News Director: Gail M. Pfeifer, MA, RN E-mail: [email protected]
New Pediatric Screening Recommendations The 2016 schedule focuses on prevention. [email protected]
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he American Academy of Pediatrics (AAP) has updated its Recommendations for Preventive Pediatric Health Care, also known as the periodicity schedule. The schedule lists the screenings that should be performed at well-child visits and at which ages. They are updated each year to reflect the latest scientific evidence. Some of the changes in the 2016 schedule are responses to increases in childhood obesity, such as the recommendation that children nine to 11 years and youths 18 to 21 years be screened for high blood cholesterol levels (dyslipidemia) and that those in between those years be screened if certain risk factors are present. About 8% of eight-to-17-year-olds have elevated total cholesterol levels. Early treatment may delay adult heart disease, although more studies are needed to ensure that such treatment is beneficial. Update highlights include the following: • Screening for congenital heart defects, using pulse oximetry, should be performed before newborns are discharged from the hospital. • To detect anemia, hematocrit or hemoglobin screenings should be performed at 15 and 30 months. • Because suicide is now a leading cause of teen deaths, yearly depression screening should be conducted in patients 11 to 21 years old. • Clinicians should use the CRAFFT (Car, Relax, Alone, Forget, Friends, Trouble) mnemonic to screen for drug and alcohol use. The yes–no questionnaire helps clinicians
identify those at risk for or already experiencing adverse consequences of substance abuse. • One in four new cases of HIV occurs in young people, ages 13 to 24. The AAP recommends HIV screening in youths 16 to 18 and earlier or later according to risk. • Tooth decay (dental caries) is the most common chronic disease in children. Parents should brush their infant’s teeth as soon as they erupt (appear) with fluoride toothpaste, and pediatricians should encourage parents to find a dentist by the infant’s first birthday. • Infants with family histories of congenital cataracts,
r etinoblastoma, or metabolic disease associated with ocular abnormalities should be evaluated by an ophthalmologist. • Screening for cervical dysplasia to detect cervical cancer should be done at 21 years. Previously, screening was performed yearly starting at 11 years; the change was made because evidence suggests that routine screening in a younger population may be more harmful than beneficial. To read more about the new screening guidelines, see http:// bit.ly/1IXW5rF. A direct link to the periodicity schedule is available at http://bit.ly/1PNGUny . —Carol Potera AJN ▼ March 2016
Vol. 116, No. 3