Anticipatory guidance is the medical version of Ben Franklin’s aphorism, “an ounce of prevention is worth a pound of cure.” Essentially, the name of the game is to decrease morbidity (pain, injuries, and trips to the office for nonfatal accidents or issues) and mortality (death). General pediatricians and other clinicians who care for children spend time at each well child checkup asking about things that can lead to bad outcomes and recommending certain courses of action to decrease the likelihood of that event.
Lawton, 2018
Texas Health Steps Checkups and Anticipatory Guidance
Anticipatory guidance is a federally required component of each Texas Health Steps medical and dental checkup for patients from birth through age 20 years. Education and counseling provided during a checkup help the child and parent/guardian understand expected growth and development. Anticipatory guidance also serves to provide information about the benefits of healthy lifestyles and practices, as well as accident and disease prevention.
In a child’s early years, health education is provided almost exclusively to parents based on the child’s development and concerns identified by parents, guardians or the health-care provider. As young people grow and develop, additional developmental and behavioral topics become pertinent, and education is delivered directly to the patient as well as to parents.
Texas Health Steps providers are not expected to address all possible age-appropriate topics during a checkup. Providers are encouraged to individualize and prioritize the topics according to the questions or concerns that are raised during the checkup.
A challenge for providers: Finding time
Many providers are challenged to have enough time during the checkup to cover topics that may be pertinent to a patient. Research conducted over several decades show that the issue is widespread. In many cases, physicians have only one or two minutes during the checkup to cover anticipatory guidance to young children and their parents, and even less time with adolescent patients.
Texas Health Steps providers know the challenge well. The anticipatory guidance activity that begins on the next page gives you the chance to select which topics you would cover during a checkup. The activity allows you four minutes, which is more than many providers allot for anticipatory guidance during checkups. Keep reading to see how a whole-office approach can streamline the process and free you up to focus on individualizing anticipatory guidance based on the patient or parent’s main concern.