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What's New in AAP 2008 Periodicity

This document summarizes additions to “Recommendations for Preventive Pediatric Health Care (Periodicity Schedule),” available on the AAP website as of 12/11/07, at http://practice.aap.org/content.aspx?aid=1599&nodeID=4003. It does not cover every change, but summarizes key additions.

NEW HEALTH SUPERVISION VISITS

30 months, 7 and 9 years

GROWTH MEASUREMENTS

Weight-for-Length
BMI

DEVELOPMENTAL/BEHAVIORAL ASSESSMENT

Now 5 sub-categories:

Developmental screening at 9, 18, and 30 months
Autism screening at 18 and 24 months
Developmental Surveillance - at each visit except when screening tool is used (9, 18, 30 months)
Psychosocial/Behavioral Assessment - risk assessment at each visit
Alcohol and Drug Use Assessment - risk assessment at ages 11 through 21

PROCEDURES

Newborn screening - by 2 months (formerly by 1 month)
Hematocrit/hemoglobin risk assessment - at 4 months (formerly 9-12 months)
Lead screening - begin lead risk assessment earlier (6 months); assess risk more frequently (6, 9, 12, 18, 24 months, and 3-6 years annually); perform risk assessments or screens, as appropriate, at 12 and 24 months, based on universal screening requirements for patients with Medicaid or high prevalence areas
TB test - assess risk by 1 mo, again at 6 mos, 12 mos, etc. (formerly risk assess. began at 12 mos)
Cholesterol (now Dyslipidemia) risk assessment: at 24 months, 4, 6, 8, and 10 years, 11-17 years; (formerly at 24 months and every visit thereafter); screen once between 18 and 21 years
Cervical Dysplasia screening: assess risk at each visit 11 - 21years
Pelvic Exam not listed, but footnote 20 states: "All sexually active girls should have screening for cervical dysplasia as part of a pelvic examination beginning within 3 years of onset of sexual activity or age 21 (whichever comes first)."
Urinalysis -- DELETED throughout

ORAL HEALTH

Oral health risk assessment: at 6 and 9 months; referral to dentist (dental home) at 12, 18, 24, and 30 months, if dental home available; otherwise, oral health risk assessment (see footnote #21). At age 3 and 6 years, determine if child has dental home, if not, make referral. Assess need for fluoride supplements as part of oral health risk assessments.

PHYSICAL EXAMINATION

Physical examination at each visit (same as 2000 periodicity), but also at 3 new visits (30 months, 7 and 9 years)

IMMUNIZATIONS

Immunization status reviewed and updated at each visit (as in 2000 Periodicity Schedule) but also at 3 new visits (30 months, 7 and 9 years)

ANTICIPATORY GUIDANCE

No breakouts for topics; users referred to Bright Futures Guidelines, Third Edition