By Vincent J. Felitti, MD, Founder, Department
of Preventive Medicine, Kaiser Permanente, San Diego
Parents understandably think of Pediatrics as a medical
specialty that deals with diseases of infants and children.
My father was a pediatrician and he had those very words
on his shingle. I am a physician and I certainly had that
limited view thirty years ago when my children were young.
There is now strong evidence that Pediatrics can also be
the medical specialty that prevents adult illnesses that
are yet to develop.
In present-day America, some of the most important work
in Pediatrics deals not with diseases but with child development.
Fifty to one hundred years ago, parents worried about polio
and tuberculosis and diphtheria. Those are distant memories
now, allowing us the luxury of expecting not only that our
children will live to grow up, but also that they will grow
up as happy and functional adults. We now know that providing
consistently nurturing attention to infants and children
is key to their normal neurological development and their
later physical health and emotional well being.
The experimental psychologist, Harry Harlow, strongly hinted
at this in the 1950’s with his famous experiments
with baby monkeys, illustrating the devastating effect of
maternal deprivation even when warmth, safety, and good
nutrition were otherwise provided. In a large medical research
study that Dr. Robert Anda and I (in conjunction with the
Centers for Disease Control in Atlanta) carried out with
18,000 middle-class adult members of the Kaiser Permanente
Medical Care Program in San Diego, we unexpectedly found
that many chronic problems in adult health and well being
had their origins in childhood events that had occurred
fifty years or more earlier. These origins had been thoroughly
concealed by time, and often by shame and secrecy; we learned
that there are childhood experiences that time does not
heal. You can learn more about the Adverse Childhood Experiences
(ACE) Study at http://www.acestudy.org
We can understand bits of this relationship between childhood
experiences and adult health when we think about children
with headaches, bedwetting, night terrors, obesity, and
behavior problems. These problems are significant not only
as they occur, but also for what they may portend for the
future if not understood early. Sometimes we try to escape
thinking about these distressing problems in our children
by readily accepting friendly advice that ‘they’ll
grow out of it’. Occasionally they do grow out of
it; but often this is merely a comforting phrase that helps
us escape thinking seriously about a disturbing problem
and its underlying cause.
Dr. Howard King shines a beacon on this path to a better
future for children. His evolving web site will help mothers
and fathers to be more understanding and effective as parents.
In parenting lies the future of the world. Think about the
implications of that!
