Physical Examination of Four‐year‐old Children

Summary An unselected population of 2 447 four‐year‐old children in two communities in southern Sweden underwent a physical examination as part of a general health control. The general health was very good, mean weight was 17.2 kg, mean height 104.2 cm, mean Hb 12.7 g/ 100 ml. Anaemia (<11 g/100 ml) was detected in 20 children (0.9%). The mean blood pressure was 100/54. No child with persistently elevated blood pressure was found. Practically all serious handicaps were detected and already taken care of before the age of 4 years. Altogether 164 children (6.7%) were referred to specialists for newly detected deviations, and 144 (5.9%) were reported back. In 52 children, 2.2%, minimal brain dysfunction was diagnosed, half of them having other neurological disturbances besides clumsiness and hyperactivity. Five children (0.2%) had other neuro‐muscular deviations, such as myo‐pathia, hemiplegia, polyneuropathia. Including children already under professional care, 3% showed a significant degree of motor dysfunction. The cardiac findings were sparse; the prevalence of heart diseases at this age was about 6/1 000, all already detected. Phimosis was the cause of referral in 12 boys (0.9%). The prevalence of retentio testis was 0.9% at this age. The orthopaedic findings were also confined to minor disabilities with little influence on the child's development and well‐being: 31 children (1.3%) had pronounced flat‐feet with complaints from the feet or the legs. Another 5.2% were already under current care for flat‐feet. From a questionnaire to the parents, some children could be designated as having neurological disorders, but the information was not selective enough to be of practical value as a screening instrument.