AAP Updates Guidelines for Preventative Health Screenings

On Monday, the American Academy of Pediatrics released new recommendations calling for more preventive screenings for children. Lauren Dunn, writing for Today, reports that children between the ages of 9 and 11 should now be screened for high blood cholesterol levels.
Atherosclerosis, the fatty substance that can cause heart attacks, strokes, and other problems, starts while children are still young. The screening change is based on concerns about the epidemic of growing obesity in children. The author of the Pediatrics report, Dr. Geoffrey Simon of Nemours DuPont Pediatrics in Wilmington, Delaware, says the goal is to identify risk factors early to reduce heart disease as adults, whether kids are obese or not.
If a child tests as having high cholesterol, lifestyle and diet changes are usually recommended. Identifying youngsters with high cholesterol may also identify parents who could be at risk.
Another added screening is for congenital heart disease in infants using pulse oximetry and should be performed before the newborn is discharged. At 15 to 30 months, another newly recommended assessment is a hematocrit or hemoglobin screening to detect anemia.
Because the top chronic disease in young children is dental cavities, fluoride varnish applications have been added to the list and are given at the doctor’s office from 6 months through five years. Physicians are suggesting a daub of toothpaste the size of a grain of rice should be used up to the age of 3. After that, a pea-sized amount may be used.
Teenagers as young as 16-18 are advised to have HIV screening at least once in a health care environment. The presence of HIV in the teen population is more than 0.1%, and sixty percent of teens who are infected with HIV do not know it. For those who live in areas with lower community HIV prevalence, routine testing for HIV is suggested for all teens who are sexually active and for those with other HIV risk factors.
Because suicide is the leading cause of death in adolescents, depression screening is advised for ages 11-21 annually. And all adolescents should take the CRAFFT (Car, Relax, Alone, Forget, Friends, Trouble) questionnaire. The survey, given by the teen’s doctor asks about cars and drug or alcohol use, relaxing by using drugs, drinking alone, forgetting things while using drugs or alcohol, friends suggesting cutting down on drinking or drug use to another teen, and getting into trouble while using drugs or alcohol.
Routine vision screenings for 18-year-olds has changed based on the fact that fewer new vision problems are developing in low-risk young adults.
There has been a change in screening for the presence of pre-cancerous cells on the surface of the cervix from every year from 11 through 21 to only at 21-years-old.
WRIC-TV reports that cholesterol screenings were only done in the past based on family history, but current research has found that those types of testings miss too many children with abnormal cholesterol levels. Also, US government data shows that approximately 20% of US teenagers have unhealthy levels of cholesterol, according to Amy Norton of HealthDay. The recommendations have been summarized in the journal Pediatrics.
Dr. Geoffrey Simon, who chairs the academy’s Committee on Practice and Ambulatory Medicine, says 11% of 12- to 17-year-olds had at least one case of major depression in 2013, according to the US National Institute of Mental Health. That amounts to 2.6 million teenagers. Simon added that doctors were trying to identify depression in kids before the point is reached where they might need medication.
Depression in children can present as sleep problems or poor appetite, so it is not always recognizable to parents.