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Determining if a child is sick involves using observable signs and symptoms, and the correct approach includes checking for the three A's—activity level, appetite, and alertness—along with looking for fever. The three A's provide a comprehensive overview of the child's general health status. Changes in these areas can indicate that a child is not feeling well, as they reflect the child's energy levels and willingness to engage in normal activities. Additionally, fever is a common and reliable indicator of illness, signaling that the body is fighting an infection or other health issue.

While other options touch on certain symptoms, they do not encompass as complete an assessment of the child's overall health as the combination of the three A's and fever. For instance, appetite loss and mood changes, while relevant, do not provide a complete picture without considering the child's energy level and alertness. Focusing solely on skin color changes or voice and energy loss overlooks other important indicators of illness. Therefore, the most effective way to assess a child's health is through a broader evaluation that includes both observable behavioral changes and physical symptoms like fever.