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Health supervision visits, the cornerstone of primary care pediatrics, provide health care 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, the health care professional supports and contributes to the healthy and positive development of children.

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 health care needs. Going beyond diagnosis, management, and treatment of health-related problems, the medical home is foremost a place for promoting health and building on the recognized strengths of the child and family. Although most children remain healthy, there is an increasing population of children living with chronic illness, disability, and other special needs. The health care professional is in a unique position to coordinate the often complex care, advocate for appropriate services, and facilitate optimum communication among the various individuals involved.

Caring for children’s health provides many rewards and challenges. 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 on the people in the child’s life, the health care professional has 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.

During time spent with a child, the health care professional’s goal is to establish as much as possible the child’s healthy growth and development with no deviations from the optimal developmental trajectory. However, when a deviation occurs, it should be detected early, receive all available appropriate treatment, and include a plan for preventing future sequelae or problems. Through the regular health supervision visits that take place throughout the child’s life, a special bond between the health care professional and the child and family often develops. This partnership is no longer unidirectional in which a health care professional imparts guidance and wisdom to a receptive child and family. In the past, health supervision visits were dictated by a periodicity schedule, and although their frequency is virtually unchanged, the visits are now parent driven and as interactive as possible. Effective health promotion involves a bidirectional relationship of receptivity that values the agenda and needs of the family while recognizing the importance of providing services essential to the health and well-being of the child and ...

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