Routine preventive services for children and adolescents (ages 2

The level of evidence grades (A-D) are provided for the most significant recommendations and are defined at the end of the "Major Recommendations" field.

Recommendations	2-6 years	7-12 years	13-18 years
Health, developmental and risk assessments	X	X	X
Parent/Child education and counseling: Nutrition, physical activity, dental health, violence and abuse, sexually transmitted infection (STI) prevention, depression, suicide threats, alcohol/drug abuse, anxiety, stress reduction, coping skills, immunizations Bicycle safety - helmet use when riding bicycle [B] Motor vehicle safety - Car seat/booster seat/seat belt use [B] Poison prevention - Keep National Poison Control numbers readily accessible; use child resistant containers; dispose expired/unused medications Burn prevention - Install smoke detectors and test bi-annually; carbon monoxide detectors; water heater temperature and fire prevention Injury prevention - Firearm safety; water safety; CPR training	X	X	X
Tobacco Use Screening: Establish tobacco use and second-hand exposure	X	X	X
Screening for overweight	Record height, weight and BMI annually
Cholesterol Screening [A]	Over age 2 if increased risk for genetic forms of hypercholesterolemia
Chlamydia Screening (sexually transmitted infection) (STI) [B]			All sexually active women 25 years and younger
Cervical Cancer Screening (Pap Smear) [B]			Beginning at age 21 or within three years after first sexual intercourse, whichever is earlier; every 3 years after 3 consecutive normal Pap smears over 5 years.
Preconception and Pregnancy Prevention Counseling		Preventive counseling beginning at age 12, or earlier if sexually active
Vision Screening [A]	Children 4 years old and younger. By age 5, should be performed as part of preschool screening.
Immunizations Consult the Advisory Committee on Immunization Practices (ACIP) website (www.cdc.gov/nip/acip/) for most updated immunization schedules for routine and high risk populations. Use combination vaccines to minimize the number of injections Update the Michigan Care Improvement Registry (MCIR)	4-6 years	11-12 years	15-18 years
DTaP [A]	X	Tdap
IPV	X
MMR (MMRV) [A]	X
Varicella [A]	X
Meningococcal		X
Influenza [B]	X 6 – 59 months, annually
Human papilloma Virus (females 9 – 26 years)		X 3-dose series	X 3-dose series

Abbreviations: BMI, body mass index; CPR, cardiopulmonary resuscitation; DTaP, diphtheria, tetanus, acellular pertussis; IPV, inactivated poliovirus vaccine; MMR, measles, mumps, rubella; MMRV, measles, mumps, rubella, varicella; Tdap, tetanus-diphtheria-acellular pertussis

Definitions:

Levels of Evidence for the Most Significant Recommendations

Randomized controlled trials
Controlled trials, no randomization
Observational studies
Opinion of expert panel

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