TABLE 1

Health Supervision Guidelines for Children With Neurofibromatosis

	Prenatal	Infancy (1 mo to 1 y)					Early Childhood (1 to 5 y)						Late Childhood (5 to 13 y), Annual^a	Adolescence (13 to 21 y), Annual^a
	Prenatal	Neonatal	2 mo	4 mo	6 mo	9 mo	12 mo	15 mo	18 mo	24 mo	3 y^a	4 y^a	Late Childhood (5 to 13 y), Annual^a	Adolescence (13 to 21 y), Annual^a
Diagnosis
DNA analysis	X^b
Phenotype review	X^c	X
Genetic counseling	X^c	X												X^d
Reproductive options for parents
Adoption/termination	X
Future reproductive planning		X					X			X			X^d
Anticipatory guidance
Family support	X	X	X	X	X	X	X	X	X	X	X	X	X	X
Support groups	X	X	X				X						X^d	X^d
Long-term planning	X	X					X						X^d	X^d
Sexual and reproductive issues													X^d	X
Medical evaluation and treatment^e
Growth		O	O	O	O	O	O	O	O	O	O	O	O	O
Blood pressure		O	O	O	O	O	O	O	O	O	O	O	O	O
Skin examination		O	O	O	O	O	O	O	O	O	O	O	O	O
Bone examination/scoliosis		O	O	O	O	O	O	O	O	O	O	O	O	O
Neurologic examination		O	O	O	O	O	O	O	O	O	O	O	O	O
Vision screening		S/O	S/O	S/O	S/O	S/O	S/O^f	S	S	S/O^f	S/O^f	S/O^f	S/O^f	S/O^f
Hearing screening		S	S	S	S	S	S/O^f	S	S	S	S	S/O^f	S/O	S/O
Sexual maturation													O	O
Diagnostic imaging examinations^e
Psychosocial evaluation
Development and behavior		S/O	S/O	S/O	S/O	S/O	S/O	S/O	S/O	S/O	S/O	S/O^f	S/O	S/O
Preschool program											S	S
School placement/performance													S/O	S/O
Psychological/social adjustment							S	S	S	S	S	S	S	S
Intrafamily relationships		S			S		S	S	S	S	S	S	S	S

X indicates to be performed; S, subjective, by history; O, objective, by a standard testing method.
↵a Advise semiannual visits, as indicated.
↵b See “Discussion.”
↵c Or at the time of diagnosis.
↵d Once in this time period.
↵e As needed for significant abnormalities and/or new signs.
↵f Refer to subspecialist.