ITEMS IN AFP WITH MESH TERM:
ABSTRACT: The goals of the well-child examination in school-aged children (kindergarten through early adolescence) are promoting health, detecting disease, and counseling to prevent injury and future health problems. A complete history should address any concerns from the patient and family and screen for lifestyle habits, including diet, physical activity, daily screen time (e.g., television, computer, video games), hours of sleep per night, dental care, and safety habits. School performance can be used for developmental surveillance. A full physical examination should be performed; however, the U.S. Preventive Services Task Force recommends against routine scoliosis screening and testicular examination. Children should be screened for obesity, which is defined as a body mass index at or above the 95th percentile for age and sex, and resources for comprehensive, intensive behavioral interventions should be provided to children with obesity. Although the evidence is mixed regarding screening for hypertension before 18 years of age, many experts recommend checking blood pressure annually beginning at three years of age. The American Academy of Pediatrics recommends vision and hearing screening annually or every two years in school-aged children. There is insufficient evidence to recommend screening for dyslipidemia in children of any age, or screening for depression before 12 years of age. All children should receive at least 400 IU of vitamin D daily, with higher doses indicated in children with vitamin D deficiency. Children who live in areas with inadequate fluoride in the water (less than 0.6 ppm) should receive a daily fluoride supplement. Age-appropriate immunizations should be given, as well as any missed immunizations.
Using Nontraditional Risk Factors in Coronary Heart Disease Risk Assessment - Putting Prevention into Practice
Screening for the Early Detection and Prevention of Oral Cancer - Cochrane for Clinicians
Preventing Dementia: Is There Hope for Progress? - Editorials
Screening for Osteoporosis - Putting Prevention into Practice
Screening for Osteoporosis: Recommendation Statement - U.S. Preventive Services Task Force
Speech and Language Delay in Children - Article
ABSTRACT: Speech and language delay in children is associated with increased difficulty with reading, writing, attention, and socialization. Although physicians should be alert to parental concerns and to whether children are meeting expected developmental milestones, there currently is insufficient evidence to recommend for or against routine use of formal screening instruments in primary care to detect speech and language delay. In children not meeting the expected milestones for speech and language, a comprehensive developmental evaluation is essential, because atypical language development can be a secondary characteristic of other physical and developmental problems that may first manifest as language problems. Types of primary speech and language delay include developmental speech and language delay, expressive language disorder, and receptive language disorder. Secondary speech and language delays are attributable to another condition such as hearing loss, intellectual disability, autism spectrum disorder, physical speech problems, or selective mutism. When speech and language delay is suspected, the primary care physician should discuss this concern with the parents and recommend referral to a speech-language pathologist and an audiologist. There is good evidence that speech-language therapy is helpful, particularly for children with expressive language disorder.
Screening for Developmental Delay - Article
ABSTRACT: According to the literature, 12 to 16 percent of children in the United States have at least one developmental delay, yet as many as one-half of affected children will not be identified by the time they enter kindergarten. If developmental delays are detected too late, opportunities for early intervention may be lost. Empirical literature on clinical recommendations for developmental delay screening in primary care is inconsistent and often insufficient to direct the family physician. In addition, multiple barriers exist, which often prevent physicians from performing initial screening and completing additional evaluation and referrals. Implementing office-based systems for screening and referrals may overcome these barriers and improve outcomes. Recent studies support the use of a validated screening tool at regular, repeated intervals, in addition to physician surveillance, at all well-child visits. The literature also supports screening for developmental delay with parent-completed tools rather than directly administered tools. The most extensively evaluated parent-completed tools are the Parents’ Evaluation of Developmental Status and the Ages and Stages Questionnaire. Family physicians should be familiar with currently available screening tools, as well as their limitations and strengths. Additional evaluations and referrals are recommended if developmental delay is identified or suspected.
Better Integration of Mental Health Care Improves Depression Screening and Treatment in Primary Care - Graham Center Policy One-Pagers