Changing the Pediatric Paradigm: Focusing on Strengths.

Pediatricians need to adopt a strengths-based approach within their practices to better address their patients' health-related social needs. This approach becomes even more important as the pediatric population in the United States becomes increasingly diverse. Pediatricians must be cognizant of and address biases within their practices to maximize effectiveness of a strengths-based approach. With evidence mounting about their significance to health, a paradigm shift is needed to address health-related social needs by focusing on assets, not deficits. This shift will hopefully improve pediatric health outcomes which have languished in the United States, despite outspending other wealthy nations for decades.

Carolyn Rovee-Collier's legacy to applied psychology, intervention, and public policy.

In this article, we reflect upon Carolyn Rovee-Collier's pioneering research on learning and memory in infants, especially that using the mobile conjugate reinforcement task, for our understanding of (a) cognitive development in infants born prematurely and those with Down's syndrome and (b) her prediction that infants' performance in the mobile conjugate reinforcement and similar operant tasks would predict later intellectual functioning. We then examine the implications of her research on time windows (the integration of new information into a memory) and memory reactivation (the retrieval of a forgotten memory as a result of the re-exposure to a component of the original learning experience) for early intervention programs and clinicians treating victims of early trauma. We conclude with a discussion of the value of Rovee-Collier's work for the growing field of infant/toddler science and how this science has informed public policy and program development.

The effectiveness of early head start for 3-year-old children and their parents: lessons for policy and programs.

Early Head Start, a federal program begun in 1995 for low-income pregnant women and families with infants and toddlers, was evaluated through a randomized trial of 3,001 families in 17 programs. Interviews with primary caregivers, child assessments, and observations of parent-child interactions were completed when children were 3 years old. Caregivers were diverse in race-ethnicity, language, and other characteristics. Regression-adjusted impact analyses showed that 3-year-old program children performed better than did control children in cognitive and language development, displayed higher emotional engagement of the parent and sustained attention with play objects, and were lower in aggressive behavior. Compared with controls, Early Head Start parents were more emotionally supportive, provided more language and learning stimulation, read to their children more, and spanked less. The strongest and most numerous impacts were for programs that offered a mix of home-visiting and center-based services and that fully implemented the performance standards early.

Child care quality matters: how conclusions may vary with context.

Three studies examined associations between early child care and child outcomes among families different from those in the National Institute of Child Health and Human Development (NICHD) Early Child Care Research Network study. Results suggest that quality is an important influence on children's development and may be an important moderator of the amount of time in care. Thus, the generalizability of the NICHD findings may hinge on the context in which those results were obtained. These studies, conducted in three national contexts, with different regulatory climates, ranges of child care quality, and a diversity of family characteristics, suggest a need for more complete estimates of how both quality and quantity of child care may influence a range of young children's developmental outcomes.