Well-child care: effectiveness of current recommendations

Well-child care is the main source of preventive health care for children in the United States. Repeated examinations of healthy children during health supervision visits are used to assess biomedical health, development, behavior, and family functioning. In addition, well-child care serves to provide parent education through age appropriate counseling referred to as anticipatory guidance. Recommendations for well-child care are found in the Health Supervision Guidelines III, published by American Academy of Pediatrics, last revised in 1993, and a publication from the National Center for Education in Maternal and Child Health, The Bright Futures, Guidelines for Health Supervision of Infants, Children and Adolescents, revised in 2000. This article reviews the evidence for the effectiveness of the current recommendation for well-child care including the recommendations for the number of visits, history and physical examination as a screening technique, observation of parent-child interaction, and the recommendation for provision of anticipatory guidance. This article also summarizes the recent advances in well-child care and identifies an agenda for future research.