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Well-Child Care

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INTRODUCTION

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Health supervision visits, the cornerstone of primary care pediatrics, provide healthcare professionals the opportunity to promote the optimal health and well-being of children and their families in the communities in which they live. The value of contributing to and influencing the developmental trajectory of a child cannot be overstated. Through promoting children’s health, nurturing their growth, anticipating their needs, and guiding their families, child healthcare professionals support and contribute to the healthy and positive development of children and youth.

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Children have many “homes” where they receive care, but it is the medical home that looks after their health. Health supervision entails a variety of interrelated activities, including health promotion, prevention, surveillance, and management, and the coordination of care for children and youth with special healthcare needs. Going beyond diagnosis, management, and treatment of health-related problems, the medical home is foremost a place for promoting health and development and building on the recognized strengths of the child and family.

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Although most children remain healthy, there is an increasing population of children living with chronic illness, disability, mental health problems, and other special needs. Child healthcare professionals are in a unique position to coordinate the often complex care, advocate for appropriate services, and facilitate optimum communication among the various individuals involved. In addition, societal and community forces, such as poverty, racism, and stigma, limit the life chances of far too many children. By getting at the root causes of these issues and working in tandem with families, schools, community agencies (such as public health and mayors’ offices), child healthcare professionals can greatly improve the life situations and long-term health and development of all children and youth.

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Caring for children’s health provides many rewards and challenges for child healthcare providers. The interplay between environmental influence and factors intrinsic to the child becomes evident in many aspects of pediatric health and development. Continuity care is based on a developmental framework that recognizes the constancy of growth and change throughout childhood. Appreciating the impact of physical and psychosocial health not only on the child but also on the people in the child’s life, child healthcare professionals have responsibilities beyond the traditional medical model that include health promotional activities, such as consideration for emotional, spiritual, and environmental health, and for community and societal health as well as their influences on the child’s future development.

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Most children are generally healthy and grow along a predictable trajectory. The first task of well-child care is to determine that the child is following a normal course, to document the growth and development parameters, and to celebrate and reinforce with the family their accomplishments in raising a healthy child. However, when a deviation in growth and/or development occurs, it is the role of child healthcare providers to detect the problem early and to provide the child and family with prompt, appropriate treatment. It is also ...

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