Published online September 1, 2004
PEDIATRICS Vol. 114 No. 3 September 2004, pp. 827-831 (doi:10.1542/10.1542/peds.2004-0416)

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SPECIAL ARTICLE

2003 C. Anderson Aldrich Award Lecture: Enhancing Developmental Services in Child Health Supervision—An Idea Whose Time Has Truly Arrived

Paul H. Dworkin, MD

From the Department of Pediatrics, University of Connecticut School of Medicine and Connecticut Children's Medical Center, Hartford, Connecticut

The first 300 words of the full text of this article appear below.

	PREFACE

 
In 1938, in his famous Babies Are Human Beings, C. Anderson Aldrich was cautious in describing the feasibility of enhancing children's developmental potential:

"Every human being, as he grows into childhood, must inevitably be hampered and opposed by the restrictions of his environment, and the best we can hope for is to modify somewhat the urgency of this conflict. The degree to which we are considerate of our baby's early needs, however, may be the measure of his later ability to feel secure in a world of change and to adapt himself to the necessities of circumstance."^{1(p xi)}

Aldrich's contributions occurred at a crucial transitional period for child health. In the early 20th century, child health services were almost exclusively focused on the treatment of the sick child, with the modest exception of cursory examinations to detect signs of contagion, milk stations for feeding and weighing, and urban child health conferences for examining and later immunizing children. Subsequent control of infection through improved sanitation, public health measures, the introduction of antibiotic agents, and effective immunization profoundly influenced the scope of child health care, with the founding of the American Academy of Pediatrics in 1930 heralding a shift of emphasis to include health promotion and disease prevention.² In 1944, Aldrich helped to pioneer this shift through the founding of the Rochester (Minnesota) Child Health Institute, devoted to research on the development of normal infants and children and to a program of delivering child health care to an entire community.

Contemporary efforts to enhance the effectiveness of developmental services similarly occur within the context of a profound transition in children's health services. In the mid-1970s, the recognition of developmental, behavioral, and psychosocial problems as the "new morbidity" of pediatric practice by Haggerty et al³ reinforced an emphasis on prevention and promotion and . . . [Full Text of this Article]

Reprint requests to (P.H.D.) Connecticut Children's Medical Center, 282 Washington St, Hartford, CT 06106. E-mail: pdworki@ccmckids.org

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