Well-child Visits Research Articles

The Impact of COVID-19 on Preventive Oral Health Care During Wave One

Introduction: Early childhood caries burdens children, their families, and the health care system. Utilizing fluoride varnish at medical well-child visits with non-dental primary care providers can be an interprofessional strategy to combat early childhood caries. The COVID-19 pandemic dramatically altered preventive health care delivery and the effects on preventive oral health care delivery have not been previously described.Methods: This analysis used descriptive statistics and non-parametric Wilcoxon Mann-Whitney tests to compare preventive oral health utilization among 1 to 5-year old children in two state Medicaid agencies before and during the pandemic. Fluoride utilization rates at dental visits and medical well-child visits were calculated as number of users per 1,000 enrolled children. Additionally, the proportion of well-child visits that included fluoride application was calculated for each state.Results: During the pandemic, the quarterly fluoride utilization rate significantly decreased at dental visits (pre-pandemic = 153.5 per 1,000 enrolled children; pandemic = 36.1 per 1,000 enrolled children, p < 0.001) and signficantly decreased at medical well-child visits (pre-pandemic = 72.2 per 1,000 enrolled children; pandemic = 32.3 per 1,000 enrolled children, p = 0.03) during the pandemic.Conclusions: The findings highlight the importance of interprofessional collaboration among non-dental primary care providers and dental providers to provide access to preventive oral health services, particularly when access to dentists is limited. Future directions might include rigorous evaluations of co-located medical and dental services or the use of interprofessional telehealth technologies.

Recognizing Adolescent Depression with Parent- and Youth-Report Screens in Pediatric Primary Care

To compare the use of the parent-report Pediatric Symptom Checklist (PSC-17P) and youth-report Patient Health Questionnaire-9 Modified for Teens (PHQ-9M) in compliance with recent quality standards for adolescent depression screening. Parents of 5411 pediatric outpatients (11.0-17.9years old) completed the PSC-17P, which contains scales that assign categorical risk for overall (PSC-17P-OVR), internalizing (PSC-17P-INT), externalizing (PSC-17P-EXT), and attention (PSC-17P-ATT) problems. Adolescents completed the PHQ-9M, which assesses depressive symptoms. Both forms were completed online within 24hours of each other before pediatric well-child visits. A total of 9.9% of patients (n=535) were at risk on the PSC-17P-OVR, 14.3% (n=775) were at risk on the PSC-17P-INT, and 17.0% (n=992) were at risk on either or both scales (PSC-17P-OVR and/or PSC-17P-INT). Using the PHQ-9M cut-off score of 10 (moderate-very severe depression), an additional 2.4% (n=131) were classified as at risk, with 66.8% (n=263) of all PHQ-9M positives (n=394) also coded as at risk by the PSC-17P-OVR and/or PSC-17P-INT scales. Using a PHQ-9M cut-off score of 15 (severe-very severe depression), only 29 patients (21.8% of the PHQ-9M positives) not identified by the PSC-17P-OVR and/or PSC-17P-INT were classified as being at risk. The combined PSC-17P-OVR and/or PSC-17P-INT scales identified 17% of adolescents as at risk for depression, including about two-thirds to three-quarters of adolescents classified as at risk on the PHQ-9M. These findings support using the PSC-17P to meet quality standards for depression as well as overall screening in pediatrics. Primary care clinicians can add the PHQ-9M to identify additional adolescents who may self-report depressive symptoms.

Adverse childhood experiences and transcriptional response in school-age children.

This study evaluated whether children with higher adverse childhood experiences (ACE) scores had alterations in immune cell gene expression profiles. RNA sequencing was conducted on dried blood spot samples from 37 generally healthy English-speaking children (age 5-11) who were recruited from well-child visits at a university-affiliated pediatric practice. The Whole Child Assessment was used to assess ACE exposure. Primary analyses examined an a priori-specified composite of 19 pro-inflammatory gene transcripts. Secondary analyses examined a 34-gene composite assessing Type I interferon response, and used Transcript Origin Analyses to identify cellular mechanisms. After controlling for age, body mass index percentile, sex, race/ethnicity, current insurance status, and household smoking exposure, pro-inflammatory gene expression was elevated by 0.094 log2 RNA expression units with each Child-ACE total score point (p = .019). Type I interferon gene expression was similarly upregulated (0.103; p = .008). Transcript origin analyses implicated CD8+ T cell as the primary sources of gene transcripts upregulated, and nonclassical (CD16+) monocytes as sources of downregulated transcripts. These preliminary analyses suggest that parent-reported ACE exposures are associated with increased expression of both inflammatory and interferon gene transcripts in children's circulating blood cells.

Improving breastfeeding duration through creation of a breastfeeding-friendly pediatric practice.

Breastfeeding is the gold standard for infant feeding. In the United States, 83.2% of women initiate breastfeeding on their infant's birth. When the infant reaches 6 months of age, however, only 57.6% of mothers are still breastfeeding, and a mere 24.9% are breastfeeding exclusively. Breastfeeding rates in rural areas are below the national averages. The greatest disparities exist in minorities and individuals with lower educational and socioeconomic status. A preintervention/postintervention design was used for this quality improvement project. The Model for Improvement's Plan, Do, Study, Act cycle guided the project processes. Breastfeeding rates were obtained at each well-child visit from newborn through 4 months of age. On completion, mean preimplementation and postimplementation breastfeeding rates were compared to determine effectiveness. A breastfeeding support initiative was implemented at a multisite rural Illinois pediatric practice. An evidence-based breastfeeding policy was developed, staff education sessions were conducted, private lactation rooms were created, and breastfeeding photographs/posters were displayed throughout the offices. Lactation support services were publicized via signs and social media postings. Overall breastfeeding rates were higher at each time point after implementation. Statistically significant increases occurred at the newborn and 1-month visits, with a modest improvement at 2 and 4 months. This project demonstrated an improvement in breastfeeding duration rates. It is anticipated that this practice-wide standard of care change will promote breastfeeding throughout the first 12 months of life.

Autism and General Developmental Screening Practices Among Primary Care Providers.

Using standardized screening tools increases accuracy in early identification of autism. The American Academy of Pediatrics recommends systematic developmental screening at all 9-, 18-, and 24- or 30-month well-child visits (WCVs) and autism-specific screening at all 18- and 24-month WCVs. The study objectives were to examine the extent to which these guidelines have been adopted in practice among primary care providers (PCPs) and to identify potential provider-level factors associated with screening practices. Participants included 94 PCPs (79% pediatricians) from 13 states enrolled in a study of an autism training program. Self-report and chart-review data collected before training were examined. Screening practices were assessed through chart review of all 9-, 18-, and 24-month WCVs within a 30-day window. Sixty-four percent of PCPs administered developmental screening tools at all 9-month WCVs, and 62% at all 18-month WCVs. Fifty-one percent administered autism screening tools at all 18-month WCVs, and 41% at all 24-month WCVs. Screening practices varied by provider type (pediatrician vs other PCP), self-efficacy in screening and identification, and previous autism training (autism screening only), but not by years of experience. Overall, general developmental and autism-specific screenings are not being consistently administered across recommended WCVs in primary care practices. Provider self-efficacy in autism identification and screening and previous autism training were associated with increased autism screening. As such, these results suggest a need for increased training and dissemination of information on screening implementation for practicing PCPs.

Temperature Measurement at Well-Child Visits in the United States

To determine the frequency and predictors of temperature measurement at well-child visits in the US and report rates of interventions associated with visits at which temperature is measured and fever is detected. In this cross-sectional study, we analyzed 22 518 sampled well-child visits from the National Ambulatory Medical Care Survey between 2003 and 2015. We estimated the frequency of temperature measurement and performed multivariable regression to identify patient, provider/clinic, and seasonal factors associated with the practice. We described rates of interventions (complete blood count, radiograph,urinalysis, antibiotic prescription, and emergency department/hospital referral) by measurement and fever (temperature ≥100.4 °F, ≥38.0 °C) status. Temperature was measured in 48.5% (95% CI 45.6-51.4) of well-child visits. Measurement was more common during visits by nonpediatric providers (aOR 2.0, 95% CI 1.6-2.5; reference: pediatricians), in Hispanic (aOR 1.9, 95% CI 1.6-2.3) and Black (aOR 1.5, 95% CI 1.2-1.9; reference: non-Hispanic White) patients, and in patients with government (aOR 2.0, 95% CI 1.7-2.4; reference: private) insurance. Interventions were more commonly pursued when temperature was measured (aOR 1.3, 95% CI 1.1-1.6) and fever was detected (aOR 3.8, 95% CI 1.5-9.4). Temperature was measured in nearly one-half of all well-child visits. Interventions were more common when temperature was measured and fever was detected. The value of routine temperature measurement during well-child visits warrants further evaluation.

Influence of a One-Time Web-Based Provider Intervention on Patient-Reported Outcomes After the Well-Child Visit: A Feasibility Study.

Patient-centered care promotes positive health outcomes in pediatrics. We created a provider-focused intervention and implemented it in a pragmatic clustered randomized controlled trial to improve health-related quality of life (HRQOL) among pediatric patients. A one-time (1-1.5-hour) webinar focusing on patient-centered care and motivational interviewing, using obesity screening as an example, was developed. Pediatric providers were recruited and randomized to either intervention (webinar) or control (usual care) arms. All well-child visits to these providers for a period of up to 5 months following webinar completion (or study enrollment for controls) were identified, and these family/patients were invited to complete a survey to assess HRQOL postvisit. Reported outcomes were compared between intervention and control participants using clustered t-tests, chi-squared tests and multiple linear regression models. We recruited 20 providers (10 intervention, 10 control) to the study; 469 parents/guardians and 235 eligible children seeing these providers completed the postvisit survey. Parents/guardians of 8-12-year-old children in the intervention group reported higher school functioning compared to controls (83.5 vs 75.8; P=0.023). There were no other differences in children's HRQOL between intervention and control groups. A one-time, web-based provider intervention is feasible to implement in pediatrics. Modest evidence, requiring further study, indicates that instructing providers on patient-centered care in the well-child visit may improve aspects of pediatric HRQOL (ie, school functioning) compared to usual care. However, this was a brief intervention, with multiple outcomes tested and no evaluation of pre- and postintervention provider knowledge, thus additional study is needed.

Social Determinants of Health Screening at Well Child Visits: A Pilot Program Implemented During the COVID-19 Pandemic.

This study demonstrates the challenges of establishing social determinants of health (SDH) screening at well child visits (WCVs) during the COVID-19 pandemic. We conducted a 6-month pre-intervention retrospective chart review (2/2020-8/2020) and 6-month post-intervention prospective chart review (8/2020-2/2021) of an SDH screening and referral protocol at a single suburban academic pediatric clinic. WCVs were screened for food, financial, and transportation needs. With the new protocol, 46% of eligible WCVs (n = 1253/2729) had documented screening results. Self-report of screened visits found 34.6% with financial strain, 32% with worry about food insecurity, 25.1% with food insecurity, 5.3% with medical transportation difficulties, and 6% with daily living transportation difficulties. There was an increase in resources offered during the post-intervention period (OR = 11.5 [7.1-18.6], P < .001). There was also an increase in resident physician self-reported knowledge in providing referrals (P = .04).

Your Child’s Eyes

Patient Education| 2021 Your Child’s Eyes Connected Content Translation: Los ojos de su hijo: (Your Child's Eyes) Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Share Icon Share Facebook Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Your Child’s Eyes. Pediatric Patient Education 2021; 10.1542/peo_document112 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All AAP SitesAll PublicationsPediatric Patient Education Search Advanced Search Topics: eye, vision, visual impairment, ophthalmic examination and evaluation A baby’s vision develops quickly during the first year of life. Newborns can see large shapes and faces, as well as bright colors. By 3 to 4 months, most babies can focus on a variety of smaller objects and tell the difference between colors (especially red and green). By 4 months, a baby’s eyes should be working together. This is when babies begin to develop depth perception (binocular vision). By 12 months, a child’s vision reaches normal adult levels while he continues to learn about and understand what he sees. Keep in mind that each child’s vision develops at his or her own rate, but the overall pattern of development is the same. Because a baby’s vision develops quickly during the first year of life, your child’s doctor will check your baby’s eyes at each well-child visit. Even after... © 2011 American Academy of Pediatrics, Updated 05/2016. All rights reserved. You do not currently have access to this content.

Vaccinating pediatric patients requires preparation, planning

In August, the U.S. Department of Health and Human Services (HHS) expanded pharmacists’ authority to immunize children ages 3 to 18 years with vaccines recommended by CDC's Advisory Committee on Immunization Practices (ACIP) and authorized or licensed by FDA—including the COVID-19 vaccine. HHS is counting on pharmacists to help boost access and administration of childhood vaccines at a time when individuals and communities need protection from vaccine-prev+entable diseases. Earlier this year, CDC reported that rates of childhood immunizations had declined sharply nationwide because of the pandemic. Pharmacists across the country are now able to immunize pediatric patients during the COVID-19 public health emergency. The authority applies to pharmacists in all states, regardless of regulations restricting pharmacists from administering specific vaccines or limiting the age groups they may immunize. Pharmacy interns and technicians who meet HHS requirements can administer childhood and COVID-19 vaccines as well. While some barriers exist—namely, the relatively few pharmacies enrolled in the Vaccines for Children (VFC) program—states and pharmacy associations are working through these roadblocks so that pharmacists, pharmacy interns, and pharmacy technicians can provide vaccinations to children. More than half of children in the United States are eligible to receive vaccinations through the VFC program, including children who are Medicaid eligible, uninsured, underinsured, American Indian, or Alaska Native. Under the VFC program, CDC purchases ACIP-recommended vaccines from manufacturers and distributes them to grantees, such as state health departments, which then partner with physicians’ offices or pharmacies that are registered VFC providers. Health care practitioners must be recognized by the VFC program to receive payment for vaccine administration. Rebecca Snead, RPh, executive vice president and CEO of the National Alliance of State Pharmacy Associations, said one of the obstacles for pharmacies providing childhood vaccinations is that fewer than 100 pharmacies in the United States are enrolled in the VFC program. For all providers participating in the VFC program, the main barrier is in the onerous enrollment process, which is essential to receiving payment for vaccine administration. In addition, according to Snead, many private insurers that cover the rest of the childhood population have not enrolled pharmacists as providers on the medical benefit where these vaccines are routinely reimbursed for other providers. “There is a time delay to get pharmacists enrolled in networks,” said Snead. Under the new authority, HHS requires pharmacists to notify a patient and their adult caregiver about the importance of the well-child visit with a pediatrician or other licensed primary care provider and to refer patients when appropriate. APhA worked with a coalition to develop three tools pharmacists can use to be compliant with the pediatric immunization patient/caregiver education requirements in the HHS authority. Pharmacists can give patients the three tools—a referral form, a well-child visit brochure, and a template letter (available at www.pharmacist.com/coronavirus/immunizations). Stephan Foster, PharmD, FAPhA, APhA liaison to ACIP, said many adolescent vaccines are not being given during this time—everything from the HPV to the meningococcal vaccine—and there would be many benefits to focusing on this age group, especially if some pharmacists are not comfortable vaccinating small children. Overall, for children ages 3 years and up through adolescence, the technique for vaccine administration is the same as for adults. Foster says needle size is important to remember. (See infographics from the Immunization Action Coalition.) Pharmacists need to be fast when giving a vaccine to a child, and a parent or caregiver can provide support by holding the child still. See the sidebar for more tips and advice. Pediatric vaccination tips from pharmacists▪Keep a bag of candy in the vaccination room, and offer it after the vaccine with the parent's permission. Stickers are an alternative.▪Make sure the child's parent or caregiver is in the room. Have them hold the child's hand, or have the child sit on their lap.▪Use kid-friendly adhesive bandages (e.g., those with a Frozen or “Pokemon” design).▪Prepare everything before entering the immunization room—nothing is scarier to a child than seeing a vaccine drawn into a syringe or a needle put into a syringe.▪Try distracting the patient by asking them what music they like listening to, for example.▪Use the Shot Blocker gadget. ▪Keep a bag of candy in the vaccination room, and offer it after the vaccine with the parent's permission. Stickers are an alternative.▪Make sure the child's parent or caregiver is in the room. Have them hold the child's hand, or have the child sit on their lap.▪Use kid-friendly adhesive bandages (e.g., those with a Frozen or “Pokemon” design).▪Prepare everything before entering the immunization room—nothing is scarier to a child than seeing a vaccine drawn into a syringe or a needle put into a syringe.▪Try distracting the patient by asking them what music they like listening to, for example.▪Use the Shot Blocker gadget.

Bright Futures Parent Handout: 9 and 10 Year Visits

Patient Education| 2021 Bright Futures Parent Handout: 9 and 10 Year Visits Connected Content Translation: Hojas informativas de Bright Futures para los padres: Visitas médica del 9 y 10 año Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Share Icon Share Facebook Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Bright Futures Parent Handout: 9 and 10 Year Visits. Pediatric Patient Education 2021; 10.1542/peo_document261 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All AAP SitesAll PublicationsPediatric Patient Education Search Advanced Search Subjects: Bright Futures (Well-Child Visits) Here are some suggestions from Bright Futures experts that may be of value to your family. Encourage your child to be independent and responsible. Hug and praise him.Spend time with your child. Get to know his friends and their families.Take pride in your child for good behavior and doing well in school.Help your child deal with conflict.If you are worried about your living or food situation, talk with us. Community agencies and programs such as SNAP can also provide information and assistance.Don’t smoke or use e-cigarettes. Keep your home and car smoke-free. Tobacco-free spaces keep children healthy.Don’t use alcohol or drugs. If you’re worried about a family member’s use, let us know, or reach out to local or online resources that can help.Put the family computer in a central place.Watch your child’s computer use. Know who he talks with online.Install a... You do not currently have access to this content.

Bright Futures Patient Handout: 7 and 8 Year Visits

Patient Education| 2021 Bright Futures Patient Handout: 7 and 8 Year Visits Connected Content Translation: Hojas informativas de Bright Futures para el paciente: Visitas médica del 7 y 8 año Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Share Icon Share Facebook Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Bright Futures Patient Handout: 7 and 8 Year Visits. Pediatric Patient Education 2021; 10.1542/peo_document260 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All AAP SitesAll PublicationsPediatric Patient Education Search Advanced Search Subjects: Bright Futures (Well-Child Visits) Here are some suggestions from Bright Futures experts that may be of value to you and your family. If you get angry with someone, try to walk away.Don’t try cigarettes or e-cigarettes. They are bad for you. Walk away if someone offers you one.Talk with us if you are worried about alcohol or drug use in your family.Go online only when your parents say it’s OK. Don’t give your name, address, or phone number on a Web site unless your parents say it’s OK.If you want to chat online, tell your parents first.If you feel scared online, get off and tell your parents.Enjoy spending time with your family. Help out at home. Brush your teeth at least twice each day, morning and night.Floss your teeth every day.Wear a mouth guard when playing sports.Eat breakfast every day.Be a healthy eater. It... You do not currently have access to this content.

Ophthalmology examination during well-child visits in primary care health centres: Knowledge and difficulties experienced by health workers

The red reflex examination (RRE) and visual acuity testing (VA) is a mandatory part of the examination during the well-child visits (WCV) in primary health care centres of the public system of health in Chile. The eye examination is aimed at the early detection of severe eye diseases in children, such as retinoblastoma, congenital cataracts, and amblyopia. The knowledge and difficulties experienced by health workers in primary care health centres for evaluating the red reflex during WCV in Chile is unknown. A survey was performed in primary community health centres of XXX Santiago de Chile. The WCV were mainly performed by physicians (45.2%) and nurses (35.8%). Only 34% of health workers performed the red reflex test, and 42.3% checked VA during the WCV. The main reasons for not doing it include the lack of direct ophthalmoscopes and VA charts (55.2% and 43.9%, respectively) at their centres, and not having the knowledge or skills (29.3% and 22%, respectively) to properly perform these clinical tests. In this series, the eye examination of children attending WCV was unfrequently performed. A better implementation of the health centres and training of the health workers are needed in order to improve the access and quality of the paediatric eye examination in primary health care institutions in Chile. El examen del rojo pupilar y la estimación de la agudeza visual durante el control del niño sano (CNS) en atención primaria en salud (APS) en Chile representan la mejor oportunidad para pesquisar y tratar precozmente la enfermedad oftalmológica grave, como el retinoblastoma y la ambliopía. El examen oftalmológico forma parte obligatoria de las normas técnicas del Ministerio de Salud para el CNS, sin embargo se desconoce el nivel de conocimiento y la frecuencia con la que los profesionales de la salud realizan el examen oftalmológico durante el CNS, así como las dificultades que enfrentan para realizarlo en APS. Mediante encuestas a profesionales de la salud que realizan CNS en centros de APS del área xxx de Santiago de Chile se investigó la frecuencia con que realizan el examen oftalmológico de los niños y los problemas a los que se enfrentan para realizarlo apropiadamente. Ciento treinta y siete profesionales respondieron la encuesta, correspondiendo mayoritariamente a médicos (45,2%) y enfermeras (35,8%). El examen del rojo pupilar y la estimación de la agudeza visual se realizaba con baja frecuencia (34% y 42,3%, respectivamente), siendo las principales causas para no hacerlo la falta de implementos para realizar los exámenes (55,2% y 43,9%, respectivamente) y la falta de capacitación (29,3% y 22%, respectivamente). En esta serie el examen oftalmológico se realizó infrecuentemente durante el CNS, requiriéndose mejor implementación y capacitación en el nivel de APS para mejorar la cobertura y calidad en beneficio de la salud visual de la población pediátrica de nuestro país.

Bright Futures Parent Handout: 11-14 Year Visits

Patient Education| 2021 Bright Futures Parent Handout: 11-14 Year Visits Connected Content Translation: Hojas informativas de Bright Futures para los padres: Visita médica de 11 hasta 14 años Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Share Icon Share Facebook Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Bright Futures Parent Handout: 11-14 Year Visits. Pediatric Patient Education 2021; 10.1542/peo_document263 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All AAP SitesAll PublicationsPediatric Patient Education Search Advanced Search Subjects: Bright Futures (Well-Child Visits) Topics: bright futures, protective helmet Here are some suggestions from Bright Futures experts that may be of value to your family. Encourage your child to be part of family decisions. Give your child the chance to make more of her own decisions as she grows older.Encourage your child to think through problems with your support.Help your child find activities she is really interested in, besides schoolwork.Help your child find and try activities that help others.Help your child deal with conflict.Help your child figure out nonviolent ways to handle anger or fear.If you are worried about your living or food situation, talk with us. Community agencies and programs such as SNAP can also provide information and assistance. Help your child get to the dentist twice a year.Give your child a fluoride supplement if the dentist recommends it.Encourage your child to brush her teeth twice a day and floss... You do not currently have access to this content.

Bright Futures Parent Handout: 2 Year Visit

Patient Education| 2021 Bright Futures Parent Handout: 2 Year Visit Connected Content Translation: Hojas informativas de Bright Futures para los padres: Visita médica del 2 año Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Share Icon Share Facebook Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Bright Futures Parent Handout: 2 Year Visit. Pediatric Patient Education 2021; 10.1542/peo_document254 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All AAP SitesAll PublicationsPediatric Patient Education Search Advanced Search Subjects: Bright Futures (Well-Child Visits), Newborns, Infants, and Toddlers Here are some suggestions from Bright Futures experts that may be of value to your family. Take time for yourself and your partner.Stay in touch with friends.Make time for family activities. Spend time with each child.Teach your child not to hit, bite, or hurt other people. Be a role model.If you feel unsafe in your home or have been hurt by someone, let us know. Hotlines and community resources can also provide confidential help.Don’t smoke or use e-cigarettes. Keep your home and car smoke-free. Tobacco-free spaces keep children healthy.Don’t use alcohol or drugs.Accept help from family and friends.If you are worried about your living or food situation, reach out for help. Community agencies and programs such as WIC and SNAP can provide information and assistance. Praise your child when he does what you ask him to do.Listen to and respect your... You do not currently have access to this content.

Choosing a Pediatrician

Patient Education| 2021 Choosing a Pediatrician Connected Content Translation: Elección de un pediatra Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Share Icon Share Facebook Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Choosing a Pediatrician. Pediatric Patient Education 2021; 10.1542/peo_document114 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All AAP SitesAll PublicationsPediatric Patient Education Search Advanced Search Topics: child health, vaccines, well child visit, immunization, emotions, schools, medical Are you expecting a baby or do you have children? If the answer is yes and you don’t have a doctor, there are many reasons why you should consider choosing a pediatrician. Read on for information from the American Academy of Pediatrics (AAP) about the benefits of choosing a pediatrician and how to choose a pediatrician and about why regular well-child visits are important. Children’s health care needs are different from those of adults. Pediatricians are trained to care for the special health care needs of children and to prevent and manage health problems in newborns, infants, children, teens, and young adults. A special bond is often developed over the years between the child, parents, and pediatrician. To become a pediatrician, a doctor must take special courses for 3 or more years after medical school. This is called residency. After... © 2017 American Academy of Pediatrics. All rights reserved. You do not currently have access to this content.

Screening traumatic life events in preschool aged children: cultural adaptation of Child and Adolescent Trauma Screen (CATS) Caregiver-report 3-6 years version.

Given the high prevalence of potentially traumatic events (PTEs), pediatric providers are in a novel position in early identification and referral of the children with PTEs. Yet paucity of culturally adapted instruments to screen PTEs and related symptoms in preschool-aged children limits pediatric providers. This multicenter study aimed to screen the traumatic life events of preschool-aged children admitted to pediatric outpatient clinics at four different cities of Turkey and to determine the socio-demographic risk factors associated with PTEs. Moreover, it was also intended to develop the cultural adaptation of the Child and Adolescent Trauma Screen (CATS) Caregiver-report 3-6 Years version to Turkish and to analyze its reliability. Participants of this multicenter study were collected from four different hospitals in three different regions (Central Anatolia, Black Sea, and Southeastern Anatolia regions) of Turkey. All parents of children at the age of 3-6 years who were admitted to the hospital for a clinical visit (sick-child or well-child visits) were invited to the study. In total, 188 preschool-aged children were included in the study. Socio-demographic characteristics of the child and the family were questioned and parents were asked to fill out the Turkish version of the CATS Caregiver-report. Internal consistency (Cronbach`s alpha) of the Turkish version of the CATS Caregiver-report 3-6 Years was found as 0.86. This study revealed that half of the participating children had experienced at least one PTE and more than one fourth experienced more than one event. Strikingly, no association between sociodemographic risk factors and PTE exposure was identified suggesting that PTE exposure is indeed widespread in our study population. The findings of this study manifest the importance of routine screening of PTEs and related symptoms in children.

Bright Futures Parent Handout: 7 and 8 Year Visits

Patient Education| 2021 Bright Futures Parent Handout: 7 and 8 Year Visits Connected Content Translation: Hojas informativas de Bright Futures para los padres: Visitas médica del 7 y 8 año Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Share Icon Share Facebook Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Bright Futures Parent Handout: 7 and 8 Year Visits. Pediatric Patient Education 2021; 10.1542/peo_document259 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All AAP SitesAll PublicationsPediatric Patient Education Search Advanced Search Subjects: Bright Futures (Well-Child Visits) Here are some suggestions from Bright Futures experts that may be of value to your family. Encourage your child to be independent and responsible. Hug and praise her.Spend time with your child. Get to know her friends and their families.Take pride in your child for good behavior and doing well in school.Help your child deal with conflict.If you are worried about your living or food situation, talk with us. Community agencies and programs such as SNAP can also provide information and assistance.Don’t smoke or use e-cigarettes. Keep your home and car smoke-free. Tobacco-free spaces keep children healthy.Don’t use alcohol or drugs. If you’re worried about a family member’s use, let us know, or reach out to local or online resources that can help.Put the family computer in a central place. Know who your child talks with online.Install a safety filter. Take your... You do not currently have access to this content.

Bright Futures Parent Handout: 2 Month Visit

Patient Education| 2021 Bright Futures Parent Handout: 2 Month Visit Connected Content Translation: Hojas informativas de Bright Futures para los padres: Visita médica del 2 mes Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Share Icon Share Facebook Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Bright Futures Parent Handout: 2 Month Visit. Pediatric Patient Education 2021; 10.1542/peo_document247 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All AAP SitesAll PublicationsPediatric Patient Education Search Advanced Search Subjects: Bright Futures (Well-Child Visits) Topics: bright futures, iron, bathing, sleep Here are some suggestions from Bright Futures experts that may be of value to your family. If you are worried about your living or food situation, talk with us. Community agencies and programs such as WIC and SNAP can also provide information and assistance.Find ways to spend time with your partner. Keep in touch with family and friends.Find safe, loving child care for your baby. You can ask us for help.Know that it is normal to feel sad about leaving your baby with a caregiver or putting him into child care. Feed your baby only breast milk or iron-fortified formula until she is about 6 months old.Avoid feeding your baby solid foods, juice, and water until she is about 6 months old.Feed your baby when you see signs of hunger. Look for her to Put her hand to her mouth.Suck, root, and fuss.Stop... You do not currently have access to this content.

Bright Futures Parent Handout: 15-17 Year Visits

Patient Education| 2021 Bright Futures Parent Handout: 15-17 Year Visits Connected Content Translation: Hojas informativas de Bright Futures para los padres: Visita médica de 15 hasta 17 años Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Share Icon Share Facebook Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Bright Futures Parent Handout: 15-17 Year Visits. Pediatric Patient Education 2021; 10.1542/peo_document265 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All AAP SitesAll PublicationsPediatric Patient Education Search Advanced Search Subjects: Bright Futures (Well-Child Visits) Topics: bright futures Here are some suggestions from Bright Futures experts that may be of value to your family. Set aside time to be with your teen and really listen to her hopes and concerns.Support your teen in finding activities that interest him. Encourage your teen to help others in the community.Help your teen find and be a part of positive after-school activities and sports.Support your teen as she figures out ways to deal with stress, solve problems, and make decisions.Help your teen deal with conflict.If you are worried about your living or food situation, talk with us. Community agencies and programs such as SNAP can also provide information and assistance. Make sure your teen visits the dentist at least twice a year.Give your teen a fluoride supplement if the dentist recommends it.Support your teen’s healthy body weight and help him be a healthy eater. Provide... You do not currently have access to this content.