13: Bright Futures

Question 1

What age?

Universal lead screening (high prevalence area or on Medicaid).

Answer 1

2

Question 2

Which visit for these Bright Futures guidelines?

• School readiness (structured learning, socialize with other children, fears, friends, fluency).
• Healthy personal habits (daily routines that promote health).
• TV/Media (Limits).
• Child and family involvement and safety in the community (activities outside the home, community projects, educational programs, domestic violence).
• Safety (booster seats, supervision, outdoor safety, guns).

Answer 2

4

Question 3

What age does this start?

Fluoride supplementation if primary water is deficient.

Answer 3

18 months

Question 4

What age does this start?

Visual acuity measurement.

Answer 4

3

Question 5

What is the first priority at each visit?

Answer 5

Attend to concerns of the parents.

Question 6

Which visit for these Bright Futures guidelines?

• Family support (parental well-being, adjustment to growing independence).
• Language Development (how child communicates, expectations for language).
• Temperament and behavior (sensitivity, approachability, adaptability, intensity).
• Toilet training (what parents have tried, techniques, personal hygiene).
• TV viewing (limits, promotion of reading, physical activity, safe play).
• Safety (car seats, parental safety belts, bike helmets, outdoor safety, guns).

Answer 6

2

Question 7

What age does this start?

Fasting lipid profile if positive for risk factors.

Answer 7

2

Question 8

What age does this start?

Lead screening if no previous screening.

Answer 8

18 months

Question 9

What age does this start?

Risk for anemia indicates need for H and H.

Answer 9

18 months

Question 10

What age does this start?

Risk for TB indicates need for TB skin test.

Answer 10

18 months

Question 11

Which visit for these Bright Futures guidelines?

• Family routines (parental consistency, day and evening routines, family activities).
• Language (interactive communication through song, play and reading).
• Social development (play with other children, limited reciprocal play, imitation of others, choices).
• Preschool considerations (readiness for early childhood programs, playgroups, or play dates).
• Safety (water, car seats, outdoor health and safety, pets, fires, burns).

Answer 11

30 months

Question 12

Which visit for these Bright Futures guidelines?

• Communication and social development (individuation, separation, communication of wants, shared attention).
• Sleep routines and issues.
• Temper tantrums and discipline (conflict predictors, distraction, praise, consistency).
• Healthy teeth (brushing, bottle usage).
• Safety (car seats, parental safety belts, poison, fire).

Answer 12

15 months

Question 13

Which visit for these Bright Futures guidelines?

• Family support (parental well-being, adjustment to growing independence).
• Development and behavior (adaptation to nonparental care, return to clinging).
• Language promotion/hearing (encouragement of language, simple words and phrases, reading, singing, talking).
• Toilet training readiness (recognizing the signs, expectations).
• Safety (car seats, parental safety belts, falls, burns, guns, poison, fire).

Answer 13

18 months

Question 14

What age does this start?

Hearing screen with audiometry.

Answer 14

4

Question 15

What age?

Autism specific screen.

Answer 15

• 18 months
• 24 months