American Academy of Pediatrics - Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents

EDITORS

Joseph F. Hagan, Jr, MD, FAAP

Judith S. Shaw, EdD, MPH, RN, FAAP

Paula M. Duncan, MD, FAAP

SUPPORTED, IN PART, BY

US Department of Health and Human Services

Health Resources and Services Administration

Maternal and Child Health Bureau

PUBLISHED BY

American Academy of Pediatrics

This publication has been produced by the American Academy of Pediatrics. Supported, in part, under its cooperative agreement (U04MC07853) with the US Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB).

Suggested citation: Hagan JF, Shaw JS, Duncan PM, eds. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents. 4th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2017

American Academy of Pediatrics Bright Futures National Center Staff

Chief Medical Officer
Senior Vice President, Child Health and Wellness
American Academy of Pediatrics: V. Fan Tait, MD

Director, Division of Developmental Pediatrics and Preventive Services: Darcy Steinberg-Hastings, MPH

Manager, Bright Futures National Center: Jane Bassewitz, MA

Manager, Bright Futures Implementation: Kathryn Janies

American Academy of Pediatrics Publishing Staff

Director, Department of Publishing: Mark Grimes

Senior Editor, Professional/Clinical Publishing: Eileen Glasstetter, MS

Production Manager, Clinical/Professional Publications: Theresa Wiener

Editorial Specialist: Amanda Helmholz

Manager, Art Direction and Production: Linda Diamond

Manager, Art Direction and Production: Peg Mulcahy

Senior Vice President, Membership Engagement and Marketing and Sales: Mary Lou White

Marketing Manager, Practice Publications: Mary Jo Reynolds

The recommendations in this publication do not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate.

The American Academy of Pediatrics is not responsible for the content of the resources mentioned in this publication. Web site addresses are as current as possible but may change at any time.

Products are mentioned for informational purposes only. Inclusion in this publication does not imply endorsement by the American Academy of Pediatrics.

The American Academy of Pediatrics has neither solicited nor accepted any commercial involvement in the development of the content of this publication.

The publishers have made every effort to trace the copyright holders for borrowed materials. If they have inadvertently overlooked any, they will be pleased to make the necessary arrangements at the first opportunity.

All authors have filed conflict of interest statements with the American Academy of Pediatrics. Any conflicts have been resolved through a process approved by the Board of Directors.

Every effort is made to keep the Guidelines consistent with the most recent advice and information available from the American Academy of Pediatrics.

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2017 American Academy of Pediatrics

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any meanselectronic, mechanical, photocopying, recording, or otherwisewithout prior permission from the publisher (locate title at .

Printed in the United States of America

3-333/0217

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BF0043

ISBN: 978-1-61002-022-0
eBook: 978-1-61002-023-7
Library of Congress Control Number: 2016940985

This work honors our coeditor, Paula Duncan, MD, FAAP, without whose energy, insight, and spirit these Guidelines would not have achieved relevance for current pediatric practice.

A graduate of Manhattanville College, Dr Duncan received her medical degree from Womens Medical College in Philadelphia and completed her pediatric residency at Albany Medical Center and at Stanford University Medical Center, where she was also a Clinical Scholar in Adolescent Medicine.

In her early career in adolescent medicine, Dr Duncan committed to the primary and community-based care that she recognized as essential to her patients healthy growth and development. She identified a mid-career opportunity to improve child and adolescent health in her community and left practice to serve as Medical Director of the Burlington (Vermont) School Department, where she was an early leader in the design of school-based health services. In addition, she created an innovative and nationally recognized curriculum for HIV/AIDS education for grades 4 through 12. From 19872001, she facilitated the Vermont public-private partnership of health care delivery at Vermont Department of Health, and served as state Maternal and Child Health Director from 19931998. Dr Duncan later became Youth Project Director for the Vermont Child Health Improvement Program at The Robert Larner, M.D. College of Medicine at the University of Vermont, where she is Clinical Professor in Pediatrics.

Dr Duncans career has also been one of service in her community and on the national level. She was vice president of the American Academy of Pediatrics (AAP) Vermont Chapter (19901994) and later president of the Vermont Medical Society (2009). Her national work with the AAP includes serving as coeditor of the AAPs Bright Futures Guidelines, 3rd and 4th editions (2008 and 2017) and the Bright Futures Tool and Resource Kit (2009) as well as chairing the AAP Bright Futures Steering Committee.

Her contributions have been honored in national and AAP awards, including the Executive Committee Clifford Grulee Award, which recognizes long-term accomplishments and outstanding service to the AAP. She also received the AAP Section on Pediatric Dentistry Oral Health Services Award, and the AAP Council on Community Pediatrics Job Lewis Smith Award, which recognizes lifelong outstanding career achievement in community pediatrics.

The US Department of Health and Human Services, Health Resources and Service Administration (HRSA) Maternal Child Health Bureau (MCHB) Directors Award was presented to Dr Duncan in 2007 in recognition of contributions made to the health of infants, mothers, children, adolescents, and children with special health needs in the Nation. In 2011, Dr Duncan was recipient of the Abraham Jacobi Award, which is presented to a pediatrician who is a member of both the AAP and the American Medical Association. This award recognizes long-term, notable national contributions to pediatrics in teaching, patient care, and/or clinical research.

Dr Duncan reminds us that the heart of Bright Futures is establishing trust to build a therapeutic relationship. She has championed and devoted her career to the use of strength-based approaches. And this is who she is. Dr Duncans warmth, joyfulness, and ability to see the best in people enable her to behold the innate strengths of families. It is her passion to teach all of us how to see families as she does and serve them better. This focus on strengths and protective factors in the clinical encounter of preventive services is her essential contribution to our