A training program for pediatric residents in childdevelopment and guidance

Abstract

Summary Pediatric training and practice arebecoming more and more concerned with the interrelated aspects of the growth, development, and social adjustment of the child. Considerable emphasis is being placed upon the relationship between physical and emotional development, both in illness and in health. An understanding of such processes can provide the basis for optimal pediatric care aimed at helping parents guide their children toward positive mental health and an avoidance of serious emotional disturbance. The teaching program of the Children's Hospital of the East Bay which is directed toward providing the pediatrician with such an understanding emphasizes: 1. The recognition of normal patternsof growth and development and individual differences as they are part of normal development and as they may be symptomatic of pathology. 2. An understanding of the dynamicsof growth and development and the interpersonal relations of the child. 3. The value of a history which is patient as well as disease centered. 4. The recognition of particular anxiety-provoking experiences within the family. 5. The role of the pediatrician in providing support and guidance for the child and his parents. 6. The use of community resourcesfor referral of the more severely disturbed families and the evaluation of the readiness of a family for psychiatric referral. Such a learning experience for the pediatrician is of necessity a personalized one as it involves teacher and student. It is essential that teaching begin with the well child in a descriptive manner and evolve with the child in his growth and developmental maturation. A nursery school is one effective method of providing direct experiences for the pediatrician to meet the child at the child's level of play and behavioral patterns. Learning about the total care of the child should be integrated with the existing knowledge of disease and the general work of a children's hospital lest the purely psychological aspects of the child's growth and development be overemphasized and the role of the pediatrician lost in the more specialized work of the psychiatrist. While it is too early to evaluate thepractical results of such a teaching program, an immediate result has been a better understanding of the child as an individual throughout the hospital services.