2021 Recommendations for Preventive Pediatric Health Care

Hackell, Jesse M.; Abularrage, Joseph J.; Almendarez, Yvette M.; Boudreau, Alexy D. Arauz; Berhane, Abeba M.; Cantrell, Patricia E.; Kafer, Lisa M.; Schafer, Katherine S.; Skatrud, Alisa; Warner, Robin; Hagan, Joseph F.; Kemper, Alex R.; Shaw, Judith S.

doi:10.1542/peds.2020-049776

Cited by 18 publications

(4 citation statements)

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“…The American Academy of Pediatrics recommends routine developmental surveillance at all well-child visits. Additionally, it recommends developmental screening (which may include speech and language domains, but is not specific to speech and language delay and disorders) with validated tools at the 9-month, 18-month, and 30-month visits . The Canadian Task Force on Preventive Health Care recommends against screening for developmental delay using standardized tools in children aged 1 to 4 years with no apparent signs of developmental delay and whose parents and clinicians have no concerns about development …”

Section: Recommendations Of Othersmentioning

confidence: 99%

Screening for Speech and Language Delay and Disorders in Children

Barry,

Nicholson,

Silverstein

et al. 2024

JAMA

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ImportanceSpeech and language delays and disorders can pose significant problems for children and their families. Evidence suggests that school-aged children with speech or language delays may be at increased risk of learning and literacy disabilities, including difficulties with reading and writing.ObjectiveThe US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate benefits and harms of screening for speech and language delay and disorders in children 5 years or younger.PopulationAsymptomatic children 5 years or younger whose parents or clinicians do not have specific concerns about their speech, language, hearing, or development.Evidence AssessmentThe USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for speech and language delay and disorders in children who do not present with signs or symptoms or parent/caregiver concerns.RecommendationThe USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for speech and language delay and disorders in children 5 years or younger without signs or symptoms. (I statement)

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Section: Recommendations Of Othersmentioning

confidence: 99%

Screening for Speech and Language Delay and Disorders in Children

Barry,

Nicholson,

Silverstein

et al. 2024

JAMA

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“…Effective techniques in infancy and early childhood highlights dietary guidance directed at parents and parental role modeling, whereas older children and adolescents saw the most benefit from motivational interviewing, programs such as 5210, and frequent follow-up. The techniques and observations described may be incorporated into pediatric office visits to help establish healthy eating behaviors [26]. More research is needed to identify additional evidence-based interventions and implementation strategies.…”

Section: Review Findingsmentioning

confidence: 99%

Clinical interventions to increase vegetable intake in children

Beals

Deierlein²,

Katzow

2022

Current Opinion in Pediatrics

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Purpose of reviewEating behaviors and dietary patterns begin in early childhood and persist into adolescence and adulthood, affecting lifelong acute and chronic disease risk. Vegetables provide a high density of necessary vitamins, minerals, and fiber. Dietary intake data show that children of all ages consume below the recommended range for vegetables. Pediatric providers are optimally positioned to promote vegetable intake in childhood. This review seeks to summarize lessons learned from behavioral interventions useful in the pediatric primary care setting to improve vegetable intake.Recent findingsTen published studies tested behavioral interventions in primary care to increase child vegetable intake. Strategies tested include teaching healthy eating behaviors and role modeling to parents of infants, and motivational interviewing paired with frequent office visits and reminders for families of older children and adolescents. Some strategies suggested positive change, despite study quality being limited by underpowered samples, heterogeneity of outcome measures, and statistical analytic approach.SummaryIncreased vegetable intake was achieved in infants through parental role-modeling when providers emphasized healthy dietary choices in parents. Older children increased their vegetable intake with motivational interviewing and frequent reminders from providers. Despite the high prevalence of inadequate vegetable intake among children, at present, there is only a modest body of literature to help guide pediatric providers in implementing practice-based interventions to improve vegetable intake in childhood, highlighting a need for high-quality research in this area.

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“… 8 However, not every child receives a blood lead test, and those who do are not randomly sampled. Although some health services (e.g., immunizations, screening for autism spectrum disorder) are recommended for all children at regular intervals, 9 lead exposure screening and blood lead testing are recommended only for children “at risk of lead exposure.” 8 This includes all children covered by Medicaid at 12 and 24 months of age; those between 24 and 72 months of age who have not previously been tested must receive a test as well. 10 However, 35–60% of children on Medicaid are not tested for lead.…”

Section: Introductionmentioning

confidence: 99%

Patterns of Children’s Blood Lead Screening and Blood Lead Levels in North Carolina, 2011–2018—Who Is Tested, Who Is Missed?

Kamai

Daniels

Delamater

et al. 2022

Environ Health Perspect

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Background: No safe level of lead in blood has been identified. Blood lead testing is required for children on Medicaid, but it is at the discretion of providers and parents for others. Elevated blood lead levels (EBLLs) cannot be identified in children who are not tested. Objectives: The aims of this research were to identify determinants of lead testing and EBLLs among North Carolina children and estimate the number of additional children with EBLLs among those not tested. Methods: We linked geocoded North Carolina birth certificates from 2011–2016 to 2010 U.S. Census data and North Carolina blood lead test results from 2011–2018. We estimated the probability of being screened for lead and created inverse probability (IP) of testing weights. We evaluated the risk of an EBLL of at of age, conditional on characteristics at birth, using generalized linear models and then applied IP weights to account for missing blood lead results among unscreened children. We estimated the number of additional children with EBLLs of all North Carolina children using the IP-weighted population and bootstrapping to produce 95% credible intervals (CrI). Results: Mothers of the 63.5% of children (402,002 of 633,159) linked to a blood lead test result were disproportionately young, Hispanic, Black, American Indian, or on Medicaid. In full models, maternal age [ ; 95% confidence interval (CI): 1.13, 1.20] or smoking ( 1.14; 95% CI: 1.12, 1.17); proximity to a major roadway ( 1.10; 95% CI: 1.05, 1.15); proximity to a lead-releasing Toxics Release Inventory site ( 1.08; 95% CI: 1.03, 1.14) or a National Emissions Inventory site ( 1.11; 95% CI: 1.07, 1.14); and living in neighborhoods with more housing built before 1950 ( 1.10; 95% CI: 1.05, 1.14) or before 1940 ( 1.18; 95% CI: 1.11, 1.25) or more vacant housing ( 1.14; 95% CI: 1.11, 1.17) were associated with an increased risk of EBLL, whereas overlap with a public water service system was associated with a decreased risk of EBLL ( 0.85; 95% CI: 0.83, 0.87). Children of Black mothers were no more likely than children of White mothers to have EBLLs ( 0.98; 95% CI: 0.96, 1.01). Complete blood lead screening in 2011–2018 may have identified an additional 17,543 (95% CrI: 17,462, 17,650) children with EBLLs . Discussion: Our results indicate that current North Carolina lead screening strategies fail to identify over 30% (17,543 of 57,398) of children with subclinical lead poisoning and that accounting for characteristics at birth alters the conclusions about racial disparities in children’s EBLLs. https://doi.org/10.1289/EHP10335

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2021 Recommendations for Preventive Pediatric Health Care

Cited by 18 publications

References 0 publications

Screening for Speech and Language Delay and Disorders in Children

Screening for Speech and Language Delay and Disorders in Children

Clinical interventions to increase vegetable intake in children

Patterns of Children’s Blood Lead Screening and Blood Lead Levels in North Carolina, 2011–2018—Who Is Tested, Who Is Missed?

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