UPDATES

AAP annual meeting

This year's meeting of the American Academy of Pediatrics set a record; with some 10,000 participants, it was the best attended AAP meeting ever. In his speech to the members that summarized his year in office, outgoing President Donald Cook, MD, counted substantial successes in his fight to secure adequate reimbursement for pediatric services and reiterated the organization's ultimate goal of universal access to quality care for all children. Until that goal is achieved, he urged pediatricians to work toward enrolling more children in Medicaid and SCHIP.

In the keynote address, Dr. Francis Collins, Director of the National Human Genome Research Institute and co-discoverer of the cystic fibrosis gene, called the project he heads "the strongest set of tools we have to alleviate suffering and heal the sick" and singled out pediatrics as the specialty most closely affected by these revolutionary developments in understanding of human genetics. Dr. Collins called on physicians to educate the public about the genomic revolution and "make sure this technology is used for good."

In seminars and workshops, pediatricians were offered an extensive menu. Topics ranged from the everyday (managing otitis, convincing parents that vaccines are good for children) to the less common (evaluating children for ADHD, using children's drawings to identify underlying issues in behavior, figuring out how parents' food fads affect the way children eat), to the laboratory (stem cell research) and the world outside the examining room (dealing with bioterrorism, being a successful lobbyist). Opposing teams of residents and faculty competed for the coveted Meconium Cup, the prize for the most wide-ranging knowledge of medical trivia. There were CME credits to earn, restaurants to visit, and the architectural treasures of Chicago to tour. For those who forgot to turn in their CME forms at the meeting, the AAP even offered a second chance: Completed forms can be mailed to PREP, American Academy of Pediatrics, PO Box 927, Elk Grove Village, IL, 60009-0927.

Children and computers

Last September, a group of educators, child-development specialists, researchers, and parents made a startling suggestion: Computers may not be as good for children as advocates suggest. The group, called the Alliance for Childhood, is calling for a moratorium on the further introduction of computers in early childhood and elementary education—except for some children with disabilities. The group has issued a report, titled Fool's Gold: A Critical Look at Computers in Childhood, questioning the wisdom of diverting time, money, and attention from children's real educational needs to expensive technology whose benefits are unproved. The report claims that massive expenditures on computer equipment are forcing many schools to cut back elsewhere—on field trips, nature study, art and music, and library books, for example. Yet, says Marilyn Benoit, MD, the next president of the American Academy of Child and Adolescent Psychiatry, "it is within the context of human relationships, play, and interactions with nature that children are socialized....Premature relegation of learning to computer interaction will rob children of that civilizing influence and of their innate creativity." The full text of Fool's Gold, along with the Alliance for Children's call to action, are available at www.allianceforchildhood.net .

What parents don't know about early childhood

Picking up a 3-month-old whenever he cries will spoil him. So will letting a 2-year-old get down from the dinner table before the rest of the family is finished and allowing a 6-year-old to pick out the clothes she will wear to school. At least, that's what a sizeable proportion of American parents and grandparents believe. This is bad news, according to Kyle Pruett, MD, clinical professor of psychiatry at the Yale University Child Study Center and president of Zero to Three, because these notions run counter to what researchers know about child development and can lead to poor parenting practices.

These widespread parental and grandparental misconceptions about early childhood were revealed in a Yankelovich survey commissioned by Zero to Three in collaboration with Civitas, a national organization that provides information on child development, and Brio, a manufacturer of children's toys.

Additional survey findings include the following:

• 61% of parents of young children condone spanking as a regular form of punishment for young children and 37% think spanking is OK for children under 2 years of age.

• 26% of all adults expect a 3-year-old to sit quietly for an hour at a time.

• 40% of parents of young children agree that a 1-year-old who flips the TV on and off while parents are trying to watch is "trying to get back at them."

• 72% of parents do not believe that infants can experience depression.

According to Matthew Melmed, executive director of Zero to Three, the persistence of such widespread misconceptions indicates a serious knowledge gap that needs to be bridged with more effective, widely disseminated educational materials. Pediatricians can help by referring parents to child development materials on the Web sites of Civitas (www.civitas.org ) and Zero to Three (www.zerotothree.org ).

EYE ON WASHINGTON

Readers may (or may not!) know by now who won the presidential election, but Updates—as we go to press—does not. During the campaign, both candidates professed great concern for the well-being of children, although they differed on how it should best be secured. But the winner, whoever he is, will have to operate within tight limits. His party's control of Congress rests on a knife edge, with a defection of one or two votes sufficient to scuttle all but the most middle-of-the-road initiatives. And until January, a lame duck Congress and president are unlikely to strike any great blows for children's welfare. Major reforms in the health-care system are on hold and likely to remain so.

Meanwhile, even as the candidates campaigned and the nation voted and the outcome was decided in county clerks' offices in Florida, the federal government continued to go about its business—much of it affecting the health and well-being of children and their families.

The Food and Drug Administration (FDA) announced it was taking steps to ban all over-the-counter products that contain phenylpropanolamine, also known as PPA, an ingredient found in many cough and cold remedies (including some marketed specifically for pediatric use) and in appetite suppressants that may be attractive to dieting teens. According to the FDA, some 400 products are being recalled. Following the announcement, several major manufacturers announced they would stop producing these products, and some of the major pharmacy chains began to pull them from their shelves. The ban is based on a study published in the New England Journal of Medicine that links PPA to a risk of stroke in young women. The study is available on the Journal's Web site, www.nejm.org .

The FDA has also proposed limits on the dose and duration of use of supplements containing ephedra alkaloids, sometimes called ma huang. These products are widely promoted and sold for weight loss and energy enhancement. The FDA action is prompted by some 140 reports of adverse events connected with ma huang the agency has received. Reported adverse events include hypertension (17 reports), palpitations or tachycardia (13), stroke (10), and seizures (7). Ten deaths and 13 events producing permanent disability have been reported. A review of the adverse events reports will be carried in the New England Journal's December 21st issue. The findings were released early because of their potential public health implications.

The General Accounting Office (GAO)issued a report criticizing the lack of regulation of so-called functional foods that contain such herbal ingredients as ginseng, echinacea, ginkgo, and St. John's wort. According to the GAO, ingredients added to food must be generally recognized as safe, and ingredients of this type do not meet that criterion. The GAO report, Food Safety: Improvements Needed in Overseeing the Safety of Dietary Supplements and Functional Foods, is available on the Web at www.gao.gov .

The Census Bureau reports that the stay-at-home mom is a rapidly vanishing figure—even when mom is married and living with her husband. According to the latest available data for 1998, both parents worked outside the home at least part of the time in slightly more than half the two-parent families in the country. The 1998 figures are the high point of a trend that has been apparent since the 1970s, but this is the first time the percentage of such families has passed the half-way point.

The Consumer Product Safety Commission (CPSC), in concert with an industry group called the Window Covering Safety Council, has issued a recall for all window blinds with horizontal slats sold over the last decade. According to the CPSC, 130 babies and young children have been strangled by window blind cords since 1991. The recall may affect as many as 500 million such blinds. Parents can request a repair kit that prevents children from pulling inner cords loose by calling the Council at 800-506-4636. A kit to reconfigure older blinds with external cords that end in a loop (recalled five years ago) is also available.

The Substance Abuse and Mental Health Services Administration has made an interactive software program available to guide pediatricians and service agencies in choosing effective substance abuse prevention programs. To access the service, go to www.preventiondss.org .

Calendar

March 3­5, 4th International Conference on Varicella, Herpes Zoster, and Post-Herpetic Neuralgia, La Jolla, CA. To register, go to the Varicella Foundation Web site, www.vzvfoundation.org .

March 3­10, Pediatrics 2001, Big Sky, MT. To register, call Maria Craig at Symposia Medicus, 925-969-1789.

April 18­21, 5th Annual Spring Conference on Pediatric Emergencies, Grand Bahama Island. To register, call 925-969-1789.

April 18­21, National Pediatric Infectious Disease Conference, Washington, DC. To register, call Robert Kruse at 317-488-1234.

April 27­May 1, Pediatric Academic Societies Annual Meeting, Baltimore, MD. To register, call 281-296-0244.

May 20­May 23, American Pediatric Surgical Association, Naples, FL. To register, call 978-526-8330.

Judith Asch-Goodkin
Contributing Editor

 

Julia McMillan. Updates. Contemporary Pediatrics 2000;12:13.