance and must be paid for by the parents.
U11: 12 to 14 years after birth (and the last screening)
From what I can find it is recommended that boys do this screening nearer the age of 14 then girls due to their tendance to start puberty later. A questionnaire will need to be filled out and the doctor will be alone with your child. Blood will be taken to determine cholesterol levels and thyroid function. A physical examination will examine the stages of puberty, such as whether the girl has had her period and to check for normal physical developments that come with puberty. For the boys, the Dr's will check if the larynx has enlarged, if his voice has broken yet, for facial hair and for other obvious signs of puberty. Both girls and boys will have their spine's carefully examined, as well as their sensory organs and other organs checked. Weight will also be looked at.
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