Well Child Care in Infancy: Promoting Readiness for Life

About the Book

Well child care is designed to promote optimal health status for children, including school and life success. This preventive care includes anticipatory guidance; continuity of care; assessment of growth and development; screening procedures for vision, hearing, dental, and cognitive development; and immunizations. Anticipatory guidance provides parental health education, counseling, and reassurance. The vast majority of Medicaid-insured children receive fewer than the American Academy of Pediatrics (AAP) recommended number of well child visits in the preschool years, and a disproportionate number of children have poor health and lack school readiness. With little empirical data available indicating clinical effectiveness other than for immunizations, the AAP recommendations for well child care were originally based on consensus expert opinion, and more than three decades later, documentation of effectiveness remained unavailable. This information gap led policymakers to question the value of well child care and limited incentive to correct its underuse. Only in the last five years have experimental findings indicated an association between well child care and both more cost efficient health care and increased school readiness. Awareness of these findings by insurance company and Medicaid administrators is limited. The purpose for this book is to increase awareness by all stakeholders of the empirically determined clinical effectiveness of well child care. The short-term goal is to facilitate increased utilization of well child care, with a longer term goal of improved child health and life success.

About the Author

Dr. Pittard received his MD from the University of Virginia and is board certified in pediatrics and the sub-board of neonatal-perinatal medicine. He also has a master of public health degree in maternal and child health and a PhD in health services and policy management. He has served for more than thirty-five years in academic pediatrics at Case Western Reserve University (1976–1985) and the Medical University of South Carolina (1985–present). For more than fifteen years, he was the director of neonatology and since retirement July 1, 2013, has served as Professor Emeritus of Pediatrics at MUSC. He has four children, and his experience and interest in the public health issues of children is reflected by his publications, most recently describing the association between well child care in the preschool years and both health status and readiness for school by South Carolina Medicaid-insured children. Dr. Roberts received his MD at Texas Tech University Health Sciences Center, completed his residency at the Medical College of Georgia, and did a general pediatric fellowship along with a master of public health in maternal and child health degree at the University of Alabama at Birmingham. He is a professor of pediatrics in the Division of General Pediatrics at the Medical University of South Carolina in Charleston. He is actively involved in patient care, teaching, and clinical investigation. Dr. Roberts is the director of the South Carolina Pediatric Practice Research Network and has co-authored more than forty peer-reviewed publications. On environmental health issues, he is nationally recognized as an expert. Dr. Roberts lives in Daniel Island, South Carolina, and enjoys spending time with his wife and two sons. He is an avid basketball player and ran his first half marathon at age forty-six. Dr. Gustafson received her MD at Southern Illinois University and her master of clinical research at the Medical University of South Carolina, where she is currently an assistant professor of pediatrics. She is the associate pediatric residency program director and the medical director of Pediatric Primary Care, the pediatric continuity clinic. Along with her patient care and teaching roles, her research has involved the use of structured clinical observations with the incorporation of the preventive screening recommendations outlined by Bright Futures/AAP, as well as quality improvement projects incorporating the CHIPRA quality indicators as part of a patient-centered medical home statewide quality demonstration grant. She lives with her husband, son, and daughter on James Island, South Carolina, and enjoys spending time with her family on the waters surrounding Charleston. Oscar Lovelace is a board-certified family physician who has been practicing rural family medicine (including obstetrics) since he graduated from residency in 1988 at the University of Virginia, where he served as chief resident. He has served on the SC Board of Family Physicians. Currently he lectures to students at MUSC as a member of the clinical faculty and teaches third-year medical students as part of a required rural clinical rotation. He chaired the SC Governors Health Care Task Force in 2003. In 2011 he was named South Carolina’s Family Physician of the Year and was among six finalists for 2012 America's Family Physician of the Year selection. He is married and has four children. His avocation is casting a net for shrimp in the tidal creeks of coastal South Carolina. Dr. Darden joined the department of pediatrics at the Oklahoma University Health Sciences Center in December 2008 as professor of pediatrics, the chief of the section of general and community pediatrics, and the CMRI James Paul Linn Chair of Pediatrics. For over twenty years, he was at the Medical University of South Carolina and held numerous positions. Most recently he was the director of the South Carolina Pediatric Practice Research Network (SCPPRN), the director of the Academic Generalist Health Services Research Fellowship, and the vice chair for fellowship programs. His training was in pediatrics at Parkland Hospital and Children’s Medical Center in Dallas, followed by fellowship training in epidemiology at McGill and Montréal Children’s Hospital, Québec. He has a long-standing interest in the delivery of preventive care and in practice-based research. In Oklahoma, he has been working with Jim Mold and the Oklahoma Physicians Resource/Research Network (OKPRN). Most of his research has related to the delivery of preventive care to children; this has involved numerous studies of the delivery of vaccines and other preventive care in office practice. He has studied continuity of care, dental caries, developmental screening, and obesity among the many issues related to primary care. Currently he is working on a project examining how adolescents and their parents make decisions regarding vaccination, and how best to help them with this process.