Health Supervision
Screening Services & Assessments: Introduction
 This
module describes health screenings and assessments* that
are part of comprehensive pediatric preventive care, including:
- Nutrition
- Vision
- Speech
and Language
- Hearing
- Developmental/Behavioral
- Dental (detailed
in the Special Health Issues section)
The
periodicity (timing and frequency) for each screening is
based on recommendations for children who are growing and
developing in a healthy way, with no significant health
problems.
The HealthCheck
Periodicity Schedule indicates the recommended
age(s) for each specific health screening. More frequent
screening
may be needed in certain circumstances (medical conditions,
risk factors, family concerns, gaps in continuity or
documentation of care).
Documenting
Health Screenings
- Nutrition Assessment:
- Record accurate measurements of the child's height and weight—these are among the most important indices of nutritional status. For 0-18 months: Breastfed or formula fed? [record formula type].
- Ask the family about dietary practices to identify unusual eating habits or diets that are deficient in nutrients and calories, or excessive in cholesterol and fat.
- Vision Screening:
- Required at 3,5,6,8,10,12,15,18 years according to the HealthCheck Periodicity Schedule.
- Document visual acuity (for both left eye and right eye); [score 20/__] and indicate [corrected or uncorrected]; document if an unsuccessful attempt.
- Hearing Screening:
- Newborn hearing screening required.
- Additional screenings required at 5,6,8,10,12,15,18 years according to the HealthCheck Periodicity Schedule.
- Document [passed or failed]; document if an unsuccessful attempt.
- Developmental Screening:
- Required at all visits according to the HealthCheck Periodicity Schedule.
- Development: indicate tool used (Denver Developmental II or other): see areas of development (PDF) to be recorded.
- Speech and language: evaluate the infant’s or child’s communication abilities in comprehension, expressive language, speech development, and social language.
- Dental Evaluation:
- Dental evaluation follows the HealthCheck Dental Periodicity Schedule (PDF).
- Oral screening must be part of every well-child physical exam, but should not be seen as a substitute for an exam by a dentist.
- An oral assessment should be done by the primary care physician/pediatrician up to age 3. Every Medicaid-enrolled infant should receive an oral health risk assessment from his/her primary health care provider or qualified health care professional by 6 months of age that includes: (1) assessing the patient’s risk of developing oral disease using the AAPD Caries-risk assessment tool; (2) providing education on infant oral health; and (3) evaluating and optimizing fluoride exposure.
- All Medicaid-enrolled children should be referred to a dentist for the establishment of a dental home within 6 months after the first tooth erupts, or 12 months of age (whichever comes first). Providers should encourage families to take their child to a dentist every 6 months.
- The oral assessment done by the primary care physician/pediatrician should not be in place to a visit to a dentist, and should include the importance of oral care and a referral to a dentist.
- For assistance in finding a dentist and scheduling an appointment, caregivers should be encouraged to call the Dental Helpline: 866-758-6807.
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