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Ages
2-6
Schedule
Every 1-3 years.
One visit is required for immunizations. Because of lack of data
and differing patient risk profiles, the scheduling of additional
visits and the frequency of the individual preventive services listed
are left to clinical discretion (except as indicated). The preventive
services are listed below.
DISCLAIMER:
Coverage of preventive services varies under PPO and indemnity plans.
Members covered under these policies need to refer to their Certificate
of Coverage or contact a customer service representative for information
regarding covered services.
Screening:
- Height and
weight
- Blood pressure
- Eye exam
for amblyopia and strabismus-ages 3 through 4 (Objective testing
including Snellen E, distance acuity, and light reflex/cover test.
Exam of external eye, fundoscopic exam, parent concerns about
vision.)
High Risk
Groups:
- Serum Lead
[HR1]-age 2
- Tuberculin
skin test (PPD) [HR2]
- Hearing
[HR3]-before age 3, if not tested earlier
Immunizations
and/or Chemoprophylaxis
- Measles-mumps-rubella
(MMR) booster vaccine-once between ages 4 and 6
- Diphtheria-tetanus-pertussis
(DTP) vaccine-once between ages 4 and 6
- Oral poliovirus
vaccine (OPV)-once between ages 4 and 6
High Risk
Groups:
- Fluoride
supplements [HR5]
- Influenza
vaccine [HR6]
Patient and/or
Parent Counseling
Diet and Exercise:
Remain Alert
for:
- Vision disorders
- Dental decay,
malalignment, premature loss of teeth, mouth breathing
- Signs of
child abuse or neglect
- Abnormal
bereavement Leading Causes of Death
- Unintentional
injuries (non-motor vehicle)
- Motor vehicle
injuries
- Congenital
anomalies
- Homicide
- Heart disease
Definitions
of High Risk Patients
These definitions
apply to the category of ages 2-6 years only.
TERM DEFINITION
- HR1: Children
who live in or frequently visit housing built before 1960 that
is dilapidated or undergoing renovation; who come in contact with
other children with known lead toxicity; who live near lead processing
plants or whose parents or household members work in a lead-related
occupations; or who live near busy highways or hazardous waste
sites.
- HR2: Household
members of persons with tuberculosis or others at risk for close
contact with the disease; recent immigrants or refugees from countries
in which tuberculosis is common (e.g., Asia, Africa, Central and
South America, Pacific islands); family members of migrant workers;
residents of homeless shelters; or persons with certain underlying
medical disorders.
- HR3:
Children with a family history of childhood hearing impairment
of a personal history of congenital perinatal infection with herpes,
syphilis, rubella, cytomegalovirus, or toxoplasmosis; malformations
involving the head or neck (e.g. dysmorphic and syndromal abnormalities,
cleft palate, abnormal pinna); birthweight below 1500g; bacterial
meningitis; hyperbilirubinemia requiring exchange transfusion;
or severe perinatal asphyxia (Apgar scores of 0-3, absence of
spontaneous respirations for 10 minutes, or hypotonia at 2 hours
of age).
- HR4:
Persons with a family history of skin cancer, large number of
moles, light skin/hair/eye color.
- HR5:
Children living in areas with inadequate water fluoridation (less
than 0.6 parts per million).
- HR6: Residents
of chronic care facilities or persons suffering from chronic cardiopulmonary
disorders, metabolic diseases (including diabetes mellitus), hemoglobinopathies,
immunosuppression or renal dysfunction.
  
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