Hippocrates II was born in Kos, Greece, in 460 BC. He is referred to as the father of Western medicine, as his beliefs and practices still guide physicians today. Hippocrates was also a teacher of others and wrote medical texts to preserve the information he discovered about health care and treatment. Perhaps, his greatest contribution was in the professionalization of medicine as a discipline of observation, documentation, and ethics. His legacy and influence on the field of health care are evidenced today in the Hippocratic Oath, which defines medical ethics and is taken by all physicians upon entry into the profession. The oath is summed up in one key phrase: First, do not harm.
Although not all of us are physicians, all of us in helping professions have ethics codes to define and guide our professional practice with infants, young children, and their families. These codes are meant to reflect a profession's values, morals, and beliefs and govern professional decisions and conduct. Their primary purpose is to protect those we serve in practice; however, I believe our ethical responsibilities extend beyond our individual practice to the larger population of vulnerable infants, young children, and their families. This is especially true when actions that will harm members of this population are instituted on behalf of a government policy. As professionals, we know that policies and actions have long-term ramifications for those affected, both directly and indirectly. Isn't it our ethical responsibility to use our professional knowledge and skills to guide, influence, and protest harm when it is happening to infants, young children, and their families, no matter the reason?
Our first article by Priscilla Weaver, Donetta Cothran, Stephanie Dickinson, and Georgia Frey examine the perspectives of 288 physical therapists practicing in early intervention with children aged birth to 3 years. The therapists completed a web-based survey to rate the importance of a group of personnel competencies for physical therapists in early intervention. Thirteen competencies received ratings of “extremely important,” and there were no significant differences found for the ratings among therapists based on demographic factors. The authors conclude with recommendations for using the top-rated competencies in physical therapy training.
Lauren Little, Anna Wallisch, Ellen Pope, and Winnie Dunn present a study about the use of telehealth interventions with families of young children with autism. A 12-week intervention model using telehealth was implemented with 17 families, who then completed a questionnaire about the process and content of the Telehealth Model. Descriptive statistics were used to estimate cost differences between a Clinic-Based Model, an In-Home Model, and a Telehealth Model. Families found the intervention in the Telehealth Model highly acceptable and effective, and it was found that telehealth could result in savings for both families and providers. The authors recommend further exploration of telehealth for the delivery of early intervention in underserved and rural areas.
An overview of the incidence and outcomes associated with congenital syphilis is provided in our next article by Sallie Porter, Rubab Qureshi, and Irina Benenson. Congenital syphilis is a growing world health problem, and infants who receive this diagnosis have many risks to development, such as prematurity, bone changes, and neurodevelopmental impairment. In addition, social vulnerabilities in their families (e.g., housing instability, incarceration) can exacerbate the negative outcomes experienced by these infants. The authors recommend using a comprehensive assessment protocol with infants diagnosed with congenital syphilis that is implemented early in their life and repeated over time. Additional recommendations include developmental intervention for the children and the availability of family support services for their families.
In our next article, Jinhee Park, Cara McComish, Britt Frisk Pados, Hayley H. Estrem, and Suzanne M. Thoyre describe positive changes in eating problems in children aged six months to seven years as a result of receiving six months of intervention at an outpatient clinic. The children's families (N = 58) completed an online survey of the Pediatric Eating Assessment Tool (PediEAT) at three time points: enrollment and three and six months later. Parents also completed questions about their demographics, their child's medical and feeding history, medical diagnoses, gastrointestinal function, and medications. Linear mixed modeling was used to examine changes in PediEAT total and subscale scores over time with associated child characteristics. The PediEAT total score significantly decreased over time, as did parent report of child symptoms of problematic eating. Several child characteristics were associated with more severe symptoms of problematic eating, which led the authors to emphasize the complexity of pediatric eating problems and recommend additional research on the factors influencing these problems.
Our last article provides preliminary evidence and information about the development and technical adequacy of the Ages & Stages Questionnaires: INVENTORY (ASQ:I). Jantina Clifford, Ching-I Chen, Huichao Xie, Chieh-Yu Chen, Kimberly Murphy, Kate Ascetta, Rebecca Frantz, and Sarah Hansen used items from the Ages & Stages Developmental Questionnaires to design a psychometrically sound tool that can be used to assess children's development from one to 36 months using naturalistic methods with parent participation. The authors describe the ASQ:I as a quality assurance measure that can be used by early childhood intervention programs to track and monitor the development of children and evaluate the effectiveness of early intervention over time.
I want to thank the authors for submitting their work to Infants & Young Children and the reviewers who assisted the editorial process by offering suggestions to bring these manuscripts to publication. The articles represent international authors, authors from the AUCD network, and new authors.
—Mary Beth Bruder, PhD