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Child Health Note (CHN) files are produced with the assistance of expert professionals in Washington State who develop and edit content specific to their practice specialty. Current topics are those developed within the past 3-4 years. CHNs are in Microsoft Word® file format.  Instructions are provided for each CHN. Please read disclaimer.

Sending a CHN for the first time? Be sure to review the suggested guideline for using CHNs.

Current CHN Topics

Tools and Resources for Office Practice

Child Health Notes
Date Created
or Updated
Decision Tree: Child with Special Needs Referral Process
Option 1
Option 2
Important:Please read Instructions 12/16
Early Intervention Services Instructions Updated 8/10,  5/10
Formula for Full-Term Infants  (generic PDF version) Instructions 1/15
Growth Charts Instructions 4/13
Oral Health Fact Sheets for CSHCN Instructions 10/10
Special Education/Collaboration with Primary Health Care Providers Instructions 1/09
WithinReach and ParentHelp123 Instructions 3/12
WithinReach Resource Finder:  Help for Children with Autism Spectrum Disorders and Other Special Health Care Needs and Their Families Instructions 10/15


Screening and Anticipatory Guidance

Child Health Notes
Date Created
or Updated
Developmental Surveillance and Screening in Primary Care   (generic PDF version) Instructions Updated 4/14,  11/09
Developmental Surveillance and Screening in Primary Care: How to “Wait and See Instructions Updated 4/14,  6/13
Early Brain and Child Development Instructions 7/14
Hearing Screening in Infants and Children Instructions 6/10
Oral Health for Children – Early Childhood Caries Instructions 1/09
Oral Health Tips for Parents Instructions 1/09
Postpartum Depression — more common than you may think…and more significant for the child than you may be aware! Instructions  NEW 4/16
Red Flags in Speech and Language Development Instructions NEW 9/16
Television and Screen Time Instructions 3/11
Toilet Training for Children with Special Needs Instructions 7/12
Vision Screening for Infants, Toddlers and Preschoolers Instructions 2013


Special Health Concerns

Early Identification and Diagnosis

Child Health Notes
Date Created
or Updated
Adverse Childhood Experiences (ACEs)  (generic PDF version)

Instructions 3/15

NEW 7/16

Asthma in Childhood Instructions 10/11
What Is Autism Now? The New DSM-5 Definition   (generic PDF version) Instructions  7/15
Down Syndrome   (generic PDF version) Instructions 11/14
Fecal Incontinence (Encopresis) In Childhood   (generic PDF version) Instructions 7/13
Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Spectrum Disorders (FASD) Instructions 7/11
Fragile X Syndrome and Related Disorders (FXTAS,FX-POI) – Testing for Instructions 3/14
Health Management in Children with ASD: Co-Occurring Gastrointestinal Problems and Sleep Disorders Instructions 5/09
Newborn Screening Panel Updates    (generic PDF version) Instructions 12/13
Obesity in Children with Special Health Care Needs Instructions 5/12
Speech Disfluency and Stuttering in Early Childhood Instructions New 12/16, rev 3/17
Tube Feedings: Managing the Nutrition Issues Instructions 12/12

See also Archived CHN Topics for Child Health Notes developed more than 4 years ago.


When customizing any CHN for use in your community, we recommend that you check the resource information to assure absolute accuracy. If you plan to make changes to didactic content, please consult the CHN Project Coordinator.

This list will be updated as additional topics are developed. Recommendations for new topics are welcome. We encourage you to email us at to share your ideas for new CHN topics, suggestions for revisions to content or updates to resource information for any CHN.

For more information about Child Health Notes, please contact:

Kate Orville, MPH,
Tel: (206) 685-1279