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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.
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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
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.
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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.
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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 ...