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Having your child vaccinated according to the recommended schedule is critical to providing your child with a long, healthy life!
Well Care / Immunizations
Advanced Pediatric Associates believes that routine well child care exams play an important role in keeping children healthy. Our providers look forward to getting to know children and their families better at these important visits. Well child care exams provide an opportunity for our providers to examine a child's growth and development and discuss age specific health, behavior and safety issues. These visits often include a vision and hearing screening, important lab work and routine immunizations. Our providers encourage families to bring a list of questions they have regarding their child's health and development to all well child care visits. To assist us in assessing childhood development, we will ask families to fill out a developmental screening questionnaire for all well care visits between the ages of 2 months through 5 years. In addition, we ask that families bring their child's immunization record to be updated at these visits. For your convenience in scheduling well-care visits, our schedule is open three months in advance. We recommend scheduling your child's appointment as early as possible as these appointments fill quickly, especially during the summer months.
Continuity of Care and the "Medical Home"
Consistent continuity of care is important to providing your child with optimal health. The providers at Advanced Pediatrics recommending contacting our office anytime your child needs medical care or advice. Each time your child is seen for an appointment in one of our offices, or you speak with one of our nurses or the after hours service, information is integrated into your child's medical record to ensure it is complete and care is consistent. For this reason, we strongly recommend against patients seeking care (including sports physicals) at retail based health clinics or urgent care facilities, as providers at these clinics have no access to a patient's medical record or health history. For more information regarding the importance of a consistent "medical home", please visit the following link:
Importance of a "Medical Home"
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Well Child Care Schedule
Consistent with guidelines from the American Academy of Pediatrics, our providers recommend the following schedule for well child care (* indicates routine immunizations):
4 - 6 year old vaccines may be given at either the 4 year or 5 year well care visit.
Annual well care exams are recommended every year for children beginning at age 2 and continuing throughout childhood and adolescence.
High school students playing sports are required by school district to have annual physical exam.
For more information on what our providers do at each of these visits, click on the link below:
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Developmental Screening at Well Care Visits (2 months - 5 years)
Advanced Pediatrics uses the "Ages & Stages" developmental screening tools at well care visits to help monitor infant and child development. At each well care visit you will be given an Ages & Stages Developmental Screening Questionnaire (ASQ) to take home, complete and return at your next well care visit. Please wait to complete the next questionnaire until the week before your next visit and then bring with you to your visit. The results will be reviewed by your provider during your well care visit. These developmental screening questionnaires are designed to provide early detection of any developmental delays, which is very important in providing optimal intervention and treatment. If you were not given a copy of the questionnaire or have lost your copy, we ask that you arrive 10 - 15 minutes early for your well care appointment, so that you will have sufficient time to complete this important questionnaire. If you prefer, you may stop by our office in advance of your appointment and pick up a copy of the questionnaire to fill out at your convenience (prior to the date of your appointment).
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Autism Screening at 18 and 24 Month Well Care Visits
In addition to regular developmental screening, Advanced Pediatrics routinely screens for Autism at both 18 and 24 month well care visits. Autism Spectrum Disorders (ASDs) are a group of related brain-based disorders that affect a child's behavior, social, and communication skills and include:
- Autistic disorder
- Asperger syndrome
- Non-specified pervasive developmental disorder
Less than 1% of children are diagnosed with an Autism Spectrum Disorder. Though ASDs are lifelong conditions with no known cure, children with ASD can progress developmentally and learn new skills. Some children may improve so much that they no longer meet the criteria for ASD, although milder symptoms may often persist. Advanced Pediatrics utilizes Ages and Stages Developmental Screening Questionnaires at well care visits, as well as the M-CHAT (Modified Checklist for Autism in Toddlers) Questionnaire at 18 and 24 month well care visits, to ensure that children are identified and receive access to services as early as possible. If your child is scheduled for an 18 or 24 month well care visit with one of our providers, please download, print and complete the M-CHAT Questionnaire below and bring it with you to your child's well care visit for review by one of our providers.
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Lead Testing
Advanced Pediatrics does routine blood lead level testing at all 12 and 24 month well child care visits. In addition, we can provide blood lead level testing at other ages if a parent is concerned about their child and possible exposure to lead. Lead can be found in homes built before 1978, old paint, soil, older painted toys and antique furniture, and food stored in some ceramic dishes (especially if made in another country). Once lead enters the body, it travels through the bloodstream and is stored mainly in the bones where it can remain for a lifetime. Very high levels of lead in the body may cause many long-term problems, including: developmental delays, hearing loss, seizures and coma, kidney problems, anemia and growth problems. If you are concerned about possible lead exposure, please discuss with your provider.
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Covered Services, Additional Issues and Health Care Reform
Recent health care reform laws require most insurance plans to provide 100% coverage for children's regular well care visits and immunizations, allowing more families to take advantage of these important preventative health visits. Unlike acute care visits that are limited to diagnosing and treating a specific illness, well-care visits have a much broader focus. Before children reach their 18th birthday, they will be seen for a total of 26 well care visits as they move through the developmental stages of infancy, childhood and adolescence! These visits, recommended by the American Academy of Pediatrics, benefit both the child and the parents with their comprehensive focus on health promotion, anticipatory guidance, disease prevention and detection. In addition they help establish a strong relationship between the family and pediatric practice, providing your child a "medical home" and continuity of care.
At a well-care visit, your provider will focus on health supervision and promotion, as well as answering questions and discussing specific concerns. The health supervision portion of the well-care visit includes a full physical exam, relevant clinical or developmental screenings, assessment and monitoring of growth, and identification of health or behavioral risks, as well as ensuring that immunizations are up to date for the prevention of disease. Health promotion at the well-care visit includes education about the many aspects of healthy child development: developmental milestones, social and emotional skills, sleep, behavioral guidance and discipline, nutrition and healthy weight, physical activity, oral health, sexual development, and safety and injury prevention.
Occasionally a well-care visit turns into a more extensive visit, in which a provider addresses issues beyond the scope of services covered in a well care visit. For example, your child may have a chronic condition that needs more in-depth evaluation, discussion or treatment; or perhaps the provider identifies a particular health risk and provides more in-depth counseling during the visit. When this happens, the provider documents both the well-care and the additional issues in the medical record and "codes" the visit for insurance submission. The charge will include the well-care visit and, if appropriate, a separate charge for "additional issues." Many insurance companies are now charging a co-payment for these extra issues since they are considered outside the scope of the regular well-care visit. Our providers do their best to alert patients when the visit may result in an "additional issue" charge, but different insurance companies and plans have different rules. For more information about what our providers do at each well care visit, see the Advanced Pediatrics Well Care & Immunization Schedule.
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Childhood Immunizations
The providers at Advanced Pediatrics firmly believe that childhood immunizations are critically important to a child's long term health. As such, we join the American Academy of Pediatrics and the Centers for Disease Control in recommending that all children be vaccinated according to the following recommended schedules:
For patients whose insurance does not cover vaccines, the  Colorado Children's Immunization Coalition Immunization Referral List provides a list of opportunities in the community to receive vaccines at lower cost. In addition, patients with no insurance are eligible to receive vaccines (in our offices) from the State of Colorado's "Vaccines for Children "(VFC) program at a cost of $14.50 per immunization.
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Our Vaccine Policy
Prior to the creation of today's vaccines, thousands - and sometimes millions - of children became infected with diseases that resulted in lifelong disabilities or death. We firmly believe that our vaccines are safe and save lives. We also firmly believe that, based on all available literature, evidence and current studies, that vaccines do not cause autism or other developmental disabilities. Please read our vaccine policy statement by clicking on the link below. In order to have enough time allocated during well care visits, we request that parents schedule a separate "immunization consultation visit" if they wish to discuss concerns regarding vaccinating their child according to the recommended schedule.
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Immunization Registry
We participate in the State of Colorado's Immunization Registry, which ensures that each patient's immunization history is part of the State's data base. All immunization data is automatically transferred to the registry unless the parent "opts out" of participating. This service provides our patients ready and rapid access to their immunization information.
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Vaccine Information Statements
For information on specific childhood immunizations, please review the following Centers for Disease Control Vaccine Information Statements:
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Immunization Reactions
Immunizations (vaccines) protect your child against serious diseases. About 25% of children have temporary symptoms following the standard vaccines of childhood, such as swelling, pain etc. For a list of immuniation reactions, how to treat and when to call us, please see the following:
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Vaccines for Travel Abroad
Advanced Pediatrics does not provide international travel immunizations within our practice. For families traveling abroad with their children, we recommend Global Travel Health, formerly Rose Travel Medicine, or Tri-County Travel Clinic for all foreign travel vaccinations. More information regarding international travel health and safety can be found at CDC Travel Information.
Global Travel Health
4545 E 9th Ave, Suite 120
Denver, CO 80220
303-468-6986
Tri-County Health Department
15400 E 14th Pl
Aurora, CO 80011
303-451-0123
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Recommended Well Care and Immunization Resources
For more information on well care and vaccine safety, please consult the resources listed below.
Articles
Books
Germ Proof Your Kids: A Complete Guide to Protecting (without overprotecting) Your Family from Infections. Harley Rotbart, MD., 2007.
Immunizations & Infectious Diseases: An Informed Parent's Guide. American Academy of Pediatrics; Margaret C. Fisher, MD, FAAP, Editor-in-Chief, 2005.
Autism's False Prophets: Bad Science, Risky Medicine, and the Search for a Cure. Paul A. Offit, MD, 2010.
Websites
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