In Children
1 When evaluating children, generate a differential diagnosis that accounts for common medical problems, which may present differently in children (e.g., urinary tract infections, pneumonia, appendicitis, depression).
2 As children, especially adolescents, generally present infrequently for medical care, take advantage of visits to ask about: – unverbalized problems (e.g., school performance). – social well-being (e.g., relationships, home, friends). – modifiable risk factors (e.g., exercise, diet). – risk behaviours (e.g., use of bike helmets and seatbelts).
3 At every opportunity, directly ask questions about risk behaviours (e.g., drug use, sex, smoking, driving) to promote harm reduction.
4 In adolescents, ensure the confidentiality of the visit, and, when appropriate, encourage open discussion with their caregivers about specific problems (e.g., pregnancy, depression and suicide, bullying, drug abuse).
5 In assessing and treating children, use age-appropriate language.
6 In assessing and treating children, obtain and share information with them directly (i.e., don’t just talk to the parents).
7 When investigation is appropriate, do not limit it because it may be unpleasant for those involved (the child, parents, or health care providers).
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