4.5.1: FRAME 1- Recognize Cues

Khloe Seng is a 5-year-old who is planning to start kindergarten in the fall. She is an only child and lives in a multigenerational home with her parents and her grandmother in a rural community. Khloe's parents both work fulltime, and she attends a daycare center Monday through Friday that integrates a pre-K curriculum. Khloe and her parents are attending a kindergarten orientation this afternoon at the local public elementary school 3 miles from their home. It is requested they bring copies of Khloe's immunization and dental screening records. Khloe's parents enthusiastically informed Khloe that she gets to go to school today and will be able to see the bus that will pick her up and take her to school every day. Khloe states, "I am scared I won't know when to get off the bus." Her parents read her the book, Bee's First School Bus Ride, before going to her kindergarten orientation. The book is about Bee, like Khloe, who is nervous about taking the bus for the first time and the adventures that come with new experiences. Khloe asks if she can take "Bee" with her when she gets on the bus at kindergarten orientation.

Review Khloe's immunization record below. Additionally, review CDC 2023 recommended immunizations for children from birth through 6 years old by clicking HERE.

Recognize Cues

QUESTION: Multiple Response Select All That Apply

Scoring Rule: +/-

Which of the following statements from Khloe’s history are preventive care measures? Select all that apply

 She attends a daycare center Monday through Friday that integrates a pre-K curriculum

 Khloe and her parents are attending a kindergarten orientation this afternoon at the local public elementary school

 Khloe has had regular scheduled appointments with her pediatrician

 Khloe is up-to-date with recommended immunizations

 Khloe has had dental screening

 Khloe has had fluoride treatments

 Khloe has no allergies or food intolerances

 Khloe has had two ear infections, treated with antibiotics

Putting It All Together

DEBRIEF

Establishing healthy behaviors to prevent chronic disease is easier and more effective during childhood and adolescence than trying to change unhealthy behaviors during adulthood (CDC, 2023). Preventive care is defined as routine health care that includes screenings, check-ups, and patient counseling to prevent illnesses, diseases, or other health problems. Khloe participants in health promotion/illness prevention measures indicated by up-to-date immunizations, regular milestone visits with the pediatrician, and dental screenings.

The Centers for Disease Control and Prevention (CDC) published new immunization guidelines for birth to 6-year-olds in 2023. The updated immunization recommendations include COVID-19 vaccination.

Dental caries in early childhood are associated with pain, loss of teeth, impaired growth, decreased weight gain, negative effects on quality of life, poor school performance, and future dental caries. Higher prevalence and severity of dental caries are found among specific racial and ethnic (e.g., Black and Mexican American) populations (Chou et al., 2021). According to the U.S. Preventive Services Task Force (USPSTF), social determinants of health associated with increased caries risk include lack of access to dental care, low socioeconomic status, personal and family oral health history, dietary habits (especially frequent intake of dietary sugars in foods and beverages), fluoride exposure, and oral hygiene practices (USPSTF, 2021). The Community Preventive Services Task Force (CPSTF) recommends Fluoridation of community water sources to reduce dental caries and school-based sealant delivery programs to prevent caries in children.

RECOGNIZING SOCIAL DETERMINANTS OF HEALTH (SDOH)

This case study focuses on disease prevention/promotion of health and well-being of a 5-year-old child and addresses four of the five SDOH domains: Education Access and Quality, Neighborhood and Built Environment, Social and Community Context, and Health care Access and Quality.

The goal for the SDOH domain, Neighborhood and Built Environment, is to create neighborhoods and environments that promote health and safety. One of the objectives for this domain is to increase the proportion of schools with policies and practices that promote health and safety (EH-D01). Assessing immunizations, dental screening, fluoride supplementation, and topical fluoride varnish to primary teeth in kindergarten screening support this objective. The second relevant objective related to Neighborhood and Built Environment for rural water sources is to increase the proportion of people whose water systems meet the Safe Drinking Water Act regulations (EH-03).

What Do You Think About?

1. Identify three childhood conditions and other factors that increase the risk for invasive pneumococcal disease.
2. What are two primary dental considerations for children living in rural communities?
3. List three additional preventive care measures recommended for elementary aged children.