Your Child’s Checkup: 20 Years

What to Expect During This Visit

The doctor and/or nurse will probably:

1. Check your son’s/daughter’s weight and height, calculate body mass index (BMI), and plot the measurements on growth charts.

2. Check your son’s/daughter’s blood pressure and vision using standard testing equipment.

3. Ask questions, address concerns, and offer advice about how your son or daughter is:

Eating. Young adults should be eating three meals a day that include a colorful array of vegetables, whole grains, and at least three servings of dairy products that provide 1,300 milligrams of calcium per day. Include enough lean meats, poultry, and seafood in the diet to reach 15 milligrams of iron per day for young women and 11 milligrams for guys. One serving of beef has 2–3 milligrams of iron. Opt for water over juice or sports drinks.

Sleeping. Young adults generally need about 8 hours of sleep per night. Inadequate sleep can lead to decreased alertness and poor performance.

Physical activity. Young adults should aim for 60 minutes of physical activity per day.

Growth and development. By 20, it’s common for many young adults to:

• have completed their physical development
• value individual relationships over peer groups
• become more independent from parents
• think abstractly to solve problems
• have long-term plans for the future

4. Perform a physical exam. In a young woman, perform a pelvic exam if she is sexually active and has excessive discharge or pelvic pain. In guys, examine the testicles for masses and varicocele (swollen veins).

5. Update immunizations. Immunizations can protect people from serious illnesses, so it’s important that people receive them on time. Your son or daughter should talk to the doctor about what to expect.

6. Order tests. Your doctor may assess whether your son or daughter is at risk for anemia, high cholesterol, and tuberculosis and order tests, if needed.

Looking Ahead

Here are some things to keep in mind:

School

1. Talk about college or work plans.
2. Encourage your son or daughter to continue to pursue areas of interest, including art, music, exercise, and community service.
3. Encourage your son or daughter to take personal responsibility for school and work. Praise accomplishments and provide support in areas where he or she is struggling.

Self

1. Encourage your son or daughter to learn strategies for coping with stress, such as exercising or meditation. Encourage him or her to continue to come to you with worries, and to also lean on friends and other family members.
2. Talk about sex and the importance of contraceptive and condom use.
3. Discuss the dangers of smoking, alcohol, and drugs, inhalants, and other means to get high. Praise your son or daughter for abstaining from these activities.
4. Look for signs of depression, which can include irritability, depressed mood, loss of interest in activities, poor academic performance, and talk of suicide.
5. If this hasn’t happened yet, your son or daughter should prepare to switch to an adult doctor. People generally begin seeing an adult doctor at age 18, but some wait until after college or until around age 21.
6. Young women should schedule a gynecologist visit. This first visit will not include a pelvic exam, unless women are sexually active or having problems.

Safety

1. Young adults should always wear a seatbelt while in a vehicle.
2. Discuss the dangers of texting and other cell phone use while driving.
3. Talk about the dangers of drinking and driving and tell your son or daughter to never get in a car with someone who has been drinking or using drugs. Instead, your son or daughter should call you (or another responsible adult) for help.
4. Prevent gun injuries by not keeping a gun in the home. If you do have a gun, keep it unloaded and locked away. Ammunition should be locked up separately.

These checkup sheets are consistent with the American Academy of Pediatrics (AAP)/Bright Futures guidelines.