U7a – Child Health Check-Up at Age 9

What is the U7a?

The U7a is one of the statutory preventive health examinations for children in Germany. It takes place at around 9 years of age (between the 8th birthday and the 10th year of life) and is part of the national program for the early detection of diseases and developmental disorders in children. The examination is carried out by a pediatrician or general practitioner and is free of charge for children with statutory health insurance.

Goals of the U7a

The U7a aims to identify potential physical, cognitive, and social developmental issues at an early stage. Special attention is given to the child´s school performance and overall well-being. Key objectives include:

• Early detection of developmental delays in language, motor skills, and cognition
• Identification of learning difficulties such as dyslexia or dyscalculia
• Assessment of behavioral issues, such as signs of ADHD
• Evaluation of body weight and eating habits (early detection of obesity)
• Checking vision and hearing
• Review of the vaccination status and booster shots if needed

How the Examination Works

The U7a includes a detailed discussion with the parents and a physical examination of the child. The physician assesses the child´s current health status and development using several criteria:

Physical Examination

• Measurement of height, weight, and BMI
• Examination of skin, heart, lungs, abdomen, and musculoskeletal system
• Assessment of sexual development and pubertal status

Developmental and Behavioral Assessment

• Evaluation of language skills and academic performance
• Assessment of concentration, attention span, and social behavior
• Integration of information from parent interviews and, where applicable, school reports

Sensory Tests and Reflexes

• Vision test (visual acuity) to detect short-sightedness or other refractive errors
• Hearing test for early identification of hearing loss

Why is the U7a Particularly Important?

The U7a takes place at a time when children have already been attending school for several years. School performance issues, social difficulties, or behavioral changes at this age can be early indicators of conditions that require medical attention. Early diagnosis enables targeted therapeutic interventions to support the child´s development.

What Happens After the Examination?

The results of the U7a are recorded in the child health booklet (yellow booklet). If any concerns are identified, the physician may initiate further tests, referrals to specialists, or therapeutic measures such as speech therapy, occupational therapy, or psychotherapy. Parents also receive guidance on healthy nutrition, physical activity, screen time management, and other aspects of their child´s daily life.

References

1. Gemeinsamer Bundesausschuss (G-BA): Kinder-Richtlinie - Regulations on early detection of diseases in children. www.g-ba.de (2023)
2. Bundeszentrale fuer gesundheitliche Aufklaerung (BZgA): Preventive health check-ups for children U1-U9. www.bzga.de (2023)
3. Deutsche Gesellschaft fuer Kinder- und Jugendmedizin (DGKJ): Recommendations on preventive examinations in childhood and adolescence. www.dgkj.de (2022)