Pediatrics

Definition and Introduction

Photo courtesy of WIndsor University School of Medicine Opens in new window Pediatrics is a specialty derived from the idea that children are not simply little adults but have their own special developmental and health needs.

Biologically, a child is a human between birth and puberty. The legal definition of child refers to a minor, otherwise known as a person younger than the age of majority.

Pediatrics is a relatively young medical specialty, developing only in the mid-nineteenth century, when society began to relate to the child not as a miniature adult but as a person of a lower level of maturity needing adult protection, love, and nurturing. Abraham Jacobi (1830 – 1919) is regarded as the father of pediatrics.

The body size differences are paralleled by maturational changes. The smaller body of a neonate, infant, or child is substantially different physiologically from that of an adult.

Another major difference between pediatrics and adult medicine is that children are minors and, in most jurisdictions, cannot make decisions for themselves. The issues of guardianship, privacy, legal responsibility, and informed consent must always be considered in every pediatric procedure.

In addition, the issues of pediatric nutrition and pediatric dosage in pharmacotherapy are to be taken into consideration. Pediatric nutrition refers to the maintenance of a proper well-balanced diet consisting of the essential nutrients and the adequate caloric intake necessary to promote growth and sustain the physiologic requirements at the various stages of a child’s development.

Pediatric dosage relates to the determination of the correct amount, frequency, and total number of doses of a medication to be administered to an infant or child. Various formulas have been devised to calculate pediatric dosage from a standard adult dose, although the most reliable method is to use one of the formulas to calculate the proportional amount of body surface area to body weight.

Success in school is critical for healthy child development. School promotes the learning of concepts and skills, the development of strategies for interacting with others, and fosters the growth of independence and a sense of self-efficacy. This brings us to the notion pediatric school psychology.

What is Pediatric School Psychology?

The essence of pediatric school psychology is to promote linkages among systems of care and interdisciplinary connections to enable children to be successful in school.

The domain of child-serving psychologists is quite diverse and includes professionals who place emphasis on varying aspects of child development. For example, clinical child and adolescent psychologists focus on mental health issues and they work to assess and treat problems, as well as to minimize and prevent risk.

Clinical psychologists have an interest in resolving mental health problems or reducing risk so that children and youth can adjust well in the community, including school. Pediatric psychologists have a similar focus on assessment, intervention, and prevention but the targets of their efforts are health conditions, including acute and chronic illnesses.

Community psychologists address the needs of children with a particular interest in how community-based agencies support the development of youth. They typically emphasize the importance of designing community organizations so that they are aligned with the cultural values and norms of the children and families served.

School psychologists directly address the development of children in school. They have a principal focus on advancing the primary mission of schools to promote the cognitive and social development of students.

Child-serving psychologists often focus on a narrow range of systems in response to prevailing models of training or practice constraints, such as institutional priorities or billing policies.

The term pediatric school psychology was coined to refer to the subset of child-serving psychologists who have a major focus on promoting child development within a wide range of systems (e.g., family, school, health system, mental health system, and other community systems), with a particular focus on the school, and facilitating the alignment of systems to promote school success (e.g., school-health system connection, school-mental health system connection, family-school connection).

The distinguishing feature of pediatric school psychologists is not the graduate program within which they receive their training (e.g., clinical vs. health vs. school), but the developmental/systems approach they use in understanding children and intervening to promote healthy and successful development especially in schools (Power, Shapiro, & DuPaul, 2003).

Pediatric school psychologists understand that promoting student success in school depends upon a wide range of variables, including school factors (e.g., content and method of instruction, teacher-student relationships, peer relationships), family factors (e.g., quality of the parent-child relationship, parental regulation of child behavior, family involvement in education), health system factors (e.g., access to health system, trust in health provider, quality of care), and the connections among these systems.

The focus is on promoting the development of the whole child, supporting the multiple systems in which children function, and facilitating relationships between the school and family, and other systems in the child’s life.

At its core, pediatric school psychology promotes interdisciplinary collaboration. In promoting connections among systems, professionals from multiple disciplines naturally intersect with one another. Strong intersystemic relationships require that professionals from various disciplines value oen another’s contributions and work to establish and maintain mutual partnerships.