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A Guide to Recommended Medical Screening Tests for Children Posted: March 9th, 2010

By Jim Sloan

Jim Sloan is a freelance writer in Reno, Nev.

From birth to adolescence, children need to be screened for various diseases and other dangers

Medical Screening Key to Keeping Children Healthy

An assessment of your child's health begins seconds after birth, and doctors continue to use simple tests throughout your child's life to ensure continued good health.

Many childhood medical screening tests, which are usually covered by health insurance, are ordered if your child is at increased risk of disorder because of family history or ethnic background. But such groups as the American Academy of Pediatrics also recommend regular physical exams and screening tests for all children.

Important Tests for Newborns

A baby's first medical exam occurs within seconds after birth. It's a simple test known as an Apgar score, and it involves your doctor assessing the baby's responsiveness and vital signs. The doctor checks the baby's heart rate, breathing, color, activity, muscle tone, and grimace reflex response. This quick test is given again at one minute and five minutes, and is used to alert the doctor if special actions, such as oxygen administration, are needed.

In the United States, newborns can be screened for up to 55 different conditions and diseases. Most of the tests are run on a small drop of blood taken from the baby's heel shortly after birth.

Here's a breakdown of what doctors are looking for:

  • Congenital Disorders: 29 separate tests are recommended, but the actual number performed varies from state to state.
  • Infectious Diseases: Typically, this type of test is only done on infants whose mother may have been exposed to an infection, or if the baby exhibits certain symptoms.
  • Genetic Disorders: These tests are administered for babies with an increased risk of genetic disorder due to family history or ethnicity.
  • Other Screenings: Generally all babies are tested for Phenylketonuria (PKU), congenital hypothyroidism, and other diseases that can be successfully treated if discovered early. Babies are also given a hearing test .

Later in Life: Ages 2-12

Unless a child shows symptoms or is exposed to certain risk factors, many medical screening tests are not necessary. However, the American Academy of Pediatrics does recommend the following exams and tests even in healthy children:

  • Height and Weight: Once a year.
  • Blood Pressure: Once a year after age 3.
  • Development Assessment, General Physical, Screening for Scoliosis: Once a year.
  • Teeth and Gums: Your child should see a dentist at least once a year after age 3.
  • Health and Vision: Make sure your child is tested at ages 3, 4, 6, 10 and 11.

The academy also recommends these tests if the child has been exposed to illness or environmental risks, or if there is a family history of the ailment:

  • Genetic Diseases: Including Tay Sach's or sickle cell anemia, if these tests were not conducted at birth.
  • Tuberculosis: Skin test annually after 24 months�
  • Lead in Blood: At nine, 12 and 24 months
  • Blood Lipids: Annually after 24 months

Other that may be necessary:

  • Diabetes: Type 2 diabetes is the sixth-leading cause of death in the U.S., and a growing concern for children and adolescents. If your child is overweight and there is a family history or an ethnic tendency toward diabetes, the American Diabetes Association recommends your child is screened every two years starting at age 10. The screening includes a glucose test or a glucose tolerance test.
  • High Cholesterol: Heart disease is the primary cause of death in the U.S., and cholesterol is a main cause of heart disease. Cholesterol testing isn't usually ordered for those under the age of 20, but if your child is overweight, eats a lot of fatty foods, and has high blood pressure or diabetes, you should test for high cholesterol. The American Pediatric Academy recommends the first cholesterol test be administered before age 10, and in some cases at age 2.
  • Lead Poisoning: Exposure in a young child can damage the brain and other organs, and pediatricians recommend the first test at the age of two. State-specific screening programs vary, but the Centers for Disease Control recommends all Medicaid-eligible children be tested at ages 1 and 2; at-risk children from ages 3 to 6 who have not previously been tested; and children who live in or regularly visit homes built before 1978.
  • Weight: According to a consortium of 15 national health care organizations, your child's weight should be checked by a health care provider at least once a year starting at age 6. Obesity in children can interfere with leg and hip growth and can pose lifelong problems, and it's the most common problem seen by pediatricians.
  • Depression: One in four visits to a pediatrician's office is for behavioral problems. The U.S Preventive Services Task Force, a federal group that makes public health recommendations, recently concluded that all adolescents ages 12 to 18 should be screened for major depression. The panel also recommended that psychotherapy be the first treatment strategy because of the danger associated with giving anti-depressants to young people.

Although medical screening tests are an important way to spot problems and treat them early, experts warn that many tests are unneeded and can have negative effects if they lead to unnecessary treatment. If you have any doubts about whether your child needs a certain test, ask your pediatrician to explain why the test was ordered.

Jim Sloan