Review of Bright Futures Guidelines

Bright Futures is a set of guidelines for health supervision of children published by the Maternal Child Health Bureau of the US Department of Health and Human Services. Goals include health promotion, developmental surveillance and anticipatory guidance. The following are selected recommendations for the routine 10 year old visit:

Developmental Surveillance and School Performance (questions for parents):

• Do you have concerns about Pablo's grades?
• How is his attendance?
• Is he reading at grade level?
• Is he doing math at grade level?
• Is he in any special classes?
• Does Pablo follow the rules at school?
• Is he proud of his achievements at school?
• How do you acknowledge Pablo's achievements at school?
• Have you visited Pablo's classroom?
• Do you participate in activities at his school?
• Does Pablo talk to you about what goes on in school?
• Has he identified certain interests he wants to pursue or talents he would like to develop?
• What did the teacher say about Pablo during the Parent-Teacher conference?
• Is Pablo ready for middle school?

Observation of the Parent-Child Interaction

Do both the parent and the child ask the questions? Does the parent let the child speak directly to the health professional, or does the parent interrupt? Is the child playful or serious with the health professional? Do the parent and child make eye contact with each other and with the health professional? If the health professional speaks with the child alone, how comfortable is the child? How does the parent react to being asked to wait outside?

Promotion of Social Competence

• Praise the child for achievements
• Help the child choose activities for which he can be successful
• Encourage the child to talk with you about his school, friends, or feelings. Answer his questions.
• Encourage reading and hobbies.
• Spend individual time with the child, doing something you both enjoy.
• Enhance the child's experiences through family trips or vacations.
• Promote interaction and allegiance with peers through participation in social activities, community groups, and team sports.
• Help the child learn how to get along with his peers. Discuss his awareness of differences among peers.
• Promote independence by encouraging developmentally appropriate decision-making
• Set limits and establish consequence for unacceptable behavior. Expect the child to follow family rules, such as those for bedtime, television viewing and chores.
• Promote positive interactions between the child and his teachers and other adults.
• Help the child learn appropriate or reasonable behavior.
• Help the child develop an ability to withstand peer pressure. Discuss strategies and try role playing.
• Help the child develop an ability to deal constructively with conflict and anger in the family, at school, and in the neighborhood.
• Assign age-appropriate chores, including responsibility for some household or yard tasks.