HealthCheck Training

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Post-Test

Overview

• EPSDT Benefits
• HealthCheck EPSDT
  • Goals
  • Participants/Providers
  • Support Services
  • Coordination

Health Supervision

• Introduction
  • Screens
  • Diagnosis/Treatment/Referral
• Health History
  • Initial History
  • Interval
  • Specific Visits
• Physical Examination
  • Unclothed Exam
  • Body Measurements
  • Specific Visits
• Screening Services
  • Nutrition
  • Vision
  • Speech/Language
  • Hearing
  • Development/Behavior
• Laboratory Tests
  • Metabolic
  • Sickle Cell
  • Lead
  • Anemia
  • Urinalysis
  • Cholesterol
  • Tuberculosis
  • STDs
• Immunizations
  • Schedule
  • Vaccines for Children Program
  • Documentation
  • Precautions/Exceptions/Contraindications
• Health Education
  • Tips for Working with Families
  • Tips for Working with Teens
  • Specific Visits

Special Health Issues

• Introduction
• Dental Health
  • History/Evaluation
  • Guidance/Referrals
  • Dental Services
  • Provider Resources
• Overweight and Obesity
  • Screening
  • Assessment
  • Treatment/Referrals
• HIV Guidelines
• Child Abuse & Neglect
• Language Barriers
  • Resources and HIPAA
  • Interpreter Tips
• Early Intervention

Documentation

• Guidelines
• Reporting
• EMRs and Required Data
• Billing Procedures
• Billing Codes

Go To Resources »

Health Supervision

Physical Examination: Assessment of Physical Growth

Body Measurements

Body measurements of infants and children help to identify significant conditions, including growth retardation, malnutrition, obesity, and developmental abnormalities.

Plot all measurements of head circumference, length/height, and weight on age- and gender-specific CDC Growth Charts.

Head Circumference (Newborn-24 Months)

• Use non-stretchable measuring tape (metal, fiberglass, or disposable paper, not cloth).
• Extend the tape around the most prominent part of the occiput to the mid-forehead; tighten the tape to compress the hair.
• Plot measurement on appropriate CDC Growth Charts.

Height (or Length)

• Measure height (or length) at each visit for all ages.
• Plot measurement on appropriate CDC Growth Charts.

For children less than 2 years (and those ages 2-3 who cannot stand unassisted):

• Place the infant or young child in a lying-down position.
• Use a measuring board with stationary headboard and sliding vertical foot piece.

For children older than 2 years:

• Obtain a standing height beginning at 2-3 years of age.
• Stand the child (barefoot or in socks only) with head, shoulder blades, buttocks, and heels touching the wall.
• Ask the child to look straight ahead, with knees straight and feet flat on the floor.
• Use a graduated ruler or tape attached to a wall.
• Place a flat surface horizontally on top of the child’s head.
• Lower the flat surface horizontally until it touches the crown of the head, compressing the hair.

Weight

• Measure weight at each visit for all ages.
• Plot measurement on appropriate CDC Growth Charts.

For infants and small children:

• Use a balance-beam table model or electronic scale (spring-type scales are not sufficiently accurate).
• Be sure the scale is zeroed before each use.
• Be sure infant or child is unclothed (or wearing only a dry diaper or light underpants).

For children and youth older than 2-3 years:

• Weigh child on a floor model beam scale.
• Check scales regularly for accuracy.
• Be sure child is unclothed and draped in a light gown.

Weight-for-Length (Newborn-18 months)

• Measure weight-for-length also at 24 and 30 months if only recumbent length is available.
• After measuring weight and length (as described above), plot on weight-for-length growth chart.
• This measurement corresponds to body-mass-index-for-age in older children.

Recording Height and Weight Measurements

• Plot measurements on age- and gender-specific CDC Growth Charts.
• Interpret measurements in the context of child’s family and growth history.
• Document measurements over time to provide an accurate record of growth.
• Recognize that large or sustained deviations signal a potential problem.

If measurements are between 10th and 25th percentiles, or between 75th and 90th percentiles:

Assess past growth patterns and genetic and environmental factors to determine whether in-depth follow-up is required.

If measurements are less than 5th percentile or greater than 95th percentile:

Recheck measurements; if confirmed, consider a detailed medical evaluation.

 

Body Mass Index (BMI) (ages 2-21 years)

• Calculate BMI using metric or English formula:
  • Metric formula: weight (kg) divided by height (m)
  • English (standard) formula: weight (lbs) divided by height (in) then multiplied by 703
  • Or use a BMI calculator
• Compare BMI to norms listed for child's gender and age by plotting on BMI-for-age graph.
• Use BMI percentile to assess for underweight (below 5th percentile), overweight (95th percentile or above), and risk for overweight (85th to 94th percentile).