U9 Check-Up: 60 - 64 Months

The U9 check-up takes place when your child is between 60 and 64 months old and it is the most comprehensive of all the early detection check-ups. Your child isn’t a toddler anymore at this point. Soon they should be in primary school. That's why your paediatrician will pay particular attention at U9 to how well your child can communicate and how they behave towards other children, adults and strangers.

The U9 can be a bit of a challenge for some kids. You need to be patient, cooperative and focused. It's best to tell your child ahead of time that the exam may take a little while. It is also helpful if you explain what the paediatrician will do. You will get lots of questions too. The aim is to identify possible delays in your child's development early and to be able to provide support where necessary and helpful.

You are already familiar with a lot of what happens the check-up. The paediatrician will once again measure your child's height, weight and head circumference, and check their eyes, ears, heart and other organs. As with the U8 check-up, it is best to bring a fresh sample of your child’s urine sample with you to the U9. Of course, they can also provide one at the doctor's office. The urine is checked for protein, blood components, sugar and bacteria.

An eye exam is also an important part of the U9. The doctor may notice signs of weak vision in your child. In this case, you should take your child to an ophthalmologist. Only they can determine for sure if your child needs glasses and prescribe the right lenses. If you suspect your child may have weak vision, you should take it seriously. The sooner it is detected, the better it can be corrected. Particularly in the case of farsightedness, glasses can even help improve vision over the course of childhood. Most importantly, your child needs to be able to see well when they go to school so that they can follow lessons without difficulty.

At the U9, the doctor also wants to know how agile and dexterous your child is. Can they stand on one leg and hop? Can they run backwards? Are they good at catching a ball? It's also important to find out how skilled your child is with their hands. Can they draw a circle, a square or a triangle? Can they cut along a straight line with a pair of children’s scissors? All of this will be observed.

The doctor also wants to get an idea of how well your child can communicate. How high can they count? Can they pronounce most words without error and for the most part reproduce stories correctly? Is the timing right? Is the narrative logical? Even if this is all done in simple sentences, you can already tell if your child's development is on the right track.

The doctor also wants to know how your child is behaving. How do they behave in kindergarten, with friends, within the family, in familiar and in unfamiliar situations? You and your child can again tell stories together here. Can they take turns playing well with other children? Can they handle disappointment well? Are they good at sharing? Do they invite other children to play and are they invited in return? Maybe you received questionnaire for your child’s kindergarten teachers to fill out before the U8 check-up. If so, bring it to the U9 and discuss the answers with the paediatrician.

If your child has been vaccinated in the past years according to the recommendations of experts, no booster vaccination is necessary at the U9. A booster vaccination against tetanus, diphtheria, and pertussis is only required five years after the last tetanus vaccination, i.e. when your child is about six years old. At some doctor’s offices, you can have your child vaccinated at the check-up. Others might require you to make an separate appointment.

The U9 concludes the series of check-ups scheduled for your child in the ‘yellow booklet’. The next comprehensive health examination is the J1 check-up, right after your child’s 13th birthday. Most health insurance companies offer their members three additional U check-ups free of charge. These include the U10 for seven- to eight-year-old children, the U11 for nine- to ten-year-olds and the J2 for 16- to 17-year-olds. For this purpose, there is also the so-called ‘green check-booklet’. You can get it from your paediatrician.