Routine Well Child Visit

Validated Screening Tools at what visits

9, 18, 30 months

Most common validated screening tool

ASQ-3

Autism screening

18 and 24 mo, using M-CHAT-R

Vitals

Weight, weight percentile, length, length percentile, head circumference (up to 2 y/o), head circumference percentile, BMI (if 24mo+), temp, pulse, resp. rate, (BP if 3 y/o+),

0-6 months weight gain

1 ounce/day, doubles birthweight in 4-5 months

12 month weight gain

Triples birth weight

12 month length change

increases by 50%

After 2 y/o weight gain & growth

2-3kg/year, 5-7 cm/year

Universal Screenings

administered to everyone of a certain age

Risk based Screening

administered to those who answered yes to risk questionnaire

Common screening tests

hemoglobin, lead, TB, lipids

CRAFFT questionnaire

screens for concerning social behaviors
CAR with someone driving who had been drinking?
RELAX by using drugs?
ALONE when you use?
FORGET things you did while using?
FAMILY or FRIENDS ever tell you to cut down?
TROUBLE while using?

administered at 12+

Depression Screening

PHQ-9 tool, administered at 12+

Eruption of primary teeth begins at what age

6 months (but ranges 4-12 months)

A child will have how many teeth for each month of age

1, between 6-26 months. up to 20 teeth

Complete eruption of primary teeth completed when

Age 2-3

AAP recommendation for baby teeth

fluoride varnish every 3-6 months

Nonnutritive sucking

fingers or pacifier sucking

Thumb-sucking initation

first as a reflex, then a habit to self-soothe

Age of stopping thumb-sucking

2-3 y/o, dental problems if beyond 4 y/o

Toilet Training Age

starts learning between 18-24 months

Impediments to toilet training

stress, constipation, spinda bifida occluta, genital anomalies

Bed wetting term

Nocturnal Enuresis

Primary Nocturnal Enuresis

a child wets their bed, but never reached the stage of non-wetting
Not a concern

Secondary Nocturnal Enuresis

Bed wetting after already establishing routine dry sleep, concerns for diabetes

Anticipatory guidance for toilet training

begins around 15 months old

Treatment for nocturnal enuresis

Fluid restrictions, alarms, medications

Discipline for toddlers and infants

redirection and distraction

“time out” discipline

must be consistent, give one minute per year of life

Entertainment Guidelines

minimized screen use (both child & infant) helps with language development, attachment, and security

ABCs of safe sleep

Alone, on Back, in a Crib

What should be in a crib with a sleeping baby

NOTHING, risks suffocation

Importance of sleeping on back

Decreases the risk of SIDS

Infant car seats

rear facing until 2 y/o or exceeds height/weight limit

Toddler Car Seats

Forward facing with harness until height/weight limit exceeded

School-aged children car seats

booster seats until 12 years old and 4’9”

Baby Walkers

not promoted by AAP, can cause injury/death and delay walking