title: Translating Developmental Science to Address Childhood Adversity.
abstract: Demystifying child development is a defining element of pediatric care, and pediatricians have long appreciated the profound influences that families and communities have on both child development and life course trajectories. Dramatic advances in the basic sciences of development are beginning to reveal the biologic mechanisms underlying well-established associations between a spectrum of childhood adversities and less than optimal outcomes in health, education and economic productivity. Pediatricians are well positioned to translate this new knowledge into both practice and policy, but doing so will require unprecedented levels of collaboration with educators, social service providers, and policy makers. Pediatricians might recognize the negative impact of family-level adversities on child development, but developing an effective response will likely require the engagement of community partners. By developing collaborative, innovative ways to promote the safe, stable, and nurturing relationships that are biologic prerequisites for health, academic success, and economic productivity, family-centered pediatric medical homes will remain relevant in an era that increasingly values wellness and population health.
authors.affiliation: Department of Pediatrics, Case Western Reserve University and University Hospitals Medical Practices, Westlake, Ohio. Electronic address: andrew.garner@UHhospitals.org.
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Garner
authors.affiliation: Department of Pediatrics, University of Massachusetts Medical School, Worcester, Mass.
authors.forename: Heather
authors.initials: H
authors.lastname: Forkey
authors.affiliation: Department of Pediatrics, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, Calif.
authors.forename: Moira
authors.initials: M
authors.lastname: Szilagyi
mesh_terms: D000293:Adolescent; D000069586:Adult Survivors of Child Adverse Events; D002648:Child; D002649:Child Abuse; D002657:Child Development; D002675:Child, Preschool; D044127:Epigenesis, Genetic; D059647:Gene-Environment Interaction; D006291:Health Policy; D006801:Humans; D007223:Infant; D018802:Patient-Centered Care; D010372:Pediatrics; D010819:Physician's Role; D000067073:Psychological Trauma; D011640:Public Policy; D013315:Stress, Psychological; D057170:Translational Research, Biomedical
keywords: adverse childhood experiences; child development; childhood adversity; medical home; pediatrics; susceptibility to context; toxic stress; trauma