Prevention Book

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Well Child Visit

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  1. See Also
    1. Pediatric Vaccination
    2. Developmental Evaluation
    3. Growth Assessment
  2. Protocol: Vital signs
    1. Body Temperature (until after age 18 months)
    2. Blood Pressure (starting at age 3 years of age)
  3. Protocol: Growth (review on growth curves at each visit)
    1. Height
    2. Weight
    3. Head Circumference (until after age 2 years)
  4. Protocol: Exam
    1. Complete physical examination
    2. Eye exam
      1. Red Reflex (until after age 2 years)
      2. Strabismus testing such as cover-uncover (until after age 2 years)
      3. Vision (subjective until age 3 years, then formally check vision)
    3. Hearing exam
      1. Subjective hearing screening until age 3 years, then formal hearing screening
  5. Protocol: Developmental Screening
    1. General Screening (at each schedule well visit)
      1. Age 2-4 months: Edinburgh Questionnaire or INI Questionnaire
      2. Age 4-18 months: ASQ Questionnaire, PEDS Questionnaire or INI Questionnaire
      3. Age 18-60 months: ASQ Questionnaire, PEDS Questionnaire or CDR Questionnaire
    2. Specific Screening: Perform for all children at specific visits
      1. Modified Checklist for Autism in Toddlers (M-CHAT): Perform at 18 and 24 months
      2. ASQ: SE Behavioral Screening: Perform at 6,12, 18, 24, 30, 36, 48 and 60 months
  6. Protocol: Labs
    1. Newborn Screening (review results at first well child visit)
    2. Hemoglobin at 9-12 months
    3. Lead level at 9-12 months and 18-24 months
  7. Protocol: Immunizations
    1. See Pediatric Vaccination for schedule
    2. Influenza Vaccine (if November to March; Give second dose in first season)
  8. Protocol: Referrals
    1. Dental visits starting at age 3 years
  9. Protocol: Anticipatory Guidance
    1. Newborn: Jaundice, eating, sleep, maternal bonding
    2. Month 2: Colic, growth, sleep, sibling adjustment
    3. Month 4: Childcare, sleep, solid introduction
    4. Month 6: Child proofing
    5. Month 9: Child proofing, stranger anxiety
    6. Month 12: Discipline, shoes, walking, turning Car Seat
    7. Month 15: Discipline, Time-Out
    8. Month 18: Temper tantrums, sleep problems
    9. Month 24: Toilet Training, sleep problems, speech development
    10. Month 36: Eating patterns, socialization, books
    11. Month 48: Speech, school readiness
    12. Month 60: Behavioral consequences
  10. References
    1. Neale (2008) Park Nicollet Primary Care Update Lecture, St. Louis Park, MN

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