By Vincent J. Felitti, MD, Founder, Department of Preventive Medicine, Kaiser Permanente, San Diego
Parents understandably think of Pediatrics as a medical specialty that deals with diseases of infants and children. My father was a pediatrician and he had those very words on his shingle. I am a physician and I certainly had that limited view thirty years ago when my children were young. There is now strong evidence that Pediatrics can also be the medical specialty that prevents adult illnesses that are yet to develop.
In present-day America, some of the most important work in Pediatrics deals not with diseases but with child development. Fifty to one hundred years ago, parents worried about polio and tuberculosis and diphtheria. Those are distant memories now, allowing us the luxury of expecting not only that our children will live to grow up, but also that they will grow up as happy and functional adults. We now know that providing consistently nurturing attention to infants and children is key to their normal neurological development and their later physical health and emotional well being.
The experimental psychologist, Harry Harlow, strongly hinted at this in the 1950’s with his famous experiments with baby monkeys, illustrating the devastating effect of maternal deprivation even when warmth, safety, and good nutrition were otherwise provided. In a large medical research study that Dr. Robert Anda and I (in conjunction with the Centers for Disease Control in Atlanta) carried out with 18,000 middle-class adult members of the Kaiser Permanente Medical Care Program in San Diego, we unexpectedly found that many chronic problems in adult health and well being had their origins in childhood events that had occurred fifty years or more earlier. These origins had been thoroughly concealed by time, and often by shame and secrecy; we learned that there are childhood experiences that time does not heal. You can learn more about the Adverse Childhood Experiences (ACE) Study at http://www.acestudy.org
We can understand bits of this relationship between childhood experiences and adult health when we think about children with headaches, bedwetting, night terrors, obesity, and behavior problems. These problems are significant not only as they occur, but also for what they may portend for the future if their implications are not understood early. Sometimes we try to escape thinking about these distressing problems in our children by readily accepting friendly advice that ‘they’ll grow out of it’. Occasionally they do grow out of it; but often this is merely a comforting phrase that helps us escape thinking seriously about a disturbing problem and its underlying cause.
Dr. Howard King shines a beacon on this path to a better future for children. His evolving web site will help mothers and fathers to be more understanding and effective as parents. In parenting lies the future of the world. Think about the implications of that!
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I would like to thank the following for their generous support, without whom this web site and training program would not exist: The Sidney R. Baer, Jr. Foundation, The Alden Trust, the Commonwealth of Massachusetts Department of Mental Health, Project INTERFACE (Newton Public Schools and the U.S. Department of Education), the Locke Educational Fund at Newton- Wellesley Hospital, Aetna Health Plan, the Kenneth B. Schwartz Center, and the families of my medical practice.
I hope you find this site useful and encourage any comments.
- Dr. Howard King, M.D.