This is the current release of the guideline.

All policy statements from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before that time.

Pediatric diseases or conditions that occur in immigrant, homeless, and migrant children

Management
Prevention
Screening

Pediatrics

Physicians
Public Health Departments

To provide guidelines for a community-based approach to health care delivery to ensure that underserved children have a medical home

Pediatric immigrant, homeless, and migrant patients from birth to 18 years of age

Screening

1. Use of screening and diagnostic protocols for foreign born children
2. Screening for developmental delays
3. Psychoeducational testing

Management/Prevention

1. Assessment of barriers to treatment
2. Immunization
3. Parental and patient education
4. Assessment of additional/complimentary medication
5. Special education services referral
6. Referral to federal, state, and community programs
7. Advocacy on patient behalf
8. Referral to dental services

Incidence of health problems in immigrant, homeless, and migrant children

Searches of Electronic Databases

Not stated

Not stated

Not stated

Not applicable

Review

Not stated

Not stated

Not applicable

A formal cost analysis was not performed and published cost analyses were not reviewed.

Peer Review

Not stated

1. Pediatricians should be aware of and sensitive to the onerous financial, educational, geographic, linguistic, and cultural barriers that interfere with achieving optimal health status for underserved children.
2. Pediatricians should be knowledgeable of the special mental and physical health problems faced by homeless, migrant, and immigrant children. Appropriate screening to identify family, environmental, and social circumstances, as well as biological factors, should be incorporated into routine pediatric assessments.
3. Pediatricians should try to provide compassionate and culturally and linguistically effective health care ("Culturally effective pediatric care," 1999) services to all children and adolescents residing in the United States regardless of their immigration or socioeconomic status. They should inquire respectfully about housing circumstances, traditional healing practices, and medication use while obtaining a patient's medical history.
4. Pediatricians should have access to information regarding federal, state, and community programs that can serve as resources to at-risk children and their families.
5. Pediatricians and American Academy of Pediatrics (AAP) chapters should advocate on behalf of underserved children at local, state, and national levels. Advocacy efforts should address outreach efforts for children who are potentially eligible for Medicaid and State Children's Health Insurance Program (SCHIP) but not enrolled, simplified enrollment for both programs, and state funding for those who are not eligible for Medicaid or SCHIP. The Medicaid reciprocity model, which allows Medicaid recipients in 1 state to qualify for services in another state without reestablishing eligibility, is an example of a model that enables underserved families to access health benefits more easily.
6. Collaborations with legislators, families, and organizations representing underserved populations may increase the effectiveness of advocacy efforts.
7. Comprehensive, coordinated, and continuous health services provided within a medical home should be integral to all efforts on behalf of homeless, migrant, and immigrant children; this is especially critical for children with chronic health care needs and mental health problems.
8. Knowledge, attitude, and skill development in cultural and linguistic competence should be a part of every pediatrician's professional agenda.

None provided

The type of supporting evidence is not specifically stated for each recommendation.

Appropriate care of immigrant, homeless, and migrant children pediatric patients

Not stated

An implementation strategy was not provided.

Getting Better
Staying Healthy

Effectiveness
Patient-centeredness

Not applicable: The guideline was not adapted from another source.

2005 Apr

American Academy of Pediatrics - Medical Specialty Society

American Academy of Pediatrics

Committee on Community Health Services

Committee on Community Health Services, 2003-2004: *Helen Marie DuPlessis, MD, MPH, Chairperson; Suzanne C. Boulter, MD; *Denice Cora-Bramble, MD, MBA; Charles R. Feild, MD, MPH; Gilbert A. Handal, MD; Murray L. Katcher, MD, PhD; Ronald V. Marino, DO, MPH; Francis E. Rushton, Jr, MD; Denia A. Varrasso, MD; David L. Wood, MD, MPH

Liaisons: Jose Belardo, MSW, MS, Maternal and Child Health Bureau; Lance E. Rodewald, MD, Ambulatory Pediatric Association

Staff: Aiysha Johnson, MA

*Lead authors

Not stated

This is the current release of the guideline.

All policy statements from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before that time.

None available

None available

This NGC summary was completed by ECRI on May 17, 2005. The information was verified by the guideline developer on June 27, 2005.

This NGC summary is based on the original guideline, which is subject to the guideline developer's copyright restrictions. Please contact the Permissions Editor, American Academy of Pediatrics (AAP), 141 Northwest Point Blvd, Elk Grove Village, IL 60007.