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Pediatric Health Maintenance 7 to 9 Year quick look
This chart rates treatment options according to general effectiveness, ease of use, side effects and safety.
Legend:     Excellent  Very Good  Good  Fair  Poor  Not available 
Development - Recommended
Treatment Overall Score Effective-
ness
Safety Ease
of Use
Side
Effects
Comments
Discuss nutrition, sleep, and school results  

Not available 
 
 
 
 
Discuss whether child is getting appropriate amounts of sleep. Homework time, school behavior/performance should also be addressed. Look for any speech impediments like lisping or stuttering.
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Discuss nutrition, sleep, and school results

For more information about developmental milestones, the University of Michigan has a helpful website at http://www.med.umich.edu/1libr/yourchild/devmile.htm

The American Academy of Pediatrics also has a useful website at: http://www.aap.org/healthtopics/stages.cfm

 

Legend:     Excellent  Very Good  Good  Fair  Poor  Not available 
Physical examination - Recommended
Treatment Overall Score Effective-
ness
Safety Ease
of Use
Side
Effects
Comments
Full physical exam  

Not available 
 
 
 
 
Physician compares height to a growth chart to see if growth is normal. Physician should also evaluate early signs of puberty and check for curature of the spine (scoliosis).
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Full physical exam

The earliest signs of puberty are underarm odor, breast bud development and pubic hair. Also growth spurt. Scoliosis is a curvature of the spine that requires evaluation by a specialist.

 

Legend:     Excellent  Very Good  Good  Fair  Poor  Not available 
Screening Tests - Recommended
Treatment Overall Score Effective-
ness
Safety Ease
of Use
Side
Effects
Comments
Lead and tuberculosis test if child is at risk  

Excellent 
 
 
 
 
Risks for tuberculosis exposure in the childhood years include the following: living in an area where tuberculosis is present, being homeless, being a recent immigrant, or history of exposure to family members with tuberculosis.

Risks for lead poisoning include living in an older house and having a sibling (brother or sister) who has had lead poisoning.

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Lead and tuberculosis test if child is at risk

 
Blood pressure check  

Excellent 
 
 
 
 
A growing number of children have high blood pressure. While most cases are due to other medical conditions, an increasing number of children are being diagnosed with primary, or "essential" hypertension (high blood pressure without a known cause). High blood pressure in children is different than in adults. It follows different diagnosis guidelines, has different treatment options, and different measures of treatment success. Early detection is important.
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Blood pressure check

 
Cholesterol blood test if there is a family history of high cholesterol  

Not available 
 
 
 
 
Cholesterol blood test if there is a family history of high cholesterol and if test has not been done previously
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Cholesterol blood test if there is a family history of high cholesterol

Childhood high cholesterol is a risk factor for vascular disease, particularly heart disease, as children progress to adulthood. Cholesterol screening is recommended after age two, and no later than age ten for children with a family history of high cholesterol or heart disease, for children with an unknown family history, as well as for children who are obese, have high blood pressure, or diabetes. Children who have elevated levels of cholesterol should focus on weight reduction (if overweight), increased physical activity, and nutritional counseling.

Previous American Academy of Pediatrics guidelines recommended the use of certain cholesterol-lowering drugs for children called "bile acid-binding drugs" (Questran/cholestyramine) which are not absorbed into the bloodstream; but only if diet management and exercise do not adequately lower cholesterol levels. The new 2008 American Academy of Pediatrics guidelines added the option of drugs called "statins" (Lipitor/atorvastin, Pravachol/pravastatin, Crestor/rosuvastatin, many others), which are the most common treatment for adults with high cholesterol. This recommendation is controversial since there is only limited, short-term data evaluating the safety of statins in children; and long-term follow-up data is completely lacking. Unlike the cholesterol-binding drugs, the statins are absorbed into the bloodstream and affect the way that the body metabolizes (processes) fats. There is some concern that long-term drug therapy with statins started at an early age may have adverse and unanticipated consequences since brain development, manufacture of hormones, and growth of other organs involve fat metabolism.

Careful consideration must be given to all of the potential risks and benefits to the child before these medications are started.

A healthier approach to the increasing problem of high cholesterol related to childhood obesity would include more emphasis on preventive public health measures, such as regulating food marketing to children, improving the quality of school nutrition, promoting physical activity at school, and providing more funding for obesity prevention programs.

For further information, the original article containing this information can be found at N Engl J Med. 2008 Sep 25;359(13):1309-12, PMID: 18815394.

 
Screening urinalysis
(should be done once in the early school-age years)
 

Very good 
 
 
 
 
Recommended once; if normal, does not need to be repeated until teen years.
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Screening urinalysis

 
Hearing/vision check  

Excellent 
 
 
 
 
Recommended. Simple wall eye chart and whispered voice testing are adequate for screening; referral for more sophisticated testing is only necessary if screening tests are abnormal.
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Hearing/vision check

 

Legend:     Excellent  Very Good  Good  Fair  Poor  Not available 
Immunizations - Recommended
Treatment Overall Score Effective-
ness
Safety Ease
of Use
Side
Effects
Comments
Influenza Vaccine
(flu shot)
 

Good 
 
 
 
 
Children over 6 months of age should get the flu shot every year. The best time to get the shot is from October to mid-November.
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Influenza Vaccine

If a child has never had a flu shot he/she will need two doses (about a month apart) the first year the vaccine is given. After the first year only one dose is needed per year. The major side effects are local pain and fever. There have been rare severe side effects reported involving the nervous system. The only children who should not get a flu shot are those with a severe allergic reaction to eggs.

 

Legend:     Excellent  Very Good  Good  Fair  Poor  Not available 
Guidance/Injury prevention - Recommended
Treatment Overall Score Effective-
ness
Safety Ease
of Use
Side
Effects
Comments
Discuss nutrition, health and sleep habits, behavior, and safety issues  

Not available 
 
 
 
 
Discuss teeth brushing twice a day. Also the need for 9-10 hours of sleep per night.
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Discuss nutrition, health and sleep habits, behavior, and safety issues

 

 
     
NOTE: Just because a drug or combination of drugs can cause a symptom does not mean it is actually causing your symptom. Symptoms can be caused by medical conditions as well. Make sure that your physician is aware of any symptoms you are experiencing so he/she can work with you to determine the cause. Please DO NOT STOP MEDICATIONS without first consulting a physician since doing so could be hazardous to your health.
DISCLAIMER: Please note that the information DoubleCheckMD.com provides is intended to help individuals to work with their medical professionals and is for educational purposes only. It does not constitute medical or healthcare advice and serves to supplement, not substitute for, the expertise and judgment of a healthcare professional. In all cases individuals should consult with a physician before taking any action based on DoubleCheckMD feedback including, but not limited to ceasing taking any drug, changing diet or commencing or discontinuing any course of treatment. The information provided by DoubleCheckMD.com is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that the use of a particular drug is safe, appropriate or effective.


 
 
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