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Literature Review: Child Development and Preventive Care

This literature review provides citations, short summaries, and Web links for articles published in professional journals that were supported by grants under the Child Development and Preventive Care Program. The articles are listed in reverse chronological order.

Exploring the Business Case for Improving the Quality of Health for Children. C Homer, D Iles, D Dougherty, et al., Health Affairs, 23 (4): 159–166, July/August 2004.
This analysis delineates aspects of children's health care—such as the need for care, patterns of use, and how care is organized and financed—that differ from adult care. It then identifies barriers and solutions that are specific to children's health care, to ensure that children's unique needs are not lost in the debate over the business case for quality.

Rethinking Well-Child Care. Edward L. Schor, M.D., Pediatrics, 114 (1): 210–216, July 2004.
This commentary argues that the nation's system of preventive pediatric care requires major revisions if chronic health problems and unmet behavioral and developmental needs among American children are to be addressed. Pointing to the prevalence of obesity, attention-deficit disorder/hyperactivity, behavior disorders, depression, adolescent risk behaviors, and the stresses faced by parents, Schor warns, "The term 'well-child care' is applicable to fewer children." As acute pediatric medical care becomes, more and more, the work of hospitals, emergency physicians, and pediatric sub-specialists, well-child care calls for new approaches—to pediatric office practice, to the scheduling of office visits, and to health care partnering.

A Practice-Based Intervention to Enhance Quality of Care in the First 3 Years of Life. C. S. Minkovitz, et al., Journal of the American Medical Association 290 (23), December 2003.
The nation's first, large clinical trial designed to improve delivery of developmental and behavioral services to young children has improved quality of care, enhanced communications between pediatricians and parents, and helped children receive appropriate preventive services, according to a national evaluation of the Healthy Steps for Young Children Program. The study finds that physician practices with childhood developmental specialists on staff showed "significant improvements" in parental satisfaction with the services they received; timelier preventive care such as immunizations; and receipt of more developmental services.

Primary Care Pediatricians' Roles and Perceived Responsibilities in the Identification and Management of Maternal Depression, Ardis L. Olson, Kathi J. Kemper et al., Pediatrics 110 (6), December 2002.
Postpartum and maternal depression can have serious consequences for mothers and their children. This study finds that a majority of pediatricians in the United States lack confidence in their ability to detect the illness—and barely more than half even consider it their responsibility to do so. The study was based on a national survey of 508 primary care pediatricians, who were asked about their roles in recognizing and treating depression, methods for identifying and managing the condition, and confidence in diagnosing it.

Child Rearing in America: Challenges Facing Parents with Young Children. Neal Halfon, et al., Cambridge University Press, January 2002.
This research book uses data from the Commonwealth Fund Survey of Parents with Young Children to present new information about the lives of families with very young children—how parents spend their time with their children, the economic and social challenges they face, and the supports they receive to improve their children's health and development. They synthesize the major themes emerging from the data and consider the family, community, and policy implications to frame and interpret the results.

Primary Care Services Promoting Optimal Child Development from Birth to Age 3 Years. Michael Regalado and Neal Halfon, Archives of Pediatrics and Adolescent Medicine, 155 (12), December 2001.
This study examines the evidence base for primary health care services promoting the optimal development of typically developing children aged birth to three years, using a review of 312 publications. It found that assessments of parental concerns and psychosocial risk factors seem to be more accurate in identifying developmental problems than clinicians' appraisals.

Estimating the Cost of Developmental and Behavioral Screening of Preschool Children in General Pediatric Practice, Deborah Dobrez et al., Pediatrics 108 (4), October 2001.
This study finds that, despite increased recognition of the importance of development and growth of young children, formal developmental and behavioral screening often is not included in general pediatric practice. This article develops a model for estimating the cost of providing pediatric developmental and behavioral screening that can be scaled to reflect a pediatric practice's patient population and choice of screening offered.

Growth, Development, and Behavior in Early Childhood Following Prenatal Cocaine Exposure: A Systematic Review. Deborah A. Frank et al., Journal of the American Medical Association, ( 285): 12, March 2001.
This study reviews outcomes in early childhood after prenatal cocaine exposure in five areas: physical growth; cognition; language skills; motor skills; and behavior, attention, affect, and neurophysiology. After controlling for confounders, it found no consistent negative association between prenatal cocaine exposure and physical growth, developmental test scores, or receptive or expressive language.

New Roles for Developmental Specialists in Pediatric Primary Care. Margot Kaplan-Sanoff, Claire Lerner, and Andrea Bernard, Zero To Three, 21 ( 2), October 2000.
This article discusses the roles of developmental specialists in helping to conduct office visits jointly with the pediatric clinician, conduct home visits to support and enhance parent-child interactions and to promote home safety; help parents manage common behavioral concerns related to early learning, fussiness, sleep, feeding, toilet training, temper tantrums, etc.; check on children's developmental progress and family health and behavior; facilitate parent groups; staff the child development telephone information line; and provid referrals and follow-up, as appropriate, to help families make connections within the community.

Child Development Services in Medicaid Managed Care Organizations: What Does It Take? Carolyn Berry et al., Pediatrics, 106 (7), July 2000.
This study investigates why certain Medicaid managed care organizations implemented child development services or programs and how they had done so. It identifies barriers and facilitators to successful initiation and implementation of child development programs. It found that high-level support was crucial for program initiation; physician buy-in, staff support, and strong working relationships with outside health professionals or agencies were principal factors in successful program implementation.

Assessing the Impact of Pediatric-Based Developmental Services on Infants, Families, and Clinicians: Challenges to Evaluating the Healthy Steps Program. Bernard Guyer et al., Pediatrics, 105 (3), March 2000.
This is the first article in a series on a national evaluation of Healthy Steps, which started in 1996 as a new model of pediatric practice incorporating child development specialists and enhanced developmental services for families of young children. It describes the evaluation design and characteristics of the Healthy Steps sites and sample for the evaluation.

Listening to Parents: A National Survey of Parents with Young Children. Kathryn Taaffe Young, PhD; Karen Davis, PhD; Cathy Schoen, MS; Steven Parker, MD, Archives of Pediatric & Adolescent Medicine,152 (3), March 1998.
This study reports on results of a survey of 2017 parents with children younger than three years. It finds that 76 percent of children younger than 3 years were reported to be in excellent health, and 88 percent had a regular source of pediatric health care. Seventy-one percent of parents who received special pediatric services rated their child's physician as excellent in providing good health care. Seventy-nine percent of parents reported they could use more information in at least one of six areas of child rearing, and 53 percent wanted information in at least three areas. It concludes that most parents view the pediatric health care system as meeting the physical health needs of their young children. Parents want more information and support on child-rearing concerns, yet pediatric clinicians often fail to discuss nonmedical questions with them.

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