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On the one hand, an increasingly biotechnological approach has evolved to further the understanding of pathophysiological processes and their diagnosis and treatment by subspecialists (with results that sometimes seem magical). The last half century has seen accelerating change in pediatric practice, change that sometimes seems schizophrenic. Until recently, developmental research has been fragmented along specific disciplinary lines among pediatricians and related medical specialists, sociologists, psychologists, educators, and economists. One reason may be that little information has been available to guide us through the minefield of complex interactions between the biological and environmental factors that determine child and adolescent development.

Should not pediatricians and others responsible for the health and development of children and adolescents have the same long-term wish—healthy, successful lives—for their patients? Do we consider the potential for health and self-sufficiency in adulthood of the child or teen we examine today? What can we do to promote a successful outcome 15 to 30 years in the future?įew of us think in these terms, although pediatricians have long been strong proponents of the "whole child" approach to managing patients, which views health and development within the context of the family. But the likelihood of success is smaller for some children than others, particularly those born into poor, socially disadvantaged families, regardless of ethnic background, and, recent research indicates, those born to teenage mothers. The wish often comes true, at least in some measure. Most new mothers today would echo the sentiment. May your baby grow up to be healthy, wealthy, and wise" was a common birthday wish for babies born half a century ago.

The data should give every pediatrician pause, and food for thought.

Miller, DrPHĪll of us want to see children become self-sufficient, self-respecting adults the question is, what makes it happen? A landmark study has identified one of the variables—the age of a child's mother when she first gives birth. The life-course development model The Pathways to Adulthood study Mother's age and child's adult outcome Mother's age and family characteristics Mother's age and child characteristics Intergenerational patterns of childbearing An eye on the futureīy Janet B.