BRIGHTFUTURES p p
p
Guidelines for Health Supervision of p p
Infants, Children, and Adolescents
p p p
TpHpIpRpDp p EpDpIpTpIpOpNp
P pO pC pK pE pT G pU pI pD pEp
Editors
JosephpF.pHagan,pJr,pMD,pFAAP
pJudithpS.pShaw,pRN,pMPH,pEd
DpPaulapM.pDuncan,pMD,pFA
AP
FUNDEDp BYp
USpDepartmentpofpHealthpandpHumanpServicespHea
lthpResourcespandpServicespAdministrationpMatern
alpandpChildpHealthpBureau
P UB LI S HE D p BYp
,ThepAmericanpAcademypofpPediatrics
,CITE p ASp
HaganpJF,pShawpJS,pDuncanpP,peds.p2008.pBrightpFutures:pGuidelinespforpHealthpSupervisionpofpInfants,pChildren,pandpAdol
escents,pThirdpEdition.pPocketpGuide.pElkpGrovepVillage,pIL:pAmericanpAcademypofpPediatrics.
Copyrightp©p2008pbypthepAmericanpAcademypofpPediatrics.pAllprightspreserved.pNoppartpofpthisppublicationpmaypbeprep
roduced,pstoredpinpapretrievalpsystem,porptransmitted,pinpanypformporpbypanypmeans,pelectronic,pmechanical,pphoto-
pcopying,precording,porpotherwise,pwithoutppriorpwrittenppermissionpfromptheppublisher.
LibrarypofpCongresspCatalogpCardpNumber:p200792996
4pISBN-13:p978-1-58110-224-6
ISBN-10:p1-58110-224-
0pBF0027
P UB LI S HE D p BYp
AmericanpAcademypofpPediatricsp
141pNorthwestpPointpBlvd
ElkpGrovepVillage,pILp60007-
1098pUSA
847-434-4000
AAPpWebpsite:pwww.aap.org
BrightpFuturespWebpsite:phttp://brightfutures.aap.org
AdditionalpcopiespofpthisppublicationparepavailablepfrompthepAmericanpAcademypofpPediatricspOnlinepBookstorepatpwww.aap.org/bookst
ore.
ThisppublicationphaspbeenpproducedpbypthepAmericanpAcademypofpPediatricspunderpitspcooperativepagreementp(U06MC
00002)pwithpthepUSpDepartmentpofpHealthpandpHumanpServices,pHealthpResourcespandpServicespAdministrationp(HRSA),p
MaternalpandpChildpHealthpBureaup(MCHB).
, TABLE OF CONTENTS p p
BrightpFuturespatpthepAmericanpAcademypofpPediatrics .......... v 15pMonthpVisit ....................................................................... 20
HowptopUsepThispGuide............................................... vii 18pMonthpVisit ....................................................................... 22
CorepConcepts .......................................................... ix 2 YearpVisit............................................................................. 24
BuildingpEffectivepPartnerships ......................................................x 212p YearpVisit........................................................................... 26
Fosteringp Family-Centeredp Communication ..................................... xi 3 YearpVisit............................................................................. 28
Promotingp Healthp andp PreventingpIllness...................................... xii 4 YearpVisit............................................................................. 30
ManagingpTimepforpHealthpPromotion........................................ xiii 5 andp6pYearpVisits................................................................... 32
EducatingpFamiliespThroughpTeachablepMoments .......................... xiv 7pandp8pYearpVisits .................................................................. 34
AdvocatingpforpChildren,pFamilies,pandpCommunities..................... xv 9pandp10pYearpVisits ................................................................ 38
SupportingpFamiliespSuccessfully................................... xvii EarlypAdolescencep(11ptop14pYearpVisits) ..................................... 42
ChildrenpandpYouthpWithpSpecialpHealthpCarepNeeds ................. xvii MiddlepAdolescencep(15ptop 17pYearpVisits) .................................. 46
CulturalpCompetence ............................................................ xvii LatepAdolescencep(18ptop21pYearpVisits)...................................... 50
ComplementarypandpAlternativepCare ....................................... xviii Appendices ............................................................ 53
BrightpFuturespThemes............................................... xix DevelopmentalpMilestonespatpapGlancep—pInfancy........................ 54
Brightp Futuresp Healthp Supervisionp Visits ............................ 1 DevelopmentalpMilestonespatpapGlancep—pEarlypChildhood ............ 55
AcronymspUsedpinpthepBrightpFuturespHealthpSupervisionpVisits........ 1 SocialpandpEmotionalpDevelopmentpinpMiddlepChildhood............... 56
PrenatalpVisit ............................................................................ 2 DomainspofpAdolescentpDevelopment......................................... 57
NewbornpVisit .......................................................................... 4 RecommendedpMedicalpScreeningp—pInfancy .............................. 58
FirstpWeekpVisit ......................................................................... 6 RecommendedpMedicalpScreeningp—pEarlypChildhood ................... 59
1 MonthpVisit ........................................................................... 8 RecommendedpMedicalpScreeningp—pMiddlepChildhood ................ 60
2 MonthpVisit ......................................................................... 10 RecommendedpMedicalpScreeningp—pAdolescence....................... 61
4pMonthpVisit ........................................................................ 12 Toothp Eruptionp Chart ................................................................ 62
6pMonthpVisit ........................................................................ 14 SexualpMaturitypRatings............................................................ 63
9pMonthpVisit ........................................................................ 16 UsefulpWebpSites..................................................................... 64
iii
12pMonthpVisit....................................................................... 18
p
Guidelines for Health Supervision of p p
Infants, Children, and Adolescents
p p p
TpHpIpRpDp p EpDpIpTpIpOpNp
P pO pC pK pE pT G pU pI pD pEp
Editors
JosephpF.pHagan,pJr,pMD,pFAAP
pJudithpS.pShaw,pRN,pMPH,pEd
DpPaulapM.pDuncan,pMD,pFA
AP
FUNDEDp BYp
USpDepartmentpofpHealthpandpHumanpServicespHea
lthpResourcespandpServicespAdministrationpMatern
alpandpChildpHealthpBureau
P UB LI S HE D p BYp
,ThepAmericanpAcademypofpPediatrics
,CITE p ASp
HaganpJF,pShawpJS,pDuncanpP,peds.p2008.pBrightpFutures:pGuidelinespforpHealthpSupervisionpofpInfants,pChildren,pandpAdol
escents,pThirdpEdition.pPocketpGuide.pElkpGrovepVillage,pIL:pAmericanpAcademypofpPediatrics.
Copyrightp©p2008pbypthepAmericanpAcademypofpPediatrics.pAllprightspreserved.pNoppartpofpthisppublicationpmaypbeprep
roduced,pstoredpinpapretrievalpsystem,porptransmitted,pinpanypformporpbypanypmeans,pelectronic,pmechanical,pphoto-
pcopying,precording,porpotherwise,pwithoutppriorpwrittenppermissionpfromptheppublisher.
LibrarypofpCongresspCatalogpCardpNumber:p200792996
4pISBN-13:p978-1-58110-224-6
ISBN-10:p1-58110-224-
0pBF0027
P UB LI S HE D p BYp
AmericanpAcademypofpPediatricsp
141pNorthwestpPointpBlvd
ElkpGrovepVillage,pILp60007-
1098pUSA
847-434-4000
AAPpWebpsite:pwww.aap.org
BrightpFuturespWebpsite:phttp://brightfutures.aap.org
AdditionalpcopiespofpthisppublicationparepavailablepfrompthepAmericanpAcademypofpPediatricspOnlinepBookstorepatpwww.aap.org/bookst
ore.
ThisppublicationphaspbeenpproducedpbypthepAmericanpAcademypofpPediatricspunderpitspcooperativepagreementp(U06MC
00002)pwithpthepUSpDepartmentpofpHealthpandpHumanpServices,pHealthpResourcespandpServicespAdministrationp(HRSA),p
MaternalpandpChildpHealthpBureaup(MCHB).
, TABLE OF CONTENTS p p
BrightpFuturespatpthepAmericanpAcademypofpPediatrics .......... v 15pMonthpVisit ....................................................................... 20
HowptopUsepThispGuide............................................... vii 18pMonthpVisit ....................................................................... 22
CorepConcepts .......................................................... ix 2 YearpVisit............................................................................. 24
BuildingpEffectivepPartnerships ......................................................x 212p YearpVisit........................................................................... 26
Fosteringp Family-Centeredp Communication ..................................... xi 3 YearpVisit............................................................................. 28
Promotingp Healthp andp PreventingpIllness...................................... xii 4 YearpVisit............................................................................. 30
ManagingpTimepforpHealthpPromotion........................................ xiii 5 andp6pYearpVisits................................................................... 32
EducatingpFamiliespThroughpTeachablepMoments .......................... xiv 7pandp8pYearpVisits .................................................................. 34
AdvocatingpforpChildren,pFamilies,pandpCommunities..................... xv 9pandp10pYearpVisits ................................................................ 38
SupportingpFamiliespSuccessfully................................... xvii EarlypAdolescencep(11ptop14pYearpVisits) ..................................... 42
ChildrenpandpYouthpWithpSpecialpHealthpCarepNeeds ................. xvii MiddlepAdolescencep(15ptop 17pYearpVisits) .................................. 46
CulturalpCompetence ............................................................ xvii LatepAdolescencep(18ptop21pYearpVisits)...................................... 50
ComplementarypandpAlternativepCare ....................................... xviii Appendices ............................................................ 53
BrightpFuturespThemes............................................... xix DevelopmentalpMilestonespatpapGlancep—pInfancy........................ 54
Brightp Futuresp Healthp Supervisionp Visits ............................ 1 DevelopmentalpMilestonespatpapGlancep—pEarlypChildhood ............ 55
AcronymspUsedpinpthepBrightpFuturespHealthpSupervisionpVisits........ 1 SocialpandpEmotionalpDevelopmentpinpMiddlepChildhood............... 56
PrenatalpVisit ............................................................................ 2 DomainspofpAdolescentpDevelopment......................................... 57
NewbornpVisit .......................................................................... 4 RecommendedpMedicalpScreeningp—pInfancy .............................. 58
FirstpWeekpVisit ......................................................................... 6 RecommendedpMedicalpScreeningp—pEarlypChildhood ................... 59
1 MonthpVisit ........................................................................... 8 RecommendedpMedicalpScreeningp—pMiddlepChildhood ................ 60
2 MonthpVisit ......................................................................... 10 RecommendedpMedicalpScreeningp—pAdolescence....................... 61
4pMonthpVisit ........................................................................ 12 Toothp Eruptionp Chart ................................................................ 62
6pMonthpVisit ........................................................................ 14 SexualpMaturitypRatings............................................................ 63
9pMonthpVisit ........................................................................ 16 UsefulpWebpSites..................................................................... 64
iii
12pMonthpVisit....................................................................... 18
