Plan Documentation for Healthy 11-Year-Old Well-Child Visit
For a healthy 11-year-old with no concerns, document the following in your plan: dyslipidemia screening (fasting lipid panel), immunization review and administration of any due vaccines (particularly Tdap, HPV, and meningococcal if not yet given), anticipatory guidance on puberty/development/substance use/safety, and return in one year for next well-child visit 1, 2.
Required Screening and Preventive Services
Dyslipidemia Screening
- Order fasting lipid panel - This is specifically recommended for children 9-11 years of age due to the obesity epidemic 1
- This is a one-time universal screening during this age window
Immunization Assessment and Administration
- Review vaccination status and administer any due vaccines 3, 4:
- Tdap (if not yet given and last tetanus was >5 years ago)
- HPV vaccine series (can start at age 11)
- Meningococcal conjugate vaccine (MenACWY at age 11-12)
- Influenza vaccine (if during flu season)
- Verify completion of MMR series (2 doses)
- Verify completion of varicella series (2 doses)
- Verify completion of hepatitis B series (3 doses)
Anticipatory Guidance Topics to Document
Address the following counseling points 2, 3, 5:
Lifestyle and Health Promotion:
- Physical activity: Recommend 60 minutes daily of moderate to vigorous activity 2, 5
- Nutrition: Counsel on diet high in fruits, vegetables, whole grains, low-fat dairy, limiting sugar and processed foods 5
- Sleep: Recommend 9-12 hours per night without disturbance 2, 5
- Dental care: Brush twice daily with fluoride toothpaste; routine dental visits 2, 3
- Screen time: Discuss Family Media Use Plan to individualize limits 5
Safety Counseling:
- Unintentional injury is the leading cause of death in this age group 2, 5
- Vehicle safety (seatbelt use, booster seat if needed)
- Water safety
- Sports safety (helmets, protective equipment)
- Firearm safety
- Home safety
Substance Use Discussion:
- Begin counseling on tobacco, alcohol, and drug use (including prescription drugs) - experts recommend starting at age 11 5
- Discuss risks and peer pressure
Puberty and Development:
- Discuss expected pubertal changes
- Address any questions about development
Follow-Up Plan
- Return in 12 months for next well-child visit
- Provide contact information for concerns between visits
- Document that parent/patient were given opportunity to ask questions
Important Caveats
The 11-year visit is a critical transition point where substance use counseling should begin, even though the child appears healthy 5. This is also the last opportunity for universal dyslipidemia screening in the 9-11 year window 1, so don't miss it.
If fluoride supplementation hasn't been addressed previously, verify the local water supply has adequate fluoride (>0.6 ppm); if not, prescribe daily fluoride supplements 3.