American family physician
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American family physician · Aug 2019
Health Maintenance in School-Aged Children: Part I. History, Physical Examination, Screening, and Immunizations.
The goals of the health maintenance visit in school-aged children (five to 12 years) are promoting health, detecting disease, and counseling to prevent injury and future health problems. During the visit, the physician should address patient and parent/caregiver concerns and ask about emergency department or hospital care since the last visit; lifestyle habits (diet, physical activity, daily screen time, secondhand smoke exposure, hours of sleep per night, dental care, safety habits); and school performance. Poor school performance may indicate problems such as learning disabilities, attention-deficit/hyperactivity disorder, or bullying. ⋯ There is insufficient evidence to recommend routine screening for depression before 12 years of age, but depression should be considered in children younger than 12 years presenting with unexplained somatic symptoms, restlessness, separation anxiety, phobias, or hallucinations. Children living in areas with inadequate levels of fluoride in the water supply (0.6 ppm or less) should receive daily fluoride supplements. Age-appropriate immunizations should be given, as well as any catch-up immunizations.