Cardio
A 3-year-old male is brought to your office by his parents for a routine well child visit. He is up to date on vaccines and the parents have no concerns to discuss today. According to the U.S. Preventive Services Task Force, this child should be screened for which one of the following conditions? A) Amblyopia B) Anemia C) Autism spectrum disorder D) Dental caries E) Hearing loss
ANSWER: A The U.S. Preventive Services Task Force (USPSTF) recommends vision screening at least once in all children 3–5 years of age to detect amblyopia or its risk factors (B recommendation). Screening may be performed using visual acuity testing with picture identification, Snellen or "tumbling E," or by an automated device that assesses visual acuity. Early identification of vision disorders can help prevent permanent vision loss due to amblyopia. Anemia screening is recommended for all children at 1 year of age by the American Academy of Pediatrics (AAP), but this approach was found to have insufficient evidence of benefit by the USPSTF (I recommendation). Screening for autism spectrum disorder is recommended by the AAP at 18 and 24 months of age, but the USPSTF found insufficient evidence that universal screening results in improved care in families without concerns about their child's development (I recommendation). The USPSTF found insufficient evidence of benefit of screening for dental caries in children <5 years of age (I recommendation). Instead, it recommends that fluoride varnish be applied every 3–6 months in all children 6 months to 5 years of age to prevent dental caries (B recommendation). This should be performed in the family physician's office if it has not been applied by a dentist. Additionally, an oral fluoride supplement is recommended to prevent dental caries in children without adequate fluoride in their water supply (B recommendation). Universal hearing screening is recommended for newborns, but screening at this age is not recommended.