Pediatricians update guidelines for kids' checkups

New guidelines released today by a leading U.S. pediatricians group recommend for the first time that healthy teens be screened for depression at their checkups, and that routine cholesterol testing begins in children at younger ages.

The American Academy of Pediatrics also has other changes in store for infants, children and teens during their regular doctor’s visits, including HIV testing in teenagers, and evaluating toddlers’ nutrition status for iron-deficiency anemia.

Last revised in 2007, the updated pediatric schedule released February 23 includes several changes and new additions to the recommended screenings and health assessments done between infancy and adolescence. The schedule is meant as a guide for pediatricians to providing children with age-appropriate preventive care at their regular checkups.

“The goal is to help kids grow up healthier by more effectively screening them for health and developmental issues that can have a real impact on their health during childhood and as adults,” said guidelines co-author Dr. Geoffrey Simon, a pediatrician at Nemours duPont Pediatrics in Wilmington, Del.

Simon, who chaired the committee of pediatricians responsible for reviewing the medical evidence and updating the recommendations, described the revisions as “minor changes.”

The new schedule is published online today and will appear in the March issue of the journal Pediatrics. [10 Scientific Tips for Raising Happy Kids]

Some highlights of the new preventive care recommendations for children include:

Cholesterol testing is now recommended between ages 9 and 11. All children regardless of their family history of heart disease or risk factors for it are being advised to have their total and HDL cholesterol checked once between 9 and 11 years of age. Previously, a first test for cholesterol was not done in young people until ages 18 to 21.

“This change was made because we now know that children at greatest risk for familial hyperlipidemia [an inherited form of high cholesterol and high blood fats] and heart disease as adults often don’t have identifiable risk factors,” Simon said. Some of these children look perfectly healthy, so it’s important to identify these kids early in life, he explained.

Teens should be screened for depression. For the first time, 11- through 21-year-olds will be asked a few quick questions about their moods, now that a new screening tool for depression is widely available to pediatricians.

Teens are at significant risk for depression and the new screening test, which takes less than a minute to give, offers pediatricians a more accurate way of identifying kids who may be feeling down, Simon told Live Science.

Doctors should evaluate teens’ risk for drug and alcohol use. Previous recommendations called for assessing young people ages 11 to 21 for their risk of drug and alcohol use, but pediatricians lacked guidelines on how to do this evaluation. “Now there’s a non-judgmental, scientifically validated screening tool to identify teenagers at risk, and those who need help,” Simon said.

Teens should be screened for HIV. It’s recommended that sexually active people ages 11 to 21 be screened for sexually transmitted infections. The newest guidelines have added HIV testing, suggesting that all teens be screened for HIV once between ages 16 and 18. “The hope is to remove any suggestions of judgment of who should and shouldn’t be tested,” Simon said.

Screening young women for cervical problems should wait until 21. Routine testing in teenage girls for precancerous signs in the cervix is no longer advised because it’s rare at younger ages.

Newborns should be screened for critical congenital heart disease before leaving the hospital. Babies need to be tested early in life for serious heart defects present at birth.

Iron-deficiency anemia screening should be done for 15- to 30-month-olds. Early detection of low iron levels in toddlers could help prevent learning delays.

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