The 2022 Recommendations for Preventive Pediatric Health Care (Periodicity Schedule) has been approved by the American Academy of Pediatrics (AAP). Each child and family is unique; therefore, these recommendations are designed for the care of children who are receiving nurturing parenting, have no manifestations of any important health problems, and are growing and developing in a satisfactory fashion. Developmental, psychosocial, and chronic disease issues for children and adolescents may require more frequent counseling and treatment visits separate from preventive care visits. Additional visits may become necessary if circumstances suggest concerns.
The AAP continues to emphasize the great importance of continuity of care in comprehensive health supervision and the need to avoid fragmentation of care.1
The Periodicity Schedule will not be published in Pediatrics. Readers are referred to the American Academy of Pediatrics website (www.aap.org/periodicityschedule) for the most recent version of the Periodicity Schedule and the full set of footnotes. This process will ensure that health care professionals have the most current recommendations. The Periodicity Schedule will be reviewed and revised annually to reflect current recommendations.
The changes made to the Periodicity Schedule since it was last published in March 2021 are provided in the following sections.
HEPATITIS B VIRUS INFECTION
Assessing risk for hepatitis B virus (HBV) infection has been added to occur from newborn to 21 years (to account for the range in which the risk assessment can take place) to be consistent with recommendations of the US Preventive Services Task Force (USPSTF) and the 2021–2024 AAP Red Book: Report of the Committee on Infectious Diseases.
Footnote 31 has been added to read, “Perform a risk assessment for hepatitis B virus (HBV) infection according to recommendations per the USPSTF (https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/hepatitis-b-virus-infection- screening) and in the 2021–2024 edition of the AAP Red Book: Report of the Committee on Infectious Diseases, making every effort to preserve confidentiality of the patient.”
SUDDEN CARDIAC ARREST AND SUDDEN CARDIAC DEATH
Assessing risk for sudden cardiac arrest and sudden cardiac death has been added to occur from 11 to 21 years (to account for the range in which the risk assessment can take place) to be consistent with AAP policy (Sudden Death in the Young: Information for the Primary Care Provider).
Footnote 33 has been added to read, “Perform a risk assessment, as appropriate, per ‘Sudden Death in the Young: Information for the Primary Care Provider’ (https://doi.org/10.1542/peds.2021-052044).”
DEPRESSION AND SUICIDE RISK SCREENING
Screening for suicide risk has been added to the existing depression screening recommendation (annually from 12 to 21 years) to be consistent with the Guidelines for Adolescent Depression in Primary Care (GLAD-PC) and AAP policy.
Footnote 16 has been updated to read, “Screen adolescents for depression and suicide risk, making every effort to preserve confidentiality of the adolescent. See ‘Guidelines for Adolescent Depression in Primary Care (GLAD-PC): Part I. Practice Preparation, Identification, Assessment, and Initial Management’ (https://doi.org/10.1542/peds.2017-4081), ‘Mental Health Competencies for Pediatric Practice’ (https://doi.org/10.1542/peds.2019-2757), ‘Suicide and Suicide Attempts in Adolescents’ (https://doi.org/10.1542/peds.2016-1420), and ‘The 21st Century Cures Act & Adolescent Confidentiality’ (https://www.adolescenthealth.org/Advocacy/Advocacy- Activities/2019-(1)/NASPAG- SAHM-Statement.aspx).”
The Psychosocial/Behavioral Assessment recommendation has been updated to Behavioral/Social/Emotional Screening (annually from newborn to 21 years) to align with AAP policy, the American College of Obstetricians and Gynecologists (Women’s Preventive Services Initiative) recommendations, and the American Academy of Child & Adolescent Psychiatry guidelines.
Footnote 14 has been updated to read, “Screen for behavioral and social-emotional problems per ‘Promoting Optimal Development: Screening for Behavioral and Emotional Problems’ (https://doi.org/10.1542/peds.2014-3716), ‘Mental Health Competencies for Pediatric Practice’ (https://doi.org/10.1542/peds.2019-2757), ‘Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Anxiety Disorders’ (https://pubmed.ncbi.nlm.nih.gov/32439401), and ‘Screening for Anxiety in Adolescent and Adult Women: A Recommendation From the Women's Preventive Services Initiative’ (https://pubmed.ncbi.nlm.nih.gov/32510990). The screening should be family centered and may include asking about caregiver emotional and mental health concerns and social determinants of health, racism, poverty, and relational health. See ‘Poverty and Child Health in the United States’ (https://doi.org/10.1542/peds.2016-0339), ‘The Impact of Racism on Child and Adolescent Health’ (https://doi.org/10.1542/peds.2019-1765), and ‘Preventing Childhood Toxic Stress: Partnering With Families and Communities to Promote Relational Health’ (https://doi.org/10.1542/peds.2021-052582).”
Footnote 37 has been updated to read, “The USPSTF recommends that primary care clinicians apply fluoride varnish to the primary teeth of all infants and children starting at the age of primary tooth eruption. (https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/prevention-of-dental-caries- in-children-younger-than-age- 5-years-screening-and- interventions1). Once teeth are present, apply fluoride varnish to all children every 3 to 6 months in the primary care or dental office based on caries risk. Indications for fluoride use are noted in ‘Fluoride Use in Caries Prevention in the Primary Care Setting’ (https://doi.org/10.1542/peds.2020-034637).”
Footnote 38 has been updated to read, “If primary water source is deficient in fluoride, consider oral fluoride supplementation. See ‘Fluoride Use in Caries Prevention in the Primary Care Setting’ (https://doi.org/10.1542/peds.2020-034637).”
This document is copyrighted and is property of the American Academy of Pediatrics and its board of directors. All authors have filed conflict of interest statements with the American Academy of Pediatrics. Any conflicts have been resolved through a process approved by the board of directors. The American Academy of Pediatrics has neither solicited nor accepted any commercial involvement in the development of the content of this publication.
Policy statements from the American Academy of Pediatrics benefit from expertise and resources of liaisons and internal (AAP) and external reviewers. However, policy statements from the American Academy of Pediatrics may not reflect the views of the liaisons or the organizations or government agencies that they represent.
The guidance in this statement does not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate.
All policy statements from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before that time.