University of Michigan Medical School, Ann Arbor, USA.
Am Fam Physician. 2011 Mar 15;83(6):683-8.
The goals of the well-child examination in school-aged children (kindergarten through early adolescence) are promoting health, detecting disease, and counseling to prevent injury and future health problems. A complete history should address any concerns from the patient and family and screen for lifestyle habits, including diet, physical activity, daily screen time (e.g., television, computer, video games), hours of sleep per night, dental care, and safety habits. School performance can be used for developmental surveillance. A full physical examination should be performed; however, the U.S. Preventive Services Task Force recommends against routine scoliosis screening and testicular examination. Children should be screened for obesity, which is defined as a body mass index at or above the 95th percentile for age and sex, and resources for comprehensive, intensive behavioral interventions should be provided to children with obesity. Although the evidence is mixed regarding screening for hypertension before 18 years of age, many experts recommend checking blood pressure annually beginning at three years of age. The American Academy of Pediatrics recommends vision and hearing screening annually or every two years in school-aged children. There is insufficient evidence to recommend screening for dyslipidemia in children of any age, or screening for depression before 12 years of age. All children should receive at least 400 IU of vitamin D daily, with higher doses indicated in children with vitamin D deficiency. Children who live in areas with inadequate fluoride in the water (less than 0.6 ppm) should receive a daily fluoride supplement. Age-appropriate immunizations should be given, as well as any missed immunizations.
儿童期（幼儿园至青春期早期）的常规健康检查旨在促进健康、发现疾病，并提供咨询以预防伤害和未来的健康问题。完整的病史应包括患者及其家属的任何关注，以及生活方式习惯的筛查，包括饮食、体育活动、每日屏幕时间（例如电视、电脑、视频游戏）、每晚睡眠时间、牙齿保健和安全习惯。学业成绩可用于发育监测。应进行全面的体格检查；然而，美国预防服务工作组建议不要常规进行脊柱侧凸筛查和睾丸检查。应筛查肥胖症，定义为体重指数达到或高于同年龄和性别的第 95 百分位，应为肥胖儿童提供全面、强化的行为干预资源。虽然在 18 岁之前筛查高血压的证据存在差异，但许多专家建议从三岁开始每年检查一次血压。美国儿科学会建议每年或每两年对学龄儿童进行视力和听力筛查。目前尚无足够证据推荐在任何年龄段筛查血脂异常，也不推荐在 12 岁之前筛查抑郁症。所有儿童每天应至少摄入 400IU 维生素 D，维生素 D 缺乏的儿童应摄入较高剂量的维生素 D。生活在水中氟含量不足（低于 0.6ppm）地区的儿童应每日补充氟化物。应给予适龄免疫接种以及任何遗漏的免疫接种。
