well child visit h&p

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Welcome to the Well Visit Planner ®

Your child, your well visit.

A quick and free pre-visit planning tool to focus care on your unique needs and goals.

Get started now: Covers all 15 age-specific well visits from your child’s first week of life to age 6

Learn more about creating a family account

Take about 10 minutes to get a personalized Well Visit Guide. Get the best care focused on your child and family’s unique goals and needs.

Do you want to use the WVP with the children and families you serve?

Learn more here!

What is a Well Visit?: Well visits are regular check-ups with your child’s personal doctor, nurse, or other child health professional. At least 15 visits are recommended in the first six years of life when children are growing rapidly. Be sure to stay on track with well visits to help your child and family thrive.

What families like about using the Well Visit Planner (WVP):

• Saves time filling out forms during visits
• Gives you a personalized Well Visit Guide with results specific to your child and family
• Provides easy to read resources on your needs and priorities
• Helps you and your child’s providers focus care on your goals and needs
• Builds confidence that your child’s care meets expert guidelines
• You choose what sections to complete and share.

Three Easy Steps for Using the Well Visit Planner

The Well Visit Planner was created to be used in partnership with your provider. If you have a unique code from your provider, enter it here now:

Enter provider ID code

If you do not have a provider ID code, please continue:

If you already have a family account, login here.

Plan ahead for well visits for all your children up to age 6

Store, save and send your personalized Well Visit Guides at any time

Pause and return to complete WVP sessions within one week

Access and review educational resources specific to your priorities, needs and goals

Please note that using the Well Visit Planner as a guest and without a “provider ID code” means you must download, save and share your Well Visit Guide each time you use the WVP . Your data and Well Visit Guides will NOT be saved for future review.

Important Note: Without a provider ID code you need to share your Well Visit Guide with your child’s provider(s) yourself.

Your personalized Well Visit Guide summarizes your priorities and needs based on the information you shared in the Well Visit Planner.  The guide provides resources about your priorities and gives you example questions to help you discuss your priorities with your child’s provider. Consider these four ways to share your Well Visit Guide with your child’s provider(s).

Save & print

Save to your phone or mobile device

Upload your Well Visit Guide to your Patient Portal

Email your Well Visit Guide to your child's provider

• Sign up for a free family account HERE to save, access, review and share your Well Visit Guides at any time.
• Do you want your Well Visit Guide to be automatically shared with your child's provider(s)? Learn more HERE .

Your Data: The Well Visit Planner is operated on a fully secure platform and your data is not shared with anyone except you and, if you agree, your child’s provider or care team.

What our families are saying!

“It’s helpful to know ahead of time what areas my provider will be checking. It also helps you to get an understanding of the milestones that you want to look out for in your child’s development. The idea that my provider can see what my concerns are before my visit is nice. Best case scenario, they would use the information to bring resources to the start of the visit rather than having to gather them during or after the visit.” (Parent)

“I would recommend the WVP, since it a tool that helps organize and prioritize the medical needs of our children. We can share concerns and our provider can get to know them beforehand. The WVP is a good medical attention guide.” [Parent, translated from Spanish]

“As a mother, I would recommend the use of the Well Visit Planner since it is a tool that can help us be organized with everything we'd like to discuss with the doctors. Also, it gives an overview of the visit.” [Parent, translated from Spanish]

“I really like the WVP, and I believe that it is a really resourceful tool to provide more communication between the provider and families. It is also a great tool to have important information to reference that is specific to the child’s growth and development.” (Parent)

Well Visit Planner: Before Getting Started

Please review and scroll to the bottom before agreeing to the voluntary consent.

VOLUNTARY CONSENT FORM

The purpose of the tool, the Well Visit Planner (WVP), is to enable parents to optimize visit time by focusing on priorities, concerns, and other issues specific to the child and family. The WVP asks parents about their child and family and the kind of topics they want to discuss at their child’s well-child visit. The health care provider can use this information to customize the visit to the needs of the parent and child. Additionally, the tool provides educational information about potential discussion topics based on national recommendations for health care providers.

To use this tool, complete the online Well Visit Planner which should take you about 10 minutes. You will be asked to do the following:

• Agree to the WVP Terms and Conditions.
• You will be asked to voluntarily consent to allow the Child and Adolescent Health Measurement Initiative to mine the de-identified information that you provide in order to analyze and improve the WVP tool.
• Provide basic information about your child who has the upcoming well-child visit.
• Answer a series of questions about your child and family that will help you and your child's health care provider know what they may need to focus on during the visit.
• Pick the topics that you want your child's doctor to address and give you information about at the upcoming visit.
• Receive a "Visit Guide" that you may use at your child's well-visit. This guide highlights the topics you may want to discuss and should be brought to the visit.
• You have the option of creating your own account on the WVP. You can use your account to plan future visits, complete unfinished WVP visits, add other eligible children, and review previous Visit Guides and educational information.

Although we have made every effort to protect your identity, there is a minimal risk of loss of confidentiality. Additionally, you may find that some questions or topics cause you emotional discomfort. You may choose not to answer some of the questions.  The choice is up to you.

You may or may not benefit from using the online Well Visit Planner. However, by completing the online tool, you may improve your child's well-visit and you may receive useful information in partnering with your child's health care provider. Additionally, the answers you provide may help your child's health care provider understand your child and family health so that they can better provide well-child care for you. Finally, your participation may help us learn how to benefit parents and children in the future by providing information to health care providers that will help them improve well-child visits.

Confidentiality

We implement a variety of security measures to maintain the safety of your personal information when you enter or submit answers. We offer the use of a secure server. All supplied sensitive information is housed in our database which is protected through a secure dedicated port which only allows data entry from the tool to our database. The database is protected by having a closed-off port for the SQL Server installation. Only authorized personnel with special access rights to our systems are given access to the data. We are required to keep the information confidential.

The WVP does not collect protected health information or information that can lead to the identification of you or your child. You are asked to provide only two pieces of personally identifiable information: child’s first name (optional) and date of birth. These are not stored in our database. The child’s first name is displayed on the Visit Guide. The date of birth is used to calculate the appropriate upcoming well-visit and present the age-specific questions. That visit (e.g. 4 month or 6 month) is stored in our database rather than the date of birth. If you choose to create an account on the WVP, you have the option to add your child’s first name or nickname to appear on the family dashboard and Visit Guide. This name will be saved on our secure servers.

The email address that you use for registering an account will not be shared with any third parties, nor will your email address be sold or used for purposes other than sharing educational resources or sending updates about the Well Visit Planner. You can unsubscribe if you wish to stop receiving emails from us by sending us an email on [email protected] .

In addition, identifying information connected to your computer (IP address) will not be recorded by the CAHMI at any time. If you choose to download or print your Visit Guide, CAHMI will not be liable for any actions related to your choice to disseminate, distribute or copy the Visit Guide with the name(s) of your child(ren) or any other information contained in the guide.

The Well Visit Planner will store the de-identified information that you provide about your child's health, development, and home environment; along with the priorities you select on a secure server. It will not be possible to link this anonymous information to you or your child. We will use this anonymous information to understand parents' concerns and priorities for their well-child visits. This information may also be combined with other parents’ responses and shared with your child’s provider to help them learn more about families they provide care to and improve well-child care for children and their families.

Access and use the Well Visit Planner is free.

You do not have to use the Well Visit Planner. If you do elect to use the Well Visit Planner, and later change your mind, you may discontinue use at any time. If you do not complete the WVP, there will be no penalty or loss of any benefits to which you are otherwise entitled.

If you have any questions, you may contact us at  [email protected]

Your provider ID code

If your child’s provider has invited you to use their tailored Well Visit Planner, you can enter their ID code below. This ID code is also the text included after “/” in the WVP URL that your child’s provider shared (i.e. www.wellvisitplanner.org/ providerIDcode ).

Your Customized Well Visit Planner

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Well Visit Planner: Voluntary Consent

Your privacy is important to us. Please review our terms and conditions , and consent form , check each box below and click the Continue button below.

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Well-Child Visits: Parent and Patient Education

The Bright Futures Parent and Patient Educational Handouts help guide anticipatory guidance and reinforce key messages (organized around the 5 priorities in each visit) for the family. Each educational handout is written in plain language to ensure the information is clear, concise, relevant, and easy to understand. Each educational handout is available in English and Spanish (in HTML and PDF format). Beginning at the 7 year visit , there is both a Parent and Patient education handout (in English and Spanish).

For the Bright Futures Parent Handouts for well-child visits up to 2 years of age , translations of 12 additional languages (PDF format) are made possible thanks to the generous support of members, staff, and businesses who donate to the AAP Friends of Children Fund . The 12 additional languages are Arabic, Bengali, Chinese, French, Haitian Creole, Hmong, Korean, Polish, Portuguese, Russian, Somali, and Vietnamese.

Reminder for Health Care Professionals:  The  Bright Futures Tool and Resource Kit, 2nd Edition ​ is available as an online access product. For more detailed information about the Toolkit, visit  shop.aap.org . To license the Toolkit to use the forms in practice and/or incorporate them into an Electronic Medical Record System, please contact  AAP Sales .

Parent Educational Handouts

Infancy visits.

3 to 5 Day Visit

1 Month Visit

2 Month Visit

4 Month Visit

6 Month Visit

9 Month Visit

Early childhood visits.

12 Month Visit

15 Month Visit

18 Month Visit

2 Year Visit

2.5 Year Visit

3 Year Visit

4 Year Visit

Parent and patient educational handouts, middle childhood visits.

5-6 Year Visit

7-8 Year Visit

7-8 Year Visit - For Patients

9-10 Year Visit

9-10 Year Visit - For Patients

Adolescent visits.

11-14 Year Visit

11-14 Year Visit - For Patients

15-17 Year Visit

15-17 Year Visit - For Patients

18-21 Year Visit - For Patients

Last updated.

American Academy of Pediatrics

Preventive Care 

Annual physical exams and other preventive services are free when you use a Preferred provider.

Preventive Care

Watch this video to take a closer look at your preventive care benefits and see how they can help you stay on top of your health.

As a Service Benefit Plan member, everyone on your plan can access a wide range of preventive care services—at no cost—when seeing a Preferred provider. Speak to your primary care doctor about which preventive care services are recommended for you.

General Health Screenings

These can help you and your doctor identify lifestyle changes you can make to avoid certain health conditions.

• Annual Physical
• Blood Pressure
• Cholesterol
• Hepatitis C
• Tobacco Use
• Well-child Visits 

Immunizations and Vaccines

It's recommended that everyone receive routine vaccinations depending on age and medical history. This includes

• Influenza (Flu Shot)
• Measles, Mumps, Rubella (MMR)
• Tetanus, Diphtheria, Pertussis (Tdap)

Cancer Screenings

Early cancer detection helps prevent the need for extensive treatment.

• Breast Cancer/Mammograms 
• Cervical Cancer
• Colon Cancer 

Family Planning

We cover a range of voluntary family planning services at no cost, limited to these services.

Contraceptive counseling, diaphragms and contraceptive rings, injectable contraceptives, oral and transdermal contraceptives, intrauterine devices (IUDs), implantable contraceptives, tubal ligation or tubal and occlusion/tubal blocking procedures only

HRSA-supported Guidelines

View a list of HRSA-supported Women’s Preventive Services Guidelines.

Contraception Coverage

View what contraception coverage is included under FEHB. If you have difficulty accessing contraceptive coverage or other reproductive healthcare, you can email [email protected]. 

Contraceptive Exception Form

View the necessary form for the contraception exception process.

Service not listed?

If your doctor recommends a surgical contraceptive service not listed above, please contact the customer service number on the back of your member ID card. They will ask that your provider send them information as to why one of the services above cannot be rendered. They will then make a coverage determination within 24 hours of receipt of sufficient medical records.

Ensure your child is healthy at every age

During their early years, children experience a lot of important development for their health. Through age 18, children should regularly see the doctor to make sure they’re growing up healthy and on track—even if they’re feeling well. These are called ‘well-child visits.’ These visits allow your child’s doctor to keep an eye out for key developmental milestones and get important routine vaccines.

Well-child visits are essential during the first 30 months of life

15 months old.

Babies need extra attention early in life. Newborns should have at least six well-child visits with their doctor during their first 15 months.

30 months old

Your baby should then have at least two more well-child visits with their doctor before they turn 30 months old.

Download our Well-Child Guide

Good health begins at an early age. This guide gives you a schedule of well-child visits recommended by the American Academy of Pediatrics plus a recommended vaccine schedule from birth through age 18.

Routine Annual Physical Incentive Program

FEP Blue Focus members can get rewarded for having their annual checkup. Earn rewards like a personalized nutrition plan, a free health club membership or other incentives.

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Browse our online directory of Preferred providers, urgent care centers, pharmacies and other facilities.

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• HealthyChildren.org
• Well-Child Visit Handouts

Parent and patient handouts from the Bright Futures Tool and Resource Kit , 2nd Edition, address key information for health supervision care from infancy through adolescence. Bright Futures is a national health care promotion and disease prevention initiative that uses a developmentally based approach to address children’s health care needs in the context of family and community.

See Handouts by Language for well-child visit handouts up to 2 years of age translated into Arabic, Bengali, Chinese, French, Haitian Creole, Hmong, Korean, Polish, Portuguese, Russian, Somali, and Vietnamese.

NEW! September 2022: Bright Futures: Health Equity Resources for Health Care Professionals This compendium of resources was created for pediatric health care professionals to address the impact of racism, bias, and discrimination on the health and well-being of their patients and families.

Handouts are accessible with a subscription. For more information about a subscription, please e-mail [email protected] )

Parent Handouts

Bright Futures Parent Handout: First Week Visit (3 to 5 Days) English PDF    |    Spanish PDF

Bright Futures Parent Handout: 1 Month Visit English PDF    |    Spanish PDF

Bright Futures Parent Handout: 2 Month Visit English PDF    |    Spanish PDF

Bright Futures Parent Handout: 4 Month Visit English PDF    |    Spanish PDF

Bright Futures Parent Handout: 6 Month Visit English PDF    |    Spanish PDF

Bright Futures Parent Handout: 9 Month Visit English PDF    |    Spanish PDF

Bright Futures Parent Handout: 12 Month Visit English PDF    |    Spanish PDF

Bright Futures Parent Handout: 15 Month Visit English PDF    |    Spanish PDF

Bright Futures Parent Handout: 18 Month Visit English PDF    |    Spanish PDF

Bright Futures Parent Handout: 2 Year Visit English PDF    |    Spanish PDF

Bright Futures Parent Handout: 2½ Year Visit English PDF    |    Spanish PDF

Bright Futures Parent Handout: 3 Year Visit English PDF    |    Spanish PDF

Bright Futures Parent Handout: 4 Year Visit English PDF    |    Spanish PDF

Bright Futures Parent Handout: 5 and 6 Year Visits English PDF    |    Spanish PDF

Bright Futures Parent Handout: 7 and 8 Year Visits English PDF    |    Spanish PDF

Bright Futures Parent Handout: 9 and 10 Year Visits English PDF    |    Spanish PDF

Bright Futures Parent Handout: 11-14 Year Visits English PDF    |    Spanish PDF

Bright Futures Parent Handout: 15-17 Year Visits English PDF    |    Spanish PDF

Patient Handouts

Bright Futures Patient Handout: 7 and 8 Year Visits English PDF    |    Spanish PDF

Bright Futures Patient Handout: 9 and 10 Year Visits English PDF    |    Spanish PDF

Bright Futures Patient Handout: 11-14 Year Visits   English PDF    |    Spanish PDF

Bright Futures Patient Handout: 15-17 Year Visits English PDF    |    Spanish PDF

Bright Futures Patient Handout: 18-21 Year Visits English PDF    |    Spanish PDF

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Well Child Check Visit Notes

Table of Contents

NEWBORN WT/COLOR CHECK

-Healthy _-month old toddler

ADOLESCENT (12 yrs and older)

• Well Child Check
• Well Adult Exam
• DERMATOLOGY
• Forms & Charts
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• A good Assessment & Plan
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Your Guide to Well-Child Visits: What To Expect and How To Prepare

With all the craziness that comes with having a young child, it’s tempting to want to put off any appointments unless your child is feeling sick. However, regular visits to your child’s pediatric provider are just as important when your child is healthy. The first few years of a child’s life can set the stage for their lifelong health and development, so it’s important to stay up to date on routine well-child visits to help them grow into happy, healthy adults. Here’s what you need to know about well-child visits.

What is a well-child visit and why is it important?

Well-child visits are an important way to keep track of your child’s emotional, social, and physical health and development. These appointments provide an opportunity for both you and your healthcare provider to check in on your child’s growth and development, as well as discuss ways to keep your child healthy and safe. Well-child visits also play a significant role in prevention as well. Through regular checkups and screenings , your child’s provider can catch potentially serious issues early on before they cause any complications or severe illness.

At your child’s visit, we’ll address questions you and your child may have, provide support for your child’s overall health and well-being, talk through any pertinent health information and offer healthcare advice. Topics that are covered may include growth, development, behavior and mental health, nutrition, sleep, safety, and guidance on what to expect in the next stage of development. Your healthcare provider will conduct a physical exam, take measurements, update immunizations, and order any applicable lab tests or specialist referrals. This is also a great time to raise any concerns you may have about your child’s health and emotional well-being you may have noticed on your own. Our goal is to form a partnership based on honest communication, trust, and respect for your family’s culture and traditions.

Who should attend the visit with your child?

It is important that a parent or legal guardian comes to the visit with your child to discuss their health history and any concerns and recommendations your provider may have. As your child reaches adolescence, they will have time alone with their provider to discuss sensitive topics.

What are the types of questions I can ask during a well-child visit?

Our providers are trained to address a wide range of concerns, such as:

• How can I get my child to eat more fruits and vegetables?
• What development milestones should I be looking for?
• How much screen time should I let my child have?
• How can I keep my child safe online?
• How many hours of sleep should my child get?
• How much exercise should my child be getting daily?
• How can I support my child’s mental health?

We encourage you to ask us anything related to your child’s health and we will do our best to help you get the answers you are looking for.

What is the well-child visit schedule?

Depending on your child’s age, you may have well-child visits every few weeks, months, or yearly. We recommend bringing your child if for a visit according to the following checkup schedule:

• Newborn (3-5 days old)
• 2 weeks old
• 1 month old
• 2 months old
• 4 months old
• 6 months old
• 9 months old
• 12 months old
• 15 months old
• 18 months old
• 2 years old
• 2.5 years old
• 3 years old: Starting at age 3 years, children should have an annual well-child check through young adulthood.

How should I prepare for a well-child visit?

There are things you can do to get the most from your child’s visit. Make a list of questions for your provider ahead of time.For the first newborn visit, bring your baby’s hospital discharge summary. If your child is a new patient, bring their vaccine records. You can request that your child’s medical records be sent to us prior to the first visit. You can prepare toddlers and young children for the visit by letting them know what will happen during their well check, reading storybooks about going to the doctor, and playing with a doctor’s kit. Older children and teens can help prepare a list of questions they may want to ask about their bodies or health.

Your well-child visit isn’t the only time you can talk with your child’s healthcare team. If questions arise after your visit, please message your provider directly, reach out to our virtual medical team , or schedule a follow-up appointment with your provider. Keeping your healthcare team up to date on any updates or changes prepares everyone for your next well-child visit.

The One Medical blog is published by One Medical , a national, modern primary care practice pairing 24/7 virtual care services with inviting and convenient in-person care at over 100 locations across the U.S. One Medical is on a mission to transform health care for all through a human-centered, technology-powered approach to caring for people at every stage of life.

Any general advice posted on our blog, website, or app is for informational purposes only and is not intended to replace or substitute for any medical or other advice. 1Life Healthcare, Inc. and the One Medical entities make no representations or warranties and expressly disclaim any and all liability concerning any treatment, action by, or effect on any person following the general information offered or provided within or through the blog, website, or app. If you have specific concerns or a situation arises in which you require medical advice, you should consult with an appropriately trained and qualified medical services provider.

Health Library 2 Month Well-Child Visit

Find another condition or treatment, healthy baby development and behavior.

Below are milestones most babies will reach between now and 4 months old. Talk with your doctor at your baby’s next well-visit if your baby is not yet reaching these milestones or there are skills your baby no longer shows each day.

Social and Emotional Milestones

• Smiles on their own to get your attention
• Chuckles when you try to make them laugh
• Looks at you, moves or makes sounds to get or keep your attention

Language and Communication Milestones

• Makes cooing sounds like “oooo” or “aahh”
• Makes sounds back when you talk to them
• Turns their head toward the sound of your voice

Thinking and Learning Milestones

• If they are hungry, opens their mouth when they see breast or bottle
• Looks at their own hands with interest

Physical Development Milestones

• Holds head steady without support when you are holding them
• Holds a toy when you put it in their hand
• Uses arms to swing at toys
• Brings hands to mouth
• Pushes up onto elbows/forearms when on tummy

Healthy Ways to Help Your Baby Learn and Grow

Development.

• Smile, talk and respond positively to the sounds your baby makes
• Sing and play music for your baby. Read together every day to help your baby learn language.
• Hold and cuddle with your baby often, giving praise and lots of loving attention.
• Lay your baby on their tummy to play. Put toys at eye level to encourage lifting the head to see the toys. Do not leave your baby alone. Take breaks when your baby is tired.
• Notice the signals your baby gives when feeling playful or tired. Are they trying to play with you by making sounds and looking at you, or are they yawning, getting fussy and needing to rest? Responding to your baby’s cues will make your baby feel safe and loved.
• Use simple routines each day for feeding, sleeping, bathing and playing.
• Limit your screen time when caring for your baby. This helps you respond to your baby’s needs and encourages your baby to learn and grow.
• Never hit or shake your baby. Your baby’s brain could be damaged. Your baby could die as a result. If you need a break to calm down, put your baby in a safe place and walk away. Check on your baby every 5–10 minutes. Your baby may cry a lot in the first few months, but it will get better!
• Many infants have more periods of fussing and crying at this age. Some crying is normal, but many parents wonder if their child has colic. Talk with your baby’s doctor if you have questions or concerns. Learn more about colic, as well as tips for calming your baby.
• Feed your baby only breast milk or formula until 6 months old.
• If breastfeeding, feed your baby on demand, usually 8–12 times in 24 hours. Give your baby vitamin D drops (400 IU a day). Continue to take your prenatal vitamins with iron and eat a healthy diet.
• If formula feeding, feed your baby on demand, usually 6–8 times in 24 hours. Hold your baby so you can look at each other during feedings. Always hold your baby’s bottle. Never prop a bottle.
• Look for signs your baby is hungry, such as putting hands to mouth, smacking/licking lips or turning the head toward the breast or bottle. Watch for signs your baby is full, such as closing the mouth or turning the head away.
• Create a schedule for naps and bedtime.
• Remember the ABCs of safe sleep:
• Alone —The safest place for your baby to sleep is alone in the crib / bassinet. It’s good to have the crib / bassinet in the room where you sleep, but don’t let the baby sleep in your bed.
• Back —Always place your baby on its back to sleep to reduce the risk of Sudden Infant Death Syndrome (SIDS).
• Crib —Always put your baby to sleep in an empty crib or bassinet with a snug, firm mattress and tight-fitting sheet. Don’t have any blankets, crib bumpers, stuffed animals, toys or sleep positioners inside the crib with your baby.
• Swaddling should not be used once your baby is rolling over.
• Learn more about safe sleep for infants.

Vehicle Safety

• Use a rear-facing car seat in the backseat of your vehicle. Learn more about car seat safety and installation.
• Never leave your baby alone in a car. Practice safe behaviors that prevent you from forgetting your baby in the car, like putting your purse or cell phone in the back seat. Learn more about the dangers of hot cars and how to keep your child safe.

Home Safety

• Never leave your baby alone in the tub, near water or in high places like a changing table, bed or couch.
• Avoid drinking hot liquids while holding your baby. Prevent tap water burns by setting the temperature of your water heater to 120°F or below.

This information is to support your visit with your child’s doctor. It should not take the place of the advice of your pediatrician.

Sources: Centers for Disease Control and Prevention, Bright Futures (4th Edition) by the American Academy of Pediatrics

Last Updated 06/2023

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Well Child Visit at 11 to 14 Years

Medically reviewed by Drugs.com. Last updated on Apr 2, 2024.

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What is a well child visit?

A well child visit is when your child sees a healthcare provider to prevent health problems. Well child visits are used to track your child's growth and development. It is also a time for you to ask questions and to get information on how to keep your child safe. Write down your questions so you remember to ask them. Your child should have regular well child visits from birth to 18 years.

What development milestones may my child reach at 11 to 14 years?

Each child develops at his or her own pace. Your child might have already reached the following milestones, or he or she may reach them later:

• Breast development (girls), testicle and penis enlargement (boys), and armpit or pubic hair
• Menstruation (monthly periods) in girls
• Skin changes, such as oily skin and acne
• Not understanding that actions may have negative effects
• Focus on appearance and a need to be accepted by others his or her own age

What can I do to help my child get the right nutrition?

• Encourage your child to eat regular meals and snacks, even if he or she is busy. Your child should eat 3 meals and 2 snacks each day to help meet his or her calorie needs. He or she should also eat a variety of healthy foods to get the nutrients he or she needs, and to maintain a healthy weight. You may need to help your child plan meals and snacks. Suggest healthy food choices that your child can make when he or she eats out. Your child could order a chicken sandwich instead of a large burger or choose a side salad instead of French fries. Praise your child's good food choices whenever you can.
• Provide a variety of fruits and vegetables. Half of your child's plate should contain fruits and vegetables. He or she should eat about 5 servings of fruits and vegetables each day. Buy fresh, canned, or dried fruit instead of fruit juice as often as possible. Offer more dark green, red, and orange vegetables. Dark green vegetables include broccoli, spinach, romaine lettuce, and collard greens. Examples of orange and red vegetables are carrots, sweet potatoes, winter squash, and red peppers.
• Provide whole-grain foods. Half of the grains your child eats each day should be whole grains. Whole grains include brown rice, whole-wheat pasta, and whole-grain cereals and breads.
• Provide lean meats, poultry, fish, and other healthy protein foods. Other healthy protein foods include legumes (such as beans), soy foods (such as tofu), and peanut butter. Bake, broil, and grill meat instead of frying it to reduce the amount of fat.
• Use healthy fats to prepare your child's food. Unsaturated fat is a healthy fat. It is found in foods such as soybean, canola, olive, and sunflower oils. It is also found in soft tub margarine that is made with liquid vegetable oil. Limit unhealthy fats such as saturated fat, trans fat, and cholesterol. These are found in shortening, butter, margarine, and animal fat.
• Help your child limit his or her intake of fat, sugar, and caffeine. Foods high in fat and sugar include snack foods (potato chips, candy, and other sweets), juice, fruit drinks, and soda. If your child eats these foods too often, he or she may eat fewer healthy foods during mealtimes. He or she may also gain too much weight. Caffeine is found in soft drinks, energy drinks, tea, coffee, and some over-the-counter medicines. Your child should limit his or her intake of caffeine to 100 mg or less each day. Caffeine can cause your child to feel jittery, anxious, or dizzy. It can also cause headaches and trouble sleeping.
• Encourage your child to talk to you or a healthcare provider about safe weight loss, if needed. Adolescents may want to follow a fad diet they see their friends or famous people following. Fad diets usually do not have all the nutrients your child needs to grow and stay healthy. Diets may also lead to eating disorders such as anorexia and bulimia. Anorexia is refusal to eat. Bulimia is binge eating followed by vomiting, using laxative medicine, not eating at all, or heavy exercise.

How can I help my child care for his or her teeth?

• Remind your child to brush his or her teeth 2 times each day. Mouth care prevents infection, plaque, bleeding gums, mouth sores, and cavities. It also freshens breath and improves appetite.
• Take your child to the dentist at least 2 times each year. A dentist can check for problems with your child's teeth or gums, and provide treatments to protect his or her teeth.
• Encourage your child to wear a mouth guard during sports. This will protect your child's teeth from injury. Make sure the mouth guard fits correctly. Ask your child's healthcare provider for more information on mouth guards.

What can I do to keep my child safe?

• Remind your child to always wear a seatbelt. Make sure everyone in your car wears a seatbelt.
• Encourage your child to do safe and healthy activities. Encourage your child to play sports or join an after school program.
• Store and lock all weapons. Lock ammunition in a separate place. Do not show or tell your child where you keep the key. Make sure all guns are unloaded before you store them.

What are other ways I can care for my child?

• Talk to your child about puberty. Puberty usually starts between ages 8 to 13 in girls, but it may start earlier or later. Puberty usually ends by about age 14 in girls. Puberty usually starts between ages 10 to 14 in boys, but it may start earlier or later. Puberty usually ends by about age 15 or 16 in boys. Ask your child's healthcare provider for information about how to talk to your child about puberty, if needed.
• Limit your child's screen time. Screen time is the amount of television, computer, smart phone, and video game time your child has each day. It is important to limit screen time. This helps your child get enough sleep, physical activity, and social interaction each day. Your child's pediatrician can help you create a screen time plan. The daily limit is usually 1 hour for children 2 to 5 years. The daily limit is usually 2 hours for children 6 years or older. You can also set limits on the kinds of devices your child can use, and where he or she can use them. Keep the plan where your child and anyone who takes care of him or her can see it. Create a plan for each child in your family. You can also go to https://www.healthychildren.org/English/media/Pages/default.aspx#planview for more help creating a plan.
• Praise your child for good behavior. Do this any time he or she does well in school or makes safe and healthy choices.
• Monitor your child's progress at school. Go to parent-teacher conferences. Ask your child to let you see your child's report card.
• Help your child solve problems and make decisions. Ask your child about any problems or concerns he or she has. Make time to listen to your child's hopes and concerns. Find ways to help your child work through problems and make healthy decisions.
• Help your child find healthy ways to deal with stress. Be a good example of how to handle stress. Help your child find activities that help him or her manage stress. Examples include exercising, reading, or listening to music. Encourage your child to talk to you when he or she is feeling stressed, sad, angry, hopeless, or depressed.
• Encourage your child to create healthy relationships. Know your child's friends and their parents. Know where your child is and what he or she is doing at all times. Encourage your child to tell you if he or she thinks he or she is being bullied. Talk with your child about healthy dating relationships. Tell your child it is okay to say "no" and to respect when someone else says "no."
• Encourage your child not to use drugs, tobacco, nicotine, or alcohol. By talking with your child at this age, you can help prepare him or her to make healthy choices as a teenager. Explain that these substances are dangerous and that you care about your child's health. Nicotine and other chemicals in cigarettes, cigars, and e-cigarettes can cause lung damage. Nicotine and alcohol can also affect brain development. This can lead to trouble thinking, learning, or paying attention. Help your teen understand that vaping is not safer than smoking regular cigarettes or cigars. Talk to him or her about the importance of healthy brain and body development during the teen years. Choices during these years can help him or her become a healthy adult.
• Be prepared to talk your child about sex. Answer your child's questions directly. Ask your child's healthcare provider where you can get more information on how to talk to your child about sex.

Which vaccines and screenings may my child get during this well child visit?

What do i need to know about my child's next well child visit.

Your child's healthcare provider will tell you when to bring your child in again. The next well child visit is usually at 15 to 18 years. Your child may be given meningococcal, HPV, MMR, or varicella vaccines. This depends on the vaccines your child was given during this well child visit. He or she may also need lipid or STI screenings if any was not done during this visit. Information about safe sex practices may be given. These practices help prevent pregnancy and STIs. Contact your child's healthcare provider if you have questions or concerns about your child's health or care before the next visit.

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Learn more about Well Child Visit at 11 to 14 Years

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

PAUL S. CARBONE, MD, MEGAN FARLEY, PhD, AND TOBY DAVIS, DO

Am Fam Physician. 2010;81(4):453-460

A more recent article on autism spectrum disorder is available .

Patient information: See related handout on helping a child with autism , written by the authors of this article.

Author disclosure: Dr. Carbone has received a Family Services Community Grant from Autism Speaks. Drs. Farley and Davis have nothing to disclose.

The earliest sign of autism in children is the delayed attainment of social skill milestones, including joint attention, social orienting, and pretend play. Language impairment is a common, but less specific, sign of autism. Repetitive behaviors and restricted interests may not be noted until after social skill and communication impairments are exhibited. Physicians should perform developmental surveillance at all well-child visits, and the American Academy of Pediatrics recommends administering an autism-specific screening tool at the 18- and 24-month visits. A referral for comprehensive diagnostic evaluation is appropriate if concerns arise from surveillance, screening, or parental observations. The goals of long-term management are to maximize functional independence and community engagement, minimize maladaptive behaviors, and provide family and caregiver support. Physicians play an important role in coordinating care through an interdisciplinary team; referring families for specialized services; and treating children's associated conditions, including sleep disturbances, gastrointestinal problems, anxiety, and hyperactivity. Autism is a lifelong condition, but early recognition, diagnosis, and treatment can improve the prognosis, whereas associated medical conditions, psychiatric conditions, and intellectual disability can worsen the prognosis.

Family physicians play a critical role in the identification and long-term management of autism in children. Autism spectrum disorders (ASDs) include autistic disorder; pervasive developmental disorder, not otherwise specified (PDD-NOS); and Asperger syndrome. The current prevalence of ASDs (approximately one in 110 children) has been rising steadily, with an increase of 57 percent between 2002 and 2006. 1 It is unclear whether this represents a true increase in disease prevalence. Potential explanations for this rise in prevalence include increased societal awareness of ASDs, changing diagnostic criteria, and better access to educational services. Autism is four times more common in boys than in girls, a consistent finding that remains unexplained. 2

ASDs share three core features: delays in social interaction, impairments in language, and restricted and repetitive behaviors. Diagnostic criteria have been developed for autistic disorder ( Table 1 3 ) and Asperger syndrome. PDD-NOS is a subthreshold diagnostic term for children with similar impairments that do not meet the full criteria for autistic disorder or Asperger syndrome. Children with Asperger syndrome demonstrate relatively normal expressive language and cognitive skills. This review focuses on autistic disorder and PDD-NOS, which are collectively referred to as autism. Table 2 lists associated conditions often present in children with autism that may have a negative impact on overall function. 1 , 4 – 10

The role of genetics in ASDs is suggested by a recurrence rate of autism in siblings of affected children that is approximately 10-fold higher than in the general population, and by studies showing a high concordance of ASDs in monozygotic twins. 2 Autism susceptibility genes have been demonstrated by whole genome screens of families with multiple children with an ASD, by cytogenetic studies of affected children, and by the evaluation of candidate genes involved in brain development. 2 , 11 The role of prenatal or postnatal environmental exposures in altering the expression of autism genes remains unclear. Epidemiologic studies have not demonstrated an association between autism and the measles, mumps, and rubella vaccine 12 or exposure to thimerosal in vaccines. 13

In a small percentage of children, autism is a feature of an underlying medical condition. For example, a boy with autism, intellectual disability, macrocephaly, and large pinnae should be tested for fragile X syndrome, which is known to account for approximately 1 percent of all cases of autism. 14 Referral to a medical geneticist should be considered when a child with autism has intellectual disability, dysmorphic physical findings, or a family history of ASD or intellectual disability. 2

Surveillance and Screening

Evidence shows that early treatment is beneficial; therefore, early diagnosis of autism is critical. 15 Physicians who routinely perform developmental surveillance and use appropriate screening tools increase the chances of an early diagnosis. 16 Surveillance entails asking parents at every well-child visit about developmental or behavioral concerns, observing for early signs of autism, and documenting a family history of ASDs. Screening involves administering an autism-specific test to all children at their 18- and 24-month office visits, not just to children who demonstrate autistic behaviors. 17 The Modified Checklist for Autism in Toddlers (M-CHAT; Online Figure A ) is a screening tool validated for use in children at these ages and is designed for a parent or caregiver to complete. It may be downloaded at http://www.mchatscreen.com . The M-CHAT is a two-step screening instrument consisting of a 23-question checklist and a structured follow-up interview that is designed to identify false-positive results from the checklist. 18 The M-CHAT has been shown to identify a considerable number of children with ASDs who were missed by surveillance alone. 18 Other primary care screening tools are also available. 17 , 18 Although the American Academy of Pediatrics (AAP) recommends using an autism-specific screening test at 18 and 24 months of age, 17 it should not take the place of surveillance. Careful clinical observation may uncover subtle social deficits that parents do not report.

DELAYED SOCIAL SKILL MILESTONES

In addition to inquiring about a family history of ASDs, surveillance involves probing for early signs of autism ( Table 3 19 ). Delayed attainment of social skill milestones is the earliest and most specific sign of autism. 20 The three milestones (joint attention, social orienting, and pretend play) can be quickly evaluated during an office visit. Joint attention is a child's inherent desire to share experiences with others. For example, if the physician points at a toy across the room and exclaims, “Look!”, a typically developing 12- to 15-month-old child will shift his or her gaze first to the object and then back to the physician. By the 18-month visit, the child may spontaneously point at the toy and look back at his or her caregiver while smiling. This is known as declarative pointing, which serves the social purpose of experience sharing. In contrast, a child who points to an object to obtain it, known as imperative pointing, is not exhibiting joint attention because the pointing does not serve a social function. Likewise, a 24-month-old child who brings a toy to his or her father and smiles is engaging in joint attention, whereas a child who brings a jar of bubbles to his or her mother so that she will open it is not exhibiting joint attention. A lack of joint attention should prompt further evaluation.

Social orienting, or orienting to name, is another easily evaluated social skill milestone that, when absent, should prompt consideration of autism. 21 A typically developing 12-month-old child will turn and look in response to hearing his or her name, whereas a child with autism may rarely or only fleetingly look, even after repeated attempts. A lack of appropriate pretend play skills is another feature of autism that can be observed in the office. 22 For example, a typically developing 18-month-old child will speak jargon into a parent's cell phone, whereas a child with autism may push the buttons repeatedly but not imitate the manner in which it should be used.

LANGUAGE IMPAIRMENT

Delayed or odd use of language is a common, but less specific, early sign of autism. Infants who do not babble (e.g., single syllables, monotone voice) by six months of age or speak jargon (e.g., multiple syllables with inflection) by nine months of age may be exhibiting early signs of autism, although autism should also be strongly considered in children 18 to 24 months of age with speech delay. 17 Children with autism have a diminished intrinsic drive to communicate. Unlike children with simple expressive language delay (late talkers) or those with mixed receptive and expressive language disorders, children with autism do not use pointing, gesturing, or facial expressions to compensate for their lack of spoken language. Speech, when present, is often repeated from what was just uttered to the child or heard on television (i.e., echolalia). Children with autism may also have difficulty understanding simple commands or identifying body parts. These early language deficits lead to trouble initiating and sustaining conversations. When conversations do occur, they may be one-sided or inappropriately focused on an area of intense interest. In approximately 25 percent of children with autism, there is a history of regression in language or other developmental area between 15 and 24 months of age. 23

RESTRICTED INTERESTS AND REPETITIVE BEHAVIORS

Compared with early social and language impairments, restricted interests and repetitive behaviors are less prominent and more variable in young children. Repetitive behaviors represent a continuum and may be exhibited by typically developing children. However, stereotypic movements (e.g., hand flapping), repetitive use of objects, and difficulty with changes in routine are more common and intense in children with autism. 24 One useful tool for physicians is the ASD Video Glossary ( http://www.autismspeaks.org/video/glossary.php ), which offers a side-by-side comparison of typically developing children and those with autism.

In addition to using surveillance and routine screening, a physician practice that wishes to improve its early detection of autism must develop a comprehensive plan for administering, scoring, and interpreting screening tools. Practices must also become familiar with community referral sources. Several online resources are available to help practices implement a program of developmental surveillance and screening, including two from the AAP (http://www.medicalhomeinfo.org/Screening/ and http://www.dbpeds.org/screening/ ).

Referral and Diagnosis

Physicians should refer children for a diagnostic evaluation as soon as concerns are raised by surveillance or screening test results. Families of children with autism often feel that their early concerns were ignored, which led to excessive delays in diagnosis. 25 Prompt, simultaneous referrals to an audiologist, a multidisciplinary autism team, an early intervention program (for children younger than three years), or the special education department of the local school district (for children three years and older) will prevent unnecessary delays in the diagnostic and treatment process. 17 Parents should be given appropriate information to prepare them for ongoing evaluations ( Table 4 ) .

Ideally, an interdisciplinary assessment team ( Table 5 ) will evaluate a child using history, observation, and diagnostic tools to apply criteria from the Diagnostic and Statistical Manual of Mental Disorders , 4th ed. The diagnostic evaluation should also include a functional assessment and a review of associated conditions.

Long-term Management

Children with ASDs should have a medical home that provides accessible, continuous, comprehensive, family-centered, coordinated, compassionate, and culturally effective care. 26 Some parents of children with autism report dissatisfaction with the service provided by their child's physician, and physicians report major barriers and low self-perceived competency in providing these services. 27 In addition to listening to family members and understanding their needs, physicians should be knowledgeable about ASDs and community resources. The goals of long-term management are to increase independent functioning, improve community engagement, and provide family and caregiver support. A successful long-term management plan requires coordinating the efforts of educators, therapists, physicians, and mental health professionals. The AAP has published guidelines, created a tool-kit, and developed a Web site (http://www.medicalhomeinfo.org/health/autism.html) to help physicians better meet the needs of families of children with autism. 28 – 30

Behavioral therapy using several approaches is the primary management strategy for behavioral deficits and excesses ( Table 6 31 – 33 ) . It can be provided by an early intervention program, a school special education program, or by therapists in private practice. Intensive behavioral therapy (i.e., at least 25 hours per week) initiated at a young age is more likely to lead to improved cognitive, language, and adaptive skill outcomes. 15 , 31 , 32 Although access to comprehensive treatment programs is currently limited, advocacy by parents and physicians has started to increase public awareness and improve access. A number of states have passed laws mandating insurance coverage for autism treatment. A recent publication entitled First 100 Days Kit ( http://www.autismspeaks.org/docs/family_services_docs/100_day_kit.pdf ) can help families arrange and advocate for effective early treatment.

Medication may also be used to treat behavioral and psychiatric conditions commonly associated with autism. A number of randomized controlled studies have documented the effectiveness of psychotropic medications for various maladaptive behaviors in children with autism ( Table 7 34 – 44 ).

Management of Associated Conditions

Physicians should be aware of medical and psychiatric conditions associated with autism, especially sleep problems, gastrointestinal symptoms, and maladaptive behaviors. Treatment can improve overall child and family functioning. For example, treating constipation, which is common in children with ASDs, can enhance toilet training and overall behavior. 45 Children with ASDs often exhibit delayed sleep onset or frequent night awakenings, which can contribute to maladaptive behaviors and family distress. 6 Melatonin is safe and is often effective for children with autism and sleep difficulties. 44

Treatment of maladaptive behaviors usually requires assistance from other members of the interdisciplinary assessment team ( Table 5 ) . Psychotropic medications are sometimes prescribed to treat associated behavioral and psychiatric conditions ( Table 7 34 – 44 ). Before prescribing medications, the physician should rule out a medical cause for a new-onset maladaptive behavior. For example, a child who begins banging his head should be evaluated for evidence of a dental abscess, headaches, sinusitis, otitis media, or other potential causes of pain. Psychotropic medications may be indicated if all treatable medical conditions have been addressed, if behavioral modification is unsuccessful, and if the behavior inhibits attainment of functional goals. 28 Although physicians may choose to refer patients to a child psychiatrist or developmental pediatrician for the initial choice of medications, effective comanagement requires communication with the prescribing physician and awareness of potential adverse effects and drug interactions.

Family-Centered Care

Autism affects everyone in the child's family. Caregivers report increased stress, 46 as well as financial hardships. 47 Delivery of family-centered services can improve patient and family outcomes. 48 Physicians should respect parents and patients as partners, listening and acting on their specific concerns. Longer well-child visits may allow assessment of the health and well-being of the entire family. A referral to a family-to-family network, such as Family Voices ( http://www.familyvoices.org ), can help parents make informed decisions, advocate for their children, and build partnerships with other families.

Complementary and Alternative Approaches

Although many complementary and alternative medicine (CAM) therapies lack proven effectiveness, 49 physicians should recognize that most families of children with ASDs are likely to try at least one CAM approach. 25 Parents of children with autism who are interested in CAM are often disappointed with their physicians' lack of knowledge or negative attitudes about CAM. Physicians can foster a trusting relationship by asking, in a nonjudgmental way, about CAM and listening to the parents' perceptions regarding the benefits of a particular treatment. Once trust is established, the physician can help families distinguish validated treatment approaches from treatments that have been proven ineffective or those that are unproven and potentially harmful. 28 Several Web sites can assist physicians with staying up to date on new treatments ( Table 4 ) .

Longitudinal research suggests that up to one half of adults with autism who have average or near-average cognitive ability can achieve a generally high level of independence in work and home life. 50 Although interest in developing social relationships often increases as persons with autism age, relatively few adults marry or develop truly reciprocal relationships. 50 Many adults with a childhood diagnosis of autism remain impaired, especially those with poorer cognitive functioning. Associated psychiatric conditions—including anxiety, mood, psychotic, and attention disorders—are a challenge for many adults with autism. However, treating these associated conditions can improve overall functioning. 29 , 36 – 39 Additionally, miscommunication, peer pressure to engage in unlawful activity, obsessional behavior, reactions to bullying, and misunderstanding of social proprieties increase this population's risk of encounters with law enforcement. 51

Improvements in service quality and availability are likely to produce better outcomes for children diagnosed today. Communicative phrase speech, early acquisition of joint attention skills, early intervention, and a childhood IQ of 70 or higher are important factors associated with obtaining a high level of independence in adulthood. 15 , 52 With earlier recognition and diagnosis, more intensive treatment, and increased acceptance and social support for families, physicians caring for children with autism can now be more optimistic regarding their prognosis.

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Ex-cop accused in 2 killings, kidnapping of baby fatally shoots self at end of chase, police say

A former Washington state police officer accused of killing his ex-wife and his girlfriend , as well as kidnapping a baby, shot and killed himself at the end of a car chase with police in Oregon, authorities said Tuesday.

Oregon State Patrol troopers on the lookout for suspect Elias Huizar, 39, spotted him driving south on Interstate 5 near Eugene about 2:40 p.m., Oregon State Police Capt. Kyle Kennedy said at an evening news conference.

A pursuit ensued and at one point the suspect lost control of the vehicle he was driving and exchanged gunfire with pursuing troopers, Kennedy said. No injuries were reported, and the chase continued south, he said.

After approaching slow traffic, Huizar hit a stopped vehicle and spun into a median, the captain said. Huizar's car then became immobile and, as troopers "contacted" the vehicle, the suspect shot himself in the head, Kennedy said.

The 1-year-old boy Huizar had allegedly kidnapped was safely taken by troopers, Kennedy said. Authorities did not detail how they believed the child was kidnapped.

No injuries were reported in the second and final crash about 25 miles from the start of the chase, the captain said.

"Today was a worst-case scenario for us — having a murder suspect in the same vehicle as an innocent juvenile," Kennedy said. "That brings everything up another level for us. It’s a zero-sum game for us. We’re thankful for the way it turned out."

Huizar was charged with first-degree murder in Monday’s slaying of Amber Rodriguez, 31, at Wiley Elementary School in West Richland as classes were being let out shortly before 3:30 p.m., Benton County Prosecutor Eric Eisinger said during a Tuesday afternoon news conference.

The charge of murder includes an aggravated circumstance allegation of domestic violence, as well as a firearm enhancement, Eisinger said.

Huizar was also being investigated in the death of a woman whose body was discovered later Monday when authorities searched his home. That victim has not been identified but was described in an Amber Alert from Washington State Patrol as Huizar’s girlfriend.

According to a court document filed against Huizar on Monday, witnesses at Wiley Elementary School said a gunman wearing black clothing and a black hat shot Rodriguez. Eight .40-caliber bullet casings were recovered at the scene. Rodriguez was identified after the killing in part through her school employee ID, the documents said.

The pair’s 9-year-old son witnessed the shooting, according to the court filing. The former husband and wife have two children together, according to court documents. 

At the time of the shooting at the school, Huizar was under conditional freedom after being accused of third-degree rape of a child and second-degree rape, Eisinger said. His total bail had been set at $250,000, the prosecutor noted.

According to a separate court filing about Huizar’s alleged rapes, two teens went to police in early February after a 17-year-old girl — whom prosecutors in the filing said identified herself as Huizar's girlfriend — told officers she woke up to Huizar performing oral sex on her 16-year-old friend, who was "passed out" after all three had been drinking alcohol.

Huizar and the 17-year-old “have a child in common,” the filing said. Huizar met her when he was a resource officer at her middle school and got her pregnant when she was 15 years old, court records said.

The teen took the baby and drove off with her 16-year-old friend after February's alleged incident, before flagging down police, the court filing said.

Washington State Patrol on Monday had issued an Amber Alert for the 1-year-old. The state patrol had said Huizar and the boy shared the same last name, but the relationship between them was not immediately clear Tuesday afternoon. It was also not immediately clear whether the child was the same one Huizar had with the 17-year-old.

The alert was extended from Washington to Oregon as well as other places in the west, Eisinger said. The alert also said the women killed were Huizar’s ex-wife and his girlfriend.

Kennedy said Oregon State Police received a request to issue the alert about 10:30 p.m. Monday and put it into effect about an hour later.

The  West Richland Police Department  said earlier that Huizar was “armed and considered dangerous, and is likely to commit more crimes." Portland police told West Richland authorities that Huizar was seen in the Oregon city overnight, possibly driving a black sedan. 

The Yakima Police Department in Washington said Huizar was an officer there from 2013 to 2022.

“He did serve as a school resource officer for a period of time, at a couple schools during his employment. Mr. Huizar resigned in February of 2022, immediately following discipline,” a department spokesperson said. 

Shelley Redinger, superintendent of the Richland School District, said Huizar passed background checks and answered no to questions that included whether he had ever resigned from an employer with allegations of misconduct pending or if he’d ever been the subject of a workplace investigation accusing him of misconduct.

Redinger said Huizar’s last day as a district employee was in June 2023.

“We are extremely disheartened. That information about his past was not disclosed to us,” she said. “It is expectation for individuals who apply for employment with the Richland school district to be forthcoming and truthful in their applications.”

Antonio Planas is a breaking news reporter for NBC News Digital. 

Andrew Blankstein is an investigative reporter for NBC News. He covers the Western U.S., specializing in crime, courts and homeland security. 

Dennis Romero is a breaking news reporter for NBC News Digital.