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In the Footsteps of Giants

  ·   By Robert Sege, MD, PhD, FAAP

Each of us is the product of our own experiences, and those who molded our personal and professional lives. This Memorial Day weekend, I found myself in the midst of encounters with my own role models in pediatrics. On Sunday, I saw T. Berry Brazelton, the kind and brilliant pediatrician whose books captured the imagination of parents in the late 20th century. Although he is now 99 years old, Berry walked in with a huge smile on his face, and promptly engaged in conversation with an eleven-year-old girl who wants to become a pediatrician.

Later this week, I will head up to Vermont for a celebration of the life of Paula Duncan, the guiding force (and I do mean force) behind the movement in pediatrics to move beyond screening for risk to assessing the positive in children and families, and partnering with parents to grow these assets.

These two leading lights amplify the themes that children need more than protection from adversity, they also need safe places to live, learn and play and to experience connection and support from the adults and peers who shape their worlds.

With the support of Casey Family Programs, I led a group of early childhood experts to produce a new report, Balancing Adverse Childhood Experiences with HOPE (Health Outcomes of Positive Experiences). This report pulls together results from four separate population surveys. We learned that adults who recalled warm, nurturing relationships with their families and communities became healthier adults, even if they had multiple adversities in childhood.

While policymakers struggle to improve screening for risk and adversity, US parents and other adults already get it: children’s brains grow and develop in response to all their experiences, both adverse and positive. According to a 2016 population survey conducted by yougov.com and reported for the first time in the HOPE report, there is wide consensus among American adults of all ethnicities about the importance of positive parenting practices, and the political will to move forward in supporting families.

HOPE complements other new approaches to supporting child development and preventing abuse and neglect. Looked at through the lens of the social-ecological model, they all fit: The CDC advocates policies that support families through its Essentials for Childhood initiative. CSSP’s Strengthening Families approach emphasizes the centrality of the family in the lives of children, and articulates a set of protective factors that families need to thrive. HOPE completes this triad by demonstrating that protective factors operate through affecting children’s experiences.

The HOPE report provides more data and background for an approach that balances concerns about trauma and adversity with one that promotes the development of healthy resilient children who have had the positive experiences we all need. Although the report and the information within it is new, my own relationships with my mentors – Paula Duncan and T. Berry Brazelton – remind me that we are in fact only adding to a solid foundation of understanding.

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Dr. Robert Sege, MD, PhD, FAAP, is a practicing pediatrician, the Chief Medical Officer at Health Resources in Action, and a Senior Fellow at CSSP. 

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