AAP Updates Recommendations for Routine Preventive Pediatric Health Care
Am Fam Physician. 2016 Aug 15;94(4):324.
Related Editorial: Increased Alignment in Preventive Services Recommendations for Children.
Author disclosure: No relevant financial affiliations.
The American Academy of Pediatrics (AAP) has updated recommendations for preventive pediatric health care services, including evidence-based screenings and assessments that should be addressed at well-child visits. The recommendations are organized by age: infancy, early childhood, middle childhood, and adolescence. The most recent changes to the schedule were approved by the AAP Committee on Practice and Ambulatory Medicine, Bright Futures Periodicity Schedule Workgroup. A complete schedule is available at http://www.aap.org/periodicityschedule.
These updates address a variety of topics. Changes include the following:
Vision Screening. In addition to routine visual acuity screening at four and five years of age and in cooperative three-year-olds, instrument-based screening can be offered to assess risk at other ages (i.e., at 12 and 24 months of age, and at well visits from three to five years of age). The recommendation for vision screening is now a risk-based assessment instead of routine screening beginning at 18 years of age. Evidence shows that fewer new vision problems develop in young adults at low risk.
Oral Health. Fluoride varnish application should begin at six months of age and continue through five years of age. This recommendation was added to address dental caries, which is the most common chronic disease in young children.
Alcohol and Drug Use Assessment. To screen adolescents for drug and alcohol use, physicians are advised to use the CRAFFT (car, relax, alone, forget, friends, trouble) screening questionnaire.
Depression. Screening for depression is recommended annually for children and adolescents 11 through 21 years of age. Suicide is a leading cause of death in this age group.
Dyslipidemia Screening. Because of concerns about the growing epidemic of obesity in this population, screening for elevated blood cholesterol levels is now recommended in children nine to 11 years of age.
Hematocrit or Hemoglobin. In addition to the universal screening recommended
Coverage of guidelines from other organizations does not imply endorsement by AFP or the AAFP.
This series is coordinated by Sumi Sexton, MD, Associate Deputy Editor.
A collection of Practice Guidelines published in AFP is available at http://www.aafp.org/afp/practguide.
Copyright © 2016 by the American Academy of Family Physicians.
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