The American Academy of Pediatrics has made some significant changes to its 2016 Recommendations for Preventive Pediatric Health Care.  The recommendations are the American Academy of Pediatrics guidelines as to what screenings and assessments pediatricians should be including during a routine well child visit.  Among the highlighted changes are the addition of a depression screening, testing for high cholesterol in patients ages 9 to 11, and HIV screening for patients ages 16-18.

The depression screening has a suggested screening every year from ages 11 through 21.  This has been added due to the fact that suicide is now a leading cause of death among adolescents.  Signs of depression can look very different in children than they do in adults.

The change to include earlier screening of cholesterol level is in response to the growing epidemic of childhood obesity.  Recent data shows 20% of teenagers have elevated cholesterol levels which is earlier than previously thought.  Previously, cholesterol checks were only performed on children this age if they had a family history of high cholesterol, but new research shows many children with abnormal cholesterol have been missed due to those types of screenings so the change was made to test all children between the ages of 9-11.

Federal statistics show that 1 in 4 new HIV infections occurs in youth aged 13-24 and that 60% of all youth infected with HIV do not know they have HIV.  For these reasons the HIV screen was added for adolescents aged 16-18.

Some of the other changes include:

• Changing the recommendation for a routine vision screening at age 18 to a risk-based assessment.This is based on evidence showing that fewer new vision problems develop in low risk young adults.

• Recommendation for fluoride varnish application from 6 months through 5 years to help prevent dental cavities which is the top chronic disease affecting young children.

• Screening for cervical dysplasia, the presence of pre-cancerous cells on the surface of the cervix, only at 21 years as opposed to risk assessment every year from 11 to 21.

• A risk assessment is added at 15 and 30 months for hematocrit or hemoglobin screening to help detect anemia, an iron deficiency.

• A screening for congenital heart disease using pulse oximetry has been added to be performed in the hospital prior to newborn discharge from the hospital.

• Recommendation to use CRAFFT (Car, Relax, Forget, Friends, Trouble) screening questionnaire for screening adolescent drug and alcohol use.

Parents with questions and concerns regarding the changes are encouraged talk to their child's pediatrician regarding their child's next well visit.  The doctor will be able to advise parents on any questions you may have regarding any part of the new screenings and risk based assessments.  Coverage for all of these services can vary from health plan to health plan, so parents may want to check with their child's insurance carrier for specific benefit information.  You can view the full version of the American Academy of Pediatrics 2016 Recommendations for Preventive Pediatric Health Care here.