March 2018
Essential Aspects of Texas Health Steps and Well-child Exams
Medical history is the foundation of any examination and the physical exam serves as another important component of Texas Health Steps (THSteps) and well-child exams. According to the Texas Health and Human Services Commission, an unclothed physical exam is required during all THSteps and well-child checkups. The following components are required at each visit according to age as stated in the THSteps checkup components list.
Measurements
Requires documentation of measurements and percentiles as appropriate:
- Length or height, and weight – all ages
- Fronto-occipital circumference – birth through 24 months of age
- Body Mass Index percentile (plotted on growth charts) – beginning at 2 years of age
- Blood pressure – beginning at 3 years of age
Sensory Screening
- Vision Services
- Visual acuity – required for 3 to 6, 8, 10, 12, 15 and 18 years of age
- Subjective – Newborn to 30 months, 7, 9, 11, 13, 14, 16, 17, 19 and 20 years of age
- Hearing Services
- Audiometric screening – required for 4 to 6, 8, 10 and 15 years of age
- Subjective – between discharged date and up to five days after discharge, 2 weeks to 3 years, 7, 9, 11 to 14 and 16 to 20 years of age
THSteps recommends that health care providers use the World Health Organization’s growth charts for infants and children ages birth to 2 years, and the Centers for Disease Control and Prevention’s growth charts for children who are 2 years of age and older.
Documentation of test results from a school vision or hearing screening program may replace the required screening if conducted within 12 months of the checkup. Vision and hearing screenings must be completed according to the requirements of the THSteps Periodicity Schedule.
These are only a few documentation components required during a well-child or THSteps exam. Reference the THSteps website to view other necessary components.