Bright Future – 7 and 8 Year Visits
Health supervision
Surveillance of development
- Demonstrates social and emotional competence (including self-regulation)
- Engages in healthy nutrition and physical activity behaviors
- Forms caring, supportive relationships with family members, other adults, and peers
Observation of Parent-Child interaction
How do parent and child interact with each other? How do parent and child interact with health care professional? Does parent engage child in an age-appropriate manner?
Complete Physical Examination, including
- Measure: Blood pressure and compare with norms
- Measure and plot: Height, weight, and BMI
- Assess/observe for: Caries, gingivitis, malocclusion; SMR; hip, knee, ankle function and gait
Screening (www.aap.org/periodicityschedule)
7 year Visit
- universal: None
- selective: Anemia; Hearing; Oral Health; Tuberculosis; Vision
8 year Visit
- universal: Hearing; Vision
- selective: Anemia; Dyslipidemia; Oral Health; Tuberculosis
Immunization
Anticipatory Guidance
The first priority is to attend to the concerns of the parents. In addition, the Bright Futures Middle Childhood Expert Panel has given priority to the following topics for discussion in the 7 and 8 Year Visits:
Social determinants of health: Risks (neighbor- hood and family violence, food security, family substance use, harm from the Internet), strengths and protective factors (emotional security and self-esteem, connectedness with family and peers)
- Teach your child nonviolent conflict-resolution techniques.
- Talk with parents/trusted adult if you are bullied.
- Contact community resources, like SNAP, for help with food assistance.
Within the past 12 months, were you ever worried whether your food would run out before you got money to buy more? Within the past 12 months, did the food you bought not last and you did not have money to get more? - Don’t use tobacco/e-cigarettes. Call 800-Quit- NoW (800-784-8669) for help to quit Talk with me if you are worried about family member drug/alcohol use.
- Put family computer in easily seen place; monitor computer use; install safety filter.
How much do you know about your child’s Internet use?
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- Don’t give out personal information online.
What would you do if you went on a site that scared you? - Encourage independence, self-responsibility; show affection; praise appropriately.
- Spend time with your Make time to talk. Know child’s friends.
How are you getting along as a family? What do you do together?
Development and mental health: Independence, rules and consequences, temper problems and con- flict resolution; puberty and pubertal development
- Encourage competence/independence/ self-responsibility.
- Discuss rules, consequences.
- Be positive role model; do not hit or let others hit.
- Talk about worries.
Who do you talk with about your worries and things that make you mad? - Be aware of pubertal changes; answer questions simply.
What have you told your child about how to care for his changing body?
Do you know what puberty is ? Has anyone talked with you about how your body will change during puberty?
School: Adaptation to school, school problems (behavior or learning issues), school performance and progress, school attendance, IEP or special education services, involvement in school activities and after-school programs, parental involvement
- Ensure child is ready to learn (regular bedtime routine, healthy breakfast).
- Show interest in school and activities.
How is your child doing in school? What types of activities is your child doing after school?
What do you like best about school.after-school activities? - If concerns, ask teacher about evaluation for special help/tutoring; help with bullying.
- If child has special health care needs, be active in IEP process
Physical growth and development: Oral health (regular visits with dentist, daily brushing and flossing, adequate fluoride, avoidance of sugar- sweetened beverages and snacks), nutrition (healthy weight, adequate calcium and vitamin D intake, limiting added sugars intake), physi- cal activity (60 minutes of physical activity a day, screen time)
- Take child to dentist twice a year
- Give fluoride supplement if dentist recommends.
- Limit sweetened drinks/snacks.
- Brush teeth twice a day; floss once.
- Wear mouth guard during sports.
- Help child choose healthy eating (provide healthy foods, eat together as a family, be a role model).
- Eat breakfast; eat vegetables/fruits.
- Eat when you’re hungry; stop when you’re satisfied
- Drink milk 3 or more times a day.
- Limit sugary drinks/foods.
- Be physically active often during the day.
- Consider making family media use plan (www.healthychildren.org/MediausePlan), which can help balance child’s needs for physical activity, sleep, school activities, and unplugged time; decide on rules for media time in time left over after all other activities; take into account quantity, quality, location of media use.
Safety: Car safety, safety during physical activity, water safety, sun protection, harm from adults, firearm safety
- Use belt-positioning booster seat in backseat.
- Ensure child uses safety equipment (helmet, pads). Be a role model and always wear a helmet.
- Teach child to swim; supervise around water.
- Use sunscreen; wear hat; avoid prolonged exposure when sun is strongest, between 11:00 am and 3:00 pm
- Know child’s friends; teach home safety rules for fire/emergencies; teach rules for how to be safe with adults: (1) no adult should tell a child to keep secrets from parents; (2) no adult should express interest in private parts; (3) no adult should ask a child for help with his/her private parts.
Do you know what do you if you get home and Mom or Dad is not there? What would you do if you felt unsafe at a friend’s house? Has anyone touched you in a way that made you feel uncomfortable? - Remove firearms from home; if firearm necessary, store unloaded and locked, with ammunition locked separately.