Dr. Andrew Garner MD PhD FAAP - Thinking Developmentally: Nurturing Wellness in Childhood to Promote Lifelong Health

Thinking
Developmentally

Nurturing Wellness in Childhood
to Promote Lifelong Health

Andrew S. Garner, MD, PhD, FAAP

Robert A. Saul, MD, FAAP, FACMG

American Academy of Pediatrics Publishing Staff

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2018 American Academy of Pediatrics

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any meanselectronic, mechanical, photocopying, recording, or otherwisewithout prior written permission from the publisher (locate title at ).

Printed in the United States of America

9-407/0518 1 2 3 4 5 6 7 8 9 10

MA0861

ISBN: 978-1-61002-152-4

eBook: 978-1-61002-153-1

EPUB: 978-1-61002-241-5

Mobi: 978-1-61002-242-2

Cover design by Linda Diamond

Book design by Peg Mulcahy

Library of Congress Control Number: 2017944378

Authors

Andrew S. Garner, MD, PhD, FAAP

Clinical Professor of Pediatrics

Case Western Reserve University School of Medicine

Primary Care Pediatrician

University Hospitals Medical Practices

Cleveland, OH

Robert A. Saul, MD, FAAP, FACMG

Professor of Pediatrics

University of South Carolina School of Medicine Greenville

Medical Director, General Pediatrics Division

Childrens Hospital

Greenville Health System

Greenville, SC

American Academy of Pediatrics Reviewers

Council on Genetics

Department of Federal Affairs

Section on Developmental and Behavioral Pediatrics

To all of our families:
the ones for whom we care so deeply,
and the ones who have so ably cared for us

Contents

Preface and Acknowledgments

If I have seen further, it is by standing on ye shoulders of giants.

Sir Isaac Newton

T his is not your typical book. Originally envisioned as cross between From Neurons to Neighborhoods it is both an approachable summary of developmental science and an unapologetic argument for change. Bringing such a hybrid to fruition has been a team sport and a true collaborative effort. Ultimately, it began with the innumerable scientists and investigators over the ages who have applied their skills to better understand the origins of disease and wellness, the mechanisms of human development, and the best ways to translate the latest science into practice and policy. They are the giants who have allowed us to see and expound on the inextricable links between epigenetics, neuroscience, life course theory, the practice of pediatrics, and many of our societys most intractable problems.

But envisioning a book is one thing; actually producing it is quite another. For taking a chance on a hybrid book that was decidedly outside its traditional purview, we are indebted to the American Academy of Pediatrics (AAP). In particular, we are grateful to our developmental editor, Chris Wiberg; the AAP Publishing leadership, including Jeff Mahony and Mark Grimes; Chief Product and Services Officer/SVP, Membership, Marketing, and Publishing Mary Lou White; and the terrific marketing and sales staff, including Kathy Juhl, Sara Hoerdeman, Linda Smessaert, and Elyce Goldstein, led by Marirose Russo and Mark Voigt. We are also thankful for the many reviewers, including Nate Blum, John Duby, Jim Duffee, and Jordan Hutchinson, whose careful attention to detail and clarity has made this book the best it can be.

Finally, as pediatricians, we owe our greatest debt to all of our families. To be sure, our personal families have provided enduring support, encouragement, and patience with us as we have disappeared for days at a time to review the latest research, to reflect on what it might mean, and to obsessively write one draft after another to make a clear and compelling case that the advances in developmental science are transformational. But the families we see in our clinics are the ones that keep us awake each night and inspire us every day. We lose sleep because we know that, despite their parents best efforts, too many children are not having their most basic biological needs met, and we understand how that sets a questionable foundation for future learning, behavior, and health. Still, we are inspired by these families unwavering commitment to their children, all too often in the face of tremendous adversity. Their undying resolve to do whatever is best for their children gives us hope that communities can be more caring, families can be more nurturing, and pediatricians can do much more to promote the foundations of lifelong health. But to turn this hope into reality, to expand parents unquestioned love for their children into a broader appreciation for the power of relational health, and to reframe pediatric care from child-centered to family-centered or even community-centered, there must first be a greater awareness of the recent advances in developmental science. We are most grateful to the entire team for the chance to do just that.

References

. Published February 5, 1675. Accessed December 28, 2017

. National Research Council, Institute of Medicine. From Neurons to Neighborhoods: The Science of Early Child Development. Committee on Integrating the Science of Early Childhood Development. Shonkoff JP, Phillips DA, eds. Washington, DC: National Academy Press; 2000