RESUMEN
Pediatricians are uniquely positioned to partner with parents as they rear and nurture their young children. This article addresses the barriers that influence the pediatrician's ability to engage in developmental guidance during regular well-child visits. Challenges related to the current structure of pediatric training programs are discussed, as well as the economics of extending time with families, and the real limitations associated with insurance reimbursement policies that make it difficult for pediatricians to focus on developmental preventive care related to social and emotional development. Recent changes in the public policy arena provide an opportunity to overcome barriers. Specific provisions are described within the Patient Protection and Affordable Care Act that have the potential to enhance opportunities to address social and emotional development through the provision of developmental guidance to parents with very young children.