141 Northwest Point Blvd
Elk Grove Village, IL 60007-1019
Phone: 847/434-4000
Fax: 847/434-8000
E-mail: kidsdocs@aap.org
www.aap.org
Executive Committee
President
O. Marion Burton, MD, FAAP
President-Elect
Robert W. Block, MD, FAAP
Immediate Past President
Judith S. Palfrey, MD, FAAP
Executive Director/CEO
Errol R. Alden, MD, FAAP
Board of Directors
District I
Carole E. Allen, MD, FAAP
Arlington, MA
District II
Henry A. Schaeffer, MD, FAAP
Brooklyn, NY
District III
Sandra Gibson Hassink, MD, FAAP
Wilmington, DE
District IV
Francis E. Rushton, Jr, MD, FAAP
Beaufort, SC
District V
Marilyn J. Bull, MD, FAAP
Indianapolis, IN
District VI
Michael V. Severson, MD, FAAP
Shakopee, MN
District VII
Kenneth E. Matthews, MD, FAAP
College Station, TX
District VIII
Mary P. Brown, MD, FAAP
Bend, OR
District IX
Myles B. Abbott, MD, FAAP
Berkeley, CA
District X
John S. Curran, MD, FAAP
Tampa, FL
Overview of AAP Early Brain and Child Development (EBCD)
Strategic Priority
Recent advances in neuroscience, epigenetics, and life course sciences (like
epidemiologic and interventional studies) are forcing a paradigm shift in our
understanding of human health and disease across the lifespan. The complex and
dynamic dance between early childhood experiences (the ecology) and genetic
predispositions (the biology) has profound effects on learning, behavior, and
health decades later, suggesting that many adult and societal maladies are, at least
in part, developmental disorders. This emerging “basic science of pediatrics” is
revealing mechanisms at the molecular and cellular levels that may underlie the
well-established associations between childhood adversity and sub-optimal life
course trajectories. These scientific advances have important implications for not
only healthcare, but for education, economics and social services. As esteemed
professionals in child development, pediatricians are called to understand these
advances, to interpret or explain both their significance and limitations, and to
advocate for changes in both policy and practice that reflect this growing science
base. As for many fields of medicine, there is a growing gap between “the bench”
and “the bedside;” between what pediatricians know about early brain and
childhood development (EBCD) and what they actually do to support it.
Because optimizing early brain and child development is so important, the
American Academy of Pediatrics (AAP) has made this area of focus one it its key
strategic priorities. This means that the AAP is committed to investing time,
energy and resources into ensuring that the importance of building healthy brains
during early childhood is understood by its membership of over 60,000
pediatricians. Ultimately the goal is to transform the way pediatrics is practiced to
ensure that families and communities have the understanding and support needed
to help their children thrive. This will be accomplished by taking sound scientific
principles of EBCD elucidated from basic research and translating them into a
workable framework that is directly applicable in both individual patient situations
as well as population health and supporting all of the above through clear,
powerful policy measures.
As community leaders and respected authorities in child health and development,
pediatric providers must go beyond merely identifying and addressing
developmental concerns to promoting healthy development. This requires that
pediatricians take a more active role in guiding their patients’ life course
outcomes. This paradigm shift would result in pediatricians becoming more
invested in promoting positive parenting and linking families with needed
community supports. In addition, pediatricians would advocate for the needed
community investments and direct more public attention to those early childhood
interventions that build a strong foundation for lifelong health as well as prepare
the child, family and community for school readiness.
Pediatricians must be educated on the important role they have in positively influencing their
patients’ life course trajectories. By identifying EBCD as one of its strategic priorities, the AAP
will focus on educating pediatricians on childhood adversity and toxic stress, and providing them
with an understanding of their role as leaders in the community to intentionally engage in a
paradigm shift from monitoring health to promoting healthy outcomes for children. Pediatricians
can accomplish this by engaging families and the community support systems to optimize child
health. Given the extent to which costly health conditions are often rooted in early childhood, the
reduction of toxic stress in young children is a high priority for medicine as a whole and for
pediatrics in particular. The AAP acknowledges this by making EBCD a strategic priority.