American Academy of Pediatrics Publishing Staff Mary Lou White, Chief Product and Services Officer/SVP, Membership, Marketing, and Publishing Mark Grimes, Vice President, Publishing Heather Babiar, MS, Senior Editor, Professional/Clinical Publishing Theresa Wiener, Production Manager, Clinical and Professional Publications Jason Crase, Manager, Editorial Services Mary Jo Reynolds, Marketing Manager, Practice Publications Published by the American Academy of Pediatrics 345 Park Blvd Itasca, IL 60143 Telephone: 630/626-6000 Facsimile: 847/434-8000 The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists, and pediatric surgical specialists dedicated to the health, safety,and well-being of infants, children, adolescents, and young adults. The recommendations in this publication do not indicate an exclusive course of treatment or serve as a standard of care. Variations, taking into account individual circumstances, may be appropriate. Any websites, brand names, products, or manufacturers are mentioned for informational and identification purposes only and do not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of external resources. Information was current at the time of publication. The publishers have made every effort to trace the copyright holders for borrowed materials. If they have inadvertently overlooked any, they will be pleased to make the necessary arrangements at the first opportunity. This publication has been developed by the American Academy of Pediatrics. The contributors are expert authorities in the field of pediatrics. No commercial involvement of any kind has been solicited or accepted in development of the content of this publication. Every effort is made to keep the AAP Healthy Development and Well-Child Support Chart consistent with the most recent advice and information available from the American Academy of Pediatrics. Special discounts are available for bulk purchases of this publication. Email Special Sales at for more information. © 2020 American Academy of Pediatrics All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means—electronic, mechanical, photocopying, recording, or otherwise—without prior permission from the publisher (locate title at and click on © Get permissions you may also fax the permissions editor at 847/434-8780 or email Printed in the United States of America 9-441/0120 1 2 3 4 5 6 7 8 9 10 MA0967 ISBN: 978-1-61002-402-0 eBook: 978-1-61002-403-7 Cover and publication design by LSD DESIGN, LLC Introduction The well-child (health supervision) visit, and the comprehensive preventive care administered within it, constitute the cornerstone of pediatric health care. Each well-child visit presents an opportunity to promote optimal development, avoid prevalent threats to wellness, provide support to parents and caregivers, and build the foundations for healthy life-course trajectories. All these features help to build a solid framework to support the peak health and well-being of infants, children, adolescents, and young adults. The American Academy of Pediatrics (AAP) is dedicated to supporting the highest-quality pediatric care achievable, whether children are seen in private practice, hospital primary care settings, public health clinics, school health centers, or other primary care facilities. The AAP recognizes that pediatric health care professionals and other child advocates in these settings require current, evidence-based, and readily accessible information and practice- friendly tools to be able to advocate for the optimal physical, mental, and social-emotional development of all children. With this vision in mind, the AAP Healthy Development and Well-Child Support Chart contains a select collection of resources to provide a new, quick, and easy-to-use visual reference on several of the most important topics covered in the pediatric well-child visit. Designed to be consistent with Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, 4th Edition, this chart can be kept on hand throughout the clinical day to support pediatric health care professionals in conducting well-child visits for children of all ages. The Academy sincerely hopes that this clinical tool, and the valuable resources within it, are helpful throughout your busy clinical day. Acknowledgments Thank you to Andrew S. Garner, MD, PhD, FAAP, and the American Academy of Pediatrics Committee on Practice and Ambulatory Medicine for their expert reviews and guidance. 1 What Children Need to Thrive 3 Promoting Early Brain and Child Development 5 Developmental Milestones: 1–12 Months 7 Developmental Milestones: 13–33 Months 9 Developmental Milestones: 3–6 Years 11 Social-Emotional Milestones 13 Social-Emotional Development 17 Adolescent Development 19 Behavioral Concerns 22 Mental Health 25 Gender Care 26 Obesity Care 31 Physical Activity 33 Sleep 37 Toxic Stress and Resilience Contents HEALTHY DEVELOPMENT FLIP CHART - INTERIOR.indd 1 11/16/19 5:36 PM
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