Well Care / Immunizations

Well Care / Immunizations

Advanced Pediatric Associates believes that routine well 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 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 developmental, vision and hearing screenings, important lab work and routine immunizations. 

Share This:

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 recommend 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:

Back to Top

Well Child Care Schedule

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. 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.

Administering childhood immunizations and monitoring childhood development are important aspects of well care. The providers at Advanced Pediatrics follow the childhood immunization schedule recommended by the American Academy of Pediatrics and the Centers for Disease Control. 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. Beginning at 11 years of age, patients will be asked to complete a "tween" or "adolescent" risk assessment questionnaire, which helps identify any important concerns regarding behavior, health and safety.

A newborn's first office visit should be scheduled within 3 days of discharge from the hospital. Consistent with guidelines from the American Academy of Pediatrics, our providers recommend the schedule below for well child care visits:

1st Newborn Visit
2 weeks
2 months

4 months
6 months
9 months

12 months
15 months
18 months
24 months

30 months
3 years
4 years
5 years

Annual well care exams are recommended every year for children beginning at age 3 and continuing throughout childhood and adolescence.

High school students playing sports are required by school district to have annual physical exam. 

Please Note: Our providers agree with recommendations from the American Academy of Pediatrics that a 30-month well care visit is beneficial, due to all of the growth and development that happens between 2 and 3 years of age. Unfortunately many insurance companies do not cover a 30 month visit, so this visit is normally an out-of-pocket cost for parents.

Back to Top

Developmental Screening (Well Care Visits 2 Months - 5 Years)

Advanced Pediatrics uses "Ages & Stages" developmental screening tools at well care visits to help monitor infant and child development. Our care coordinator will email you the appropriate questionnaire to complete when scheduling your appointment. Please wait to complete this 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. Visit our Child Development page to learn more.

Back to Top

Autism Screening (18 and 24 Month Well Care Visits)

In addition "Ages & Stages" developmental screening, Advanced Pediatrics routinely screens for Autism at both 18 and 24 month well care visits using the "M-CHAT" (Modified Checklist for Autism in Toddlers). Autism Spectrum Disorder (ASD) is a brain-based disorder that affect a child's behavior, social, and communication skills. Less than 2% of children are diagnosed with an Autism Spectrum Disorder. Though ASD is a 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.

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.

Back to Top

Lead Testing (12 and 24 Month Well Care Visits)

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.

Back to Top

Body Mass Index (Well Care Visits Beginning at Age 2)

At all well care visits beginning at age 2, your child's physical development is charted and monitored through measurements for height, weight and body mass index (BMI). The BMI is a measurement that uses the relationship between height and weight to indicate body "fatness" and potential weight problems that have associated health risks. Once your child's BMI score is calculated, your health care provider will discuss the results with you and be able to answer any questions you may have. If your child's score is high, we may advise additional lab work and make some suggestions for healthy nutrition and exercise changes you can make. For more information, see our Healthy Weight: Nutrition & Physical Fitness page.

Back to Top

Vision / Hearing Screening

Beginning at 12 months of age, all well care visits include a basic vision screening. Beginning at 3 years of age, all well care visits also include a basic hearing screening.  Should these screenings indicate a potential deficiency in either vision or hearing, your child may be referred to a specialist.

Back to Top

Lipid (Cholesterol) Screening

Consistent with American Academy of Pediatrics guidelines, Advanced Pediatrics does a universal cholesterol screening blood test between the ages of 9 - 11 years and again between 17 - 21 years of age. (Children who have family risk factors or at-risk conditions should have already been screened with a fasting lipid profile.) Universal screening is based on research showing: (1) early atherosclerosis exists in young patients with elevated cholesterol, (2) early treatment of cardiovascular risk factors in youth is effective, (3) lipid disorders are common in children and increasingly coincident with childhood obesity, and (4) 30-60% of children with high cholesterol are missed using traditional screening methods.

Back to Top

Pre-Teen and Adolescent Well Care

With so many changes taking place during the pre-teen and teen years, annual well care exams are more important than ever. In addition to a complete physical examination and recommended vaccinations, these important visits give our providers the opportunity to discuss nutrition, family, social and school issues, safety, behavior and puberty. As part of all well care exams beginning at age 11, patients will be asked to complete a risk assessment questionnaire, which helps identify any important concerns regarding behavior, health and safety. Patients between the ages of 11 - 12 will be asked to complete the "Tween Screening" questionnaire, and patients ages 13 and older will be asked to complete the "RAAPS Risk Assessment" questionnaire:

Learn more about adolescent well care by visiting our Adolescent Health page.

Back to Top

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.

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. The health promotion portion of 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." Most insurance companies charge 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.

Back to Top

Childhood Immunization Schedule

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*:

* Note -- Occasionally national vaccine shortages may require temporary modifications to the vaccine schedules noted above.

Patients who are uninsured or on Medicaid are eligible to receive government subsidized vaccines in our offices through the state funded Vaccines for Children program. (A small administration fee is charged per vaccine for uninsured patients.) In addition, immunizations are available regardless of insurance status or ability to pay for administration fees, through the Tri-County Health Department and Colorado Children's Immunization Coalition "Shots for Tots and Teens" program. 

Back to Top

Vaccine Information Statements

For information on specific childhood immunizations, please review the following Centers for Disease Control Vaccine Information Statements:

Back to Top

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. Childhood vaccines are safe and save lives. We require that ALL APA patients receive ALL of the recommended vaccines according to the schedule published by the Centers for Disease Control and the American Academy of Pediatrics by the ages of 2, 5, and 11.

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.  Additional information may be found in the "Refusal to Vaccinate Resources" link.

Back to Top

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.

Back to Top

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:

Back to Top

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, for foreign travel vaccinations. Click here for a list of additional international travel clinics.  More information regarding international travel health and safety can be found at CDC Travel Information.

Back to Top

Recommended Well Care and Immunization Resources

Back to Top