POLICY STATEMENT Organizational Principles to Guide and Define the Child Health

Care System and/or Improve the Health of all Children

2022 Recommendations for

Preventive Pediatric Health Care

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The Periodicity Schedule will not be published in Pediatrics.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.
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

The changes made to the Periodicity Schedule since it was last automatically expire 5 years after publication unless reaffirmed,
published in March 2021 are provided in the following sections. revised, or retired at or before that time.

DOI: https://doi.org/10.1542/peds.2022-058044
HEPATITIS B VIRUS INFECTION PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275).
Assessing risk for hepatitis B virus (HBV) infection has been added to Copyright © 2022 by the American Academy of Pediatrics
occur from newborn to 21 years
(to account for the range in which the risk assessment can take place)
To cite: American Academy of Pediatrics. 2022
to be consistent with recommendations of the US Preventive Services
Recommendations for Preventive Pediatric Health Care.
Task Force (USPSTF) and the 2021–2024 AAP Red Book: Report of the Pediatrics. 2022;150(1):e2022058044
Committee on Infectious Diseases.

PEDIATRICS Volume 150, number 1, July 2022:e2022058044 FROM THE AMERICAN ACADEMY OF PEDIATRICS
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  Footnote 31 has been added to (GLAD-PC): Part I. Practice
read, “Perform a risk assessment Preparation, Identification,
for hepatitis B virus (HBV) Assessment, and Initial
infection according to Management’ (https://doi.org/
recommendations per the 10.1542/peds.2017-4081),
USPSTF (https://www. ‘Mental Health Competencies for
uspreventiveservicestaskforce. Pediatric Practice’ (https://doi.
org/uspstf/recommendation/ org/10.1542/peds.2019-2757),
hepatitis-b-virus-infection- ‘Suicide and Suicide Attempts in
screening) and in the 2021–2024 Adolescents’ (https://doi.org/
edition of the AAP Red Book: 10.1542/peds.2016-1420), and
Report of the Committee on ‘The 21st Century Cures Act &
Infectious Diseases, making every Adolescent Confidentiality’
effort to preserve confidentiality (https://www.adolescenthealth.
of the patient.” org/Advocacy/Advocacy-
Activities/2019-(1)/NASPAG-
SUDDEN CARDIAC ARREST AND SAHM-Statement.aspx).”
SUDDEN CARDIAC DEATH
Assessing risk for sudden cardiac BEHAVIORAL/SOCIAL/EMOTIONAL
arrest and sudden cardiac death has SCREENING
been added to occur from 11 to The Psychosocial/Behavioral
21 years (to account for the range in Assessment recommendation has
which the risk assessment can take been updated to Behavioral/Social/
place) to be consistent with AAP Emotional Screening (annually from
policy (Sudden Death in the Young: newborn to 21 years) to align with
Information for the Primary Care AAP policy, the American College of
Provider). Obstetricians and Gynecologists
(Women’s Preventive Services
 Footnote 33 has been added to Initiative) recommendations, and
read, “Perform a risk assessment, the American Academy of Child &
as appropriate, per ‘Sudden Adolescent Psychiatry guidelines.
Death in the Young: Information
for the Primary Care Provider’  Footnote 14 has been updated to
(https://doi.org/10.1542/ read, “Screen for behavioral and
peds.2021-052044).” social-emotional problems per
‘Promoting Optimal
DEPRESSION AND SUICIDE RISK Development: Screening for
SCREENING Behavioral and Emotional
Screening for suicide risk has been Problems’ (https://doi.org/
added to the existing depression 10.1542/peds.2014-3716),
screening recommendation ‘Mental Health Competencies for
(annually from 12 to 21 years) to be Pediatric Practice’ (https://doi.
consistent with the Guidelines for org/10.1542/peds.2019-2757),
Adolescent Depression in Primary ‘Clinical Practice Guideline for
Care (GLAD-PC) and AAP policy. the Assessment and Treatment of
Children and Adolescents With
 Footnote 16 has been updated to Anxiety Disorders’ (https://
read, “Screen adolescents for pubmed.ncbi.nlm.nih.gov/
depression and suicide risk, 32439401), and ‘Screening for
making every effort to preserve Anxiety in Adolescent and Adult
confidentiality of the adolescent. Women: A Recommendation
See ‘Guidelines for Adolescent From the Women's Preventive
Depression in Primary Care 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).”
FLUORIDE VARNISH
 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).”
FLUORIDE SUPPLEMENTATION
 Footnote 38 has been updated to
read, “If primary water source is
deficient in fluoride, consider
oral fluoride supplementation.
See ‘Fluoride Use in Caries

2 FROM THE AMERICAN ACADEMY OF PEDIATRICS

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 Prevention in the Primary Care REFERENCE pervision of Infants, Children, and Ado-
Setting’ (https://doi.org/ 1. Hagan JF, Shaw JS, Duncan PM, eds. lescents, 4th ed. Elk Grove Village, IL:
10.1542/peds.2020-034637).” Bright Futures: Guidelines for Health Su- American Academy of Pediatrics; 2017

PEDIATRICS Volume 150, number 1, July 2022 3

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