The American Academy of Pediatrics has published an update to its recommendations for preventative pediatric health care.
The update, published online December 7, includes key items the academy advises pediatricians check during child health screenings. A recurring theme is that the screenings are recommended for all children in certain age groups and not only for those who might be at increased risk. For example, all children must be screened for high cholesterol between the ages of 9 and 11.
At one time, screenings were only done based on family history, but new research suggests that those type of screenings miss too many children with abnormal cholesterol. Also, high cholesterol in children and adolescents has become an increasing problem according to the Center for Disease Control and Prevention (CDC).
As a result of the current U.S. childhood obesity epidemic, the CDC says conditions formerly seen only in adults, such as high cholesterol, are increasingly observed in children. According to the CDC about one in every five teens and almost one in ten children have high cholesterol.
Another change in the recommendations is a depression screening for ages 11 through 21. The American Academy of Pediatrics said with suicide now a leading cause of death among adolescents they felt it was important to add the screening to their list of recommendations.
HIV screening was added to the recommendations for teens age 16 and 18. According to federal statistics 1 in 4 new HIV infections occurs in youth ages 13 to 24 years old and that about 60 percent of all youth with HIV do not know they are infected.
- The recommendation for routine vision screening at age 18 has been changed to risk-based assessment, based on evidence showing that fewer new vision problems develop in low-risk young adults.
- To help reduce dental cavities, the top chronic disease affecting young children, a recommendation has been added for fluoride varnish applications from 6 months through 5 years.
- Pediatricians are advised to use the CRAFFT (Car, Relax, Forget, Friends, Trouble) screening questionnaire as a tool to screen adolescents for drug and alcohol use.
- Depression screening has been added, with suggested screenings every year from ages 11 through 21, with suicide now a leading cause of death among adolescents.
- A screening for dyslipidemia, or high blood cholesterol levels, has been added for patients between 9 and 11 years old. The change reflected growing concerns about the growing epidemic of obesity in children.
- A risk assessment is added at 15 and 30 months for hematocrit or hemoglobin screening to help detect anemia, an iron deficiency.
- An HIV screen was added for adolescents between 16 and 18 years to address federal statistics showing that 1 in 4 new HIV infections occurs in youth ages 13 to 24 years old and that about 60% of all youth with HIV do not know they are infected.
- Screen for cervical dysplasia, the presence of pre-cancerous cells on the surface of the cervix, only at 21 years (instead of risk assessment every year from ages 11 through 21).
- A screening for critical congenital heart disease using pulse oximetry has been added and should be performed in the hospital before newborn discharge.