Physical Growth and Measurements
CHILD AND TEEN CHECKUPS (C&TC) FACT SHEET FOR PRIMARY CARE PROVIDERS
C&TC Requirements
General
Physical measurements are required at all C&TC
visits, to identify and prevent complex medical
issues.
At all ages, measure the child’s height/length
and weight and record the results accurately on
a standardized growth grid; refer to
documentation section below.
Measure head circumference from birth
through 2 years of age (or at any age on a child
who appears to have a deviation from the
norm) and plot on a standardized growth grid.
Calculate and document Body Mass Index (BMI)
percentile for age and gender at each visit
beginning at age 2 years and plot on a
standardized growth grid.
Measure and document blood pressure starting
at 3 years of age, and compare to norms for the
child’s gender, age, and height.
Children or adolescents determined to have
nutritional risks must be referred as appropriate
for further clinical assessment and nutritional
counseling, or be referred to a nutritional
program such as Women, Infants and Children
(WIC) (www.health.state.mn.us), Supplemental
Nutrition Assistance Program (SNAP)
(www.dhs.state.mn.us) or Head Start
(www.mnheadstart.org).
Personnel
Measurements may be obtained by health staff
(e.g. nursing assistant, medical assistant, nurse)
who have completed adequate training, such as
these online training modules:
▪ CDC Growth Chart Training (www.cdc.gov).
▪ HRSA Training Module: Accurately Weighing
and Measuring Techique
(www.depts.washington.edu).
Documentation
Record numerical values for height, weight,
head circumference, BMI percentile and blood
pressure as appropriate for age in the child’s
health record. Plot growth information on
standardized growth charts based on data from
the World Health Organization (WHO) for ages
0-2 years, and the Centers for Disease Control
and Prevention (CDC) for ages 2 years and
older. CDC Growth Charts (www.cdc.gov).
For documentation examples, refer to C&TC
Documentation Forms for Providers and Clinics
(www.dhs.state.mn.us).
Importance of Assessment
Accurate and reliable physical measures are
used to monitor the growth of an individual,
detect growth abnormalities, monitor
nutritional status and track the effects of
medical or nutritional intervention.
Childhood obesity has both immediate and long
term health consequences that can increase the
likelihood of medical complications as well as
issues in mental health and body image.
(Kelsey, Zaepfel, Bjornstad, & Nadeau, 2013).
Assess children for obesity risks to improve
early identification of elevated BMI, medical
risks, unhealthy eating and physical activity
patterns (Lowenstein, et al., 2013).
Healthy People 2020 identified overweight and
obesity as 1 in 10 leading health indicators and
called for a reduction in the proportion of
children and adolescents who are overweight
and obese, but the United States has made little
progress toward the target goal.
PHYSICAL GROWTH AND MEASUREMENT C&TC FACT SHEET
Professional Recommendations
AAP and Bright Futures (American Academy of
Pediatrics, 2014):
▪ Measure height/length and weight at each
pediatric visit.
▪ Measure head circumference from birth
through 24 months at each pediatric
preventive health care visit
▪ Calculate BMI percentile for age and gender
and plot on the CDC health growth charts at
each visit beginning at 24 months of age.
The classification should be integrated with
other information such as growth patterns,
familial obesity, and medical risk factors to
assess the child’s risk of obesity. Provide
anticipatory guidance, further assessment
and referral as indicated.
▪ Blood pressure screening should begin at
three years of age and continue to be
measured at each preventive health visit, or
more often if medically indicated.
Resources
American Academy of Pediatrics
▪ Bright Futures: Guidelines for Health
Supervision of Infants, Children and
Adolescents (www.brightfutures.aap.org).
▪ Bright Futures Nutrition (3rd Edition) and
Pocket Guide (www.brightfutures.aap.org).
Centers for Disease Control and Prevention
▪ Clinical Growth Charts (www.cdc.gov).
▪ Healthy Weight-It's not a diet, it's a lifestyle!
About BMI for Children and Teens
(www.cdc.gov).
Minnesota Department of Human Services
▪ Supplemental Nutrition Assistance Program
(SNAP) (www.dhs.state.mn.us).
▪ MHCP Provider Manual - Child and Teen
Checkups (www.dhs.state.mn.us).
▪ Child and Teen Checkups (C&TC) Screening
Components Standards and Guidelines
(www.edocs.dhs.state.mn.us).
Minnesota Department of Health
▪ Women, Infants, and Children
(www.health.state.mn.us).
2
▪
Child and Teen Checkups (C&TC)
(www.health.state.mn.us)
References
American Academy of Pediatrics. (2014). 2014
Recommendations for Pediatric Preventive Health
Care. American Academy of Pediatrics.
Kelsey, M., Zaepfel, A., Bjornstad, P., & Nadeau, K.
(2013). Age-Related Consequences of Childhood
Obesity. Gerontology, 60(3), 222-228.
Lowenstein, L., Perrin, E., Campbell, M., Campbell,
D., Jianwen, C., & Ammerman, A. (2013). Primary
Care Providers' Self-Efficacy and Outcome
Expectations for Childhood Obesity Counseling.
Childhood Obesity, 9(3), 208-215.
Nutrition, Physical Activity, and Obesity. (2015).
Retrieved from Healthy People 2020:
http://www.healthypeople.gov/2020/leadinghealth-indicators/2020-lhi-topics/Nutrition-PhysicalActivity-and-Obesity
For More Information
Minnesota Department of Health
Child and Teen Checkups Program
PO Box 64882,
St. Paul, MN 55164-0882
Phone 651-201-3760
[email protected]
www.health.state.mn.us
Reviewed: 09/2016
To obtain this information in a different format, call
651-201-3760.