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What to Expect at a Pre-Teen Well-Child Visit at Ages 10–13

What to expect at a pre-teen wellness checkup at the pediatrician

Diet and Nutrition

  • BMI is a measure of weight adjusted for height and helps us accurately assess the level of body fat and overall health of your child.
    • < 5th percentile – underweight
    • 5th – 84th percentile – healthy weight
    • 85th – 95th percentile – overweight
    • >95th percentile – obese
    • >99th percentile – morbidly obesity
  • As always, it is important to remember that children should never cut calories or diet. This can result in a disruption in their normal growth patterns and may prevent them from taking in nutrients that they need for normal growth and development of organs. We strongly encourage that they learn to make healthy choices, eat appropriate portion sizes and stay active.
  • Currently, in the US, school age children are consuming 10% of dietary energy in the form of juices and soft drinks. These should be treats and not given soon a daily basis. Now is the time for your children to learn the correct concepts of good nutrition.

Stages of Puberty


  • Puberty generally starts earlier for girls than for boys, sometime between 8-13 years of age. For most girls, the first evidence of puberty is breast development, but it may be the growth of pubic hair in some. Growth spurts usually occur 1-2 years after the 1st signs of puberty. Her body will begin to build up fat, particularly in the breasts and around her hips and thighs, as she takes on the contours of a woman.
  • The culminating event will be the arrival of menarche, her first period (also called menstruation). Depending on the age at which they begin their pubertal development, girls may get their first period between the ages of 9 and 16. Their growth spurt usually ends after the arrival of menarche.


  • The physical changes of puberty usually start with enlargement of the testicles and sprouting of pubic hair, followed by a growth spurt between the ages of 10 to 16; on average, 1-2 years later than when girls starts.
  • A boy may become concerned if he notices tenderness or swelling under his nipples. This temporary development of breast tissue is called gynecomastia and it happens to about 50% of boys during puberty. It usually disappears within 6 months.
  • Dark, coarse, curly hair will sprout just above his penis and his scrotum, and later under his arms and in the beard area. His penis and testes will get larger, and erections, which a boy begins experiencing as an infant, will become more frequent. Ejaculation (the release of sperm containing semen) will also occur.

Talking to your Child about Puberty

  • Boys and girls can see these changes happening to each other. It’s important to talk to your child about how their bodies change, sooner rather than later.
  • It’s best not the have “the talk” but rather a series of talks, ideally beginning when your child is young and starting to ask questions about body parts. Each time you talk, offer more and more detail depending upon your child’s maturity level and interest in the topic. If your child has a question, answer it right away.


  • Sleep is very important to overall health and well-being in children – a typical school aged child requires about 10 hours of sleep every night. They still need predictable bedtime “down time” that is not interrupted by television or other forms of stimulation (computers, cell phones caffeinated beverages).

Body Image Concerns

  • Rapid physical changes lead to the adolescent to be increasingly preoccupied with body image characterized by:
    • Preoccupation with self
    • Uncertainty about appearance and attractiveness
    • Frequent comparison of own body with those of other adolescents
    • Increased interest with sexual anatomy and physiology

Independence-Dependence Struggle

  • Early adolescence is characterized by the beginning of the shifting from dependence on parents to independent behavior. Common events at this time include:
    • Less interest in parental activities and more reluctance to accept advice or criticism.
    • An emotional void created by separation from parents
    • Wide mood and behavior swings

Peer Group Involvement

  • With the beginning of movement away from the family, the adolescent becomes more dependent of friends as a source of comfort.
  • Solitary friendships with a member of the same sex: this idealized friendship can become intense
  • Strongly emotional, tender feelings towards peers
  • Peer contact primarily with the same sex

Identity Development

  • At the same time that rapid changes are occurring, the adolescent’s cognitive skills are improving markedly. This corresponds to the evolution from concrete thinking to abstract thinking
  • Increased ability to reason abstractly
  • Frequent daydreaming
  • Setting unrealistic vocation goals (i.e., rock star, airplane pilot, or truck driver)
  • Testing authority
  • A need for greater privacy
  • Emergence of sexual feeling
  • Development of adolescent’s own value system
  • Lack of impulse control
  • Tendency to magnify one’s personal situation

Your Local Pediatrician Serving Cumming and Beyond

We work with parents to optimize physical and social development. Our goal is to help your child live a happy and healthy life with the best pediatric care.
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Sick Visits

Our pediatricians treat children’s illnesses or minor injuries, with same-day sick visits and urgent care treatment appointments also available.

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Well-Child Checkups

Wellness checkups monitor your child’s development, keep immunizations up-to-date and ensure quality preventive pediatric medical care.

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