Literacy Promotion: An Essential Component of Primary Care Pediatric Practice: Technical Report.

Early literacy promotion in pediatric primary care supports parents and caregivers in reading with their children from birth, offering counseling in interactive, developmentally appropriate strategies and providing developmentally and culturally appropriate and appealing children's books. This technical report reviews the evidence that reading with young children supports language, cognitive, and social-emotional development. Promoting early literacy in pediatric primary care offers a strengths-based strategy to support families in creating positive childhood experiences, which strengthen early relational health.

Literacy Promotion: An Essential Component of Primary Care Pediatric Practice: Policy Statement.

Reading together often with infants and young children strengthens their relationships with parents and caregivers at a critical time in child development, stimulating brain circuitry and early attachment. A positive parenting practice, shared reading helps build the foundation for healthy social-emotional, cognitive, language, and literacy development, setting the stage for school readiness and providing enduring benefits across the life course. Pediatric physicians and advanced care providers have a unique opportunity to encourage parents and caregivers to establish routines and enjoy conversations around books and stories with their children beginning in infancy.

Relationship between epa level of supervision with their associated subcompetency milestone levels in pediatric fellow assessment.

Background: Entrustable Professional Activities (EPA) and competencies represent components of a competency-based education framework. EPAs are assessed based on the level of supervision (LOS) necessary to perform the activity safely and effectively. The broad competencies, broken down into narrower subcompetencies, are assessed using milestones, observable behaviors of one's abilities along a developmental spectrum.

Agreement of Program Directors With Clinical Competency Committees for Fellow Entrustment.

Objectives: Fellowship program directors (FPD) and Clinical Competency Committees (CCCs) both assess fellow performance. We examined the association of entrustment levels determined by the FPD with those of the CCC for 6 common pediatric subspecialty entrustable professional activities (EPAs), hypothesizing there would be strong correlation and minimal bias between these raters.

Methods: The FPDs and CCCs separately assigned a level of supervision to each of their fellows for 6 common pediatric subspecialty EPAs.

Integrated, Family-based, Partial Hospital Treatment for Complex Pediatric Illness.

This paper describes a unique treatment program for complex pediatric illness. The Hasbro Children's Partial Hospital Program uses a family systems orientation, integrated care, and a partial hospital setting to treat children with a wide range of pediatric illnesses that have failed outpatient and inpatient treatments. We have treated more than 2000 children with at least 80 different ICD-9 diagnoses.

Epigenetics and child abuse: Modern-day Darwinism--The miraculous ability of the human genome to adapt, and then adapt again.

It has long been recognized that early adversity can have life-long consequences, and the extent to which this is true is gaining increasing attention. A growing body of literature implicates Adverse Childhood Experiences, including physical, sexual, and emotional abuse, in a broad range of negative health consequences including adult psychopathology, cardiovascular, and immune disease. Increasing evidence from animal, clinical, and epidemiological studies highlight the critical role of epigenetic programing, such as DNA methylation and histone modification, in altering gene expression, brain structure and function, and ultimately life-course trajectories.

Literacy promotion: an essential component of primary care pediatric practice.

Reading regularly with young children stimulates optimal patterns of brain development and strengthens parent-child relationships at a critical time in child development, which, in turn, builds language, literacy, and social-emotional skills that last a lifetime. Pediatric providers have a unique opportunity to encourage parents to engage in this important and enjoyable activity with their children beginning in infancy. Research has revealed that parents listen and children learn as a result of literacy promotion by pediatricians, which provides a practical and evidence-based opportunity to support early brain development in primary care practice.

Resident education in developmental behavioral pediatrics: the impact of the 80-hour work week.

Objective: This study assessed the structure of pediatric resident developmental behavioral pediatrics (DBP) rotations in the context of the Accreditation Council for Graduate Medical Education duty hour mandates.

Methods: : We distributed an online survey addressing rotation structure, call schedule, and impact of the duty hour policy to resident DBP rotation directors in 114 of 204 pediatric residency programs in the United States and Canada and received responses from 81 programs (71% response rate).

Results: Seventy-five percent of respondents reported an average of 16% reduction in their DBP rotation after implementation of the Duty Hours rule in 2003.

Longitudinal study of maternal report of sleep problems in children with prenatal exposure to cocaine and other drugs.

Sleep data were collected by maternal report in a prospective longitudinal follow up of cocaine-exposed and unexposed children. There were 139 participants: 23 with no prenatal drug exposure, 55 exposed to cocaine alone or in combination with other drugs, and 61 exposed to drugs other than cocaine. Characteristics differed between exposure groups including birth size, caretaker changes, maternal socioeconomic status, and postnatal drug use.

School readiness.

School readiness includes the readiness of the individual child, the school's readiness for children, and the ability of the family and community to support optimal early child development. It is the responsibility of schools to be ready for all children at all levels of readiness. Children's readiness for kindergarten should become an outcome measure for community-based programs, rather than an exclusion criterion at the beginning of the formal educational experience.