Recommended Assessments and Interventions for a 12-Year-Old Male During a Well-Child Visit
A comprehensive well-child visit for a 12-year-old male should include blood pressure measurement, growth assessment, psychosocial evaluation, vision screening, and age-appropriate immunizations, with special attention to emerging adolescent health issues.
Physical Assessment Components
Growth and Development
- Measure height, weight, and calculate BMI
- Plot measurements on appropriate growth charts
- Screen for obesity (defined as BMI ≥95th percentile for age and sex) 1
- Assess pubertal development using Tanner staging 2
Vital Signs
- Blood pressure measurement (interpret using age/sex/height-specific normative values)
Physical Examination
- Complete head-to-toe examination 4
- Focused assessment of:
Screening and Laboratory Tests
Recommended Screenings
- Dyslipidemia screening (once between ages 9-11) 1
- Vision screening 3, 1
- Hearing screening 1
- Depression/mental health screening (starting at age 12) 3
- Screen for psychosocial issues that could impact development 3
Risk-Based Screening
- Tuberculosis screening if high-risk
- Hemoglobin/hematocrit if at risk for anemia
- Lead screening if risk factors present
- Diabetes screening if BMI ≥85th percentile with additional risk factors 3
Psychosocial Assessment
Mental Health
- Screen for depression, anxiety, and other mental health concerns 3
- Assess for suicidal ideation or behavior 3
- Look for signs of depression including:
- Irritable or depressed mood
- Loss of interest in previously enjoyed activities
- Sleep disturbances
- Fatigue or decreased energy
- Poor concentration or school performance 3
Social Development
- Assess peer relationships and social adjustment 3
- Screen for bullying (as victim or perpetrator)
- Evaluate school performance and learning difficulties 1
- Begin offering time alone with healthcare provider (without parents) 3
Risk Behaviors
- Screen for tobacco, alcohol, and substance use
- Assess for risky behaviors and provide appropriate counseling 3
Anticipatory Guidance
Physical Activity and Nutrition
- Recommend 60 minutes of physical activity daily
- Discuss healthy eating habits
- Limit screen time to reasonable amounts
- Counsel on adequate sleep (9-12 hours recommended at this age)
Safety
- Discuss seat belt use
- Helmet use for biking, skating, and other activities
- Water safety
- Internet safety and appropriate use of social media
- Firearm safety if applicable
School and Social Issues
- Discuss school performance
- Address bullying prevention
- Provide guidance on peer pressure
- Begin discussing puberty and physical development
Immunizations
- Review immunization status and provide any needed vaccines
- Recommended immunizations at age 12 may include:
- Tdap (tetanus, diphtheria, acellular pertussis)
- Meningococcal conjugate vaccine (MenACWY)
- HPV vaccine (if not previously administered)
- Annual influenza vaccine
- Catch-up immunizations as needed
Family Assessment
- Screen for family stressors that may impact the child's health
- Assess parental mental health (particularly maternal depression)
- Evaluate for signs of abuse or neglect during history and examination
- Provide resources for family support as needed
Follow-Up Planning
- Schedule next well-child visit (typically annual at this age)
- Arrange any needed referrals based on findings
- Provide specific follow-up for any identified concerns
This comprehensive approach ensures that all key aspects of a 12-year-old's health are addressed during the well-child visit, with attention to the physical, developmental, and psychosocial needs of this age group.