Erken Çocukluk Gelişimi - Çocuk Hekiminin Rolü

Erken çocukluk gelişimi çocukların ilkokul dönemine kadar olan fiziksel, bilişsel, dil ve sosyoduygusal gelişimini içerir. Temel bir çocuk hakkı olmasına karşın ne yazık ki pekçok çocuk doğuştan getirdiği potansiyeline erişememektedir. Çocuk hekimi, temel olarak çocuğun sağlığı, refahı ve gelişimi ile ilgilenen hekimdir. Çocuk hekiminin erken çocukluk gelişimini desteklemenin yanı sıra, gelişimsel izlem ve tarama ile erken tanı koyma sorumluluğu da vardır. DSÖ/UNICEF’in “geliştiren bakım” çerçeve programı erken çocukluk gelişimi için 5 temel alan belirlemiştir; sağlık, beslenme, duyarlı bakım, güvenli-güvenilir çevre ve erken eğitim olanaklarına erişim. Çocuk hekiminin hizmet sunucu, savunucu, araştırmacı ve eğitimci olarak tüm bu alanlarda görev ve sorumlulukları vardır. Tüm bu alanlardaki çalışmalar çocuk hekimlerinin çok yatkın olduğu mulidisipliner işbirliği ile başarılabilir.

Anahtar Kelimeler:

Erken çocukluk gelişimi, geliştiren bakım, çocuk hekimi

Early Childhood Development – The Role of The Paediatrician

Early childhood development is the physical, cognitive, linguistic, and socioemotional development of young children until primary school. Although a child right, unfortunately many children cannot reach their developmental potential. A pediatrician is a physician who is concerned primarily with the health, welfare, and development of children. Pediatricians have the responsibility to promote early childhood development as well as developmental surveillance and screening for early diagnosis. The WHO/UNICEF Nurturing Care framework has specified 5 main strategies/domains: health, nutrition, responsive care giving, secure-safe environment and early education opportunities for early childhood development. The pediatrician plays the role of service provider, advocate, researcher or educator in all these domains. All these domains can only be successfully fulfilled through multidisciplinary collaboration, a way of working that pediatricians are accustomed to using.

Keywords:

Early childhood development nurturing care, primary pediatric care, pediatrician,

PDF

___

1. Shonkoff JP, Garner AS, The Committee on Psychosocial Aspects of Child and Family health, Committee on Early Childhood, Adoption, and Dependent Care, and Section on Developmental and Behavioral Pediatrics. The Lifelong Effects of Early Childhood Adversity and Toxic Stress. Pediatrics 2012;129;e232 google scholar
2. Commitee on Pediatric Workforce. Definition of a Pediatrician. Pediatrics 2015;135:780. google scholar
3. van Esso D, del Torso S, Hadjipanayis A, Biver A, Jaeger-Roman E, Wettergren B,et al. Paediatric primary care in Europe: variation between countries. Arch Dis Child 2010;95:791-5. google scholar
4. Black MM, Walker SP, Fernald LCH , Andersen CT, DiGirolamo AM , Lu C, et al. Early childhood development coming of age: science through the life course. Lancet 2017;389:77-90. google scholar
5. Naudeau S, Kataoka N,Valerio A, Neuman MJ, Kennedy Elder L. Investing in Young Children An Early Childhood Development Guide for Policy Dialogue and Project Preparation. The World Bank Washington DC, 2011. google scholar
6. Uchitel J, Alden E, Bhutta ZA, Goldhagen J, Narayan AP, Raman S, et al. The Rights of Children for Optimal Development and Nurturing Care. Pediatrics 2019;144(6):e2019048. google scholar
7. Hanson MA, Gluckman PD. Early Developmental Conditioning of Later Health and Disease: Physiology or Pathopysiology? Physiol Rev 2014;94:1027-76. google scholar
8. Boyce WT, Levitt P, Martinez FD, McEwen BS, Shonkoff JP. Genes. Environments, and Time: The Biology of Adversity and Resilience. Pediatrics 2021;147(2):e20201651. google scholar
9. Schwarzenberg SJ, Georgieff MK, AAP Comittee on Nutrition. Advocacy for Improving Nutrition in the First 1000 Days To Support Childhood Development and Adult Health. Pediatrics 2018;141(2):e20173716. google scholar
10. Linda M Richter, Bernadette Daelmans, Joan Lombardi, Jody Heymann, Florencia Lopez Boo, Jere R Behrman. Advancing Early Childhood Development: from Science to Scale 3 Lancet 2017;389:103-18. google scholar
11. World Health Organization, United Nations Children’s Fund, World Bank Group. Nurturing care for early childhood development: a framework for helping children survive and thrive to transform health and human potential. Geneva: World Health Organization; 2018. google scholar
12. Bharadva K, Shastri D, Gaonkar N, Thakre R, Mondkar J, Nanavati R, et al. Consensus Statement of Indian Academy of Pediatrics on Early Childhood Development. Indian Pediatr 2020;57:834-41. google scholar
13. Mukherjee SJ, Agrawal D, Mishra D, Shastri D, Dalwai SH, Chattopadhyay N, et al. Indian Academy of Pediatrics Position Paper on Nurturing Care for Early Childhood Development. Indian Pediatr 2021 Jun 28;S097475591600349. google scholar
14. World Health Organization, United Nations Children’s Fund, World Bank Group. Operationalizing Nurturing Care for Early Childhood Development. The role of the health sector alongside other sectors and actors. Geneva, 2019. google scholar
15. Georgieff MK, Brunette KE, Tran PV. Early life nutrition and neural plasticity. Dev Psychopathol 2015;27:411-23. google scholar
16. Radley JJ, Sisti HM, Hao J, Rocher AB, McCall T, Hof PR, et al. Chronic behavioral stress induces apical dendritic reorganization in pyramidal neurons of the medial prefrontal cortex. Neuroscience 2004;125(1):1-6. google scholar
17. Grandjean P, Landrigan PL.Neurobehavioural effects of developmental toxicity Lancet Neurol 2014;13:330-8. google scholar
18. Lipkin PH, Macias MM, AAP Council on Children with Disabilities, Section on Developmental and Behavioral Pediatrics. Promoting Optimal Development: Identifying Infants and Young Children With Developmental Disorders Through Developmental Surveillance and Screening. Pediatrics 2020;145(1):e20193449. google scholar
19. Çelen Yoldaş T, Özmert EN, Bayazıt Y, Tanrıkulu B, Yetim H, Çakır B. Developmental Concerns, Parental Perceptions and Missed Opportunities from Different Levels of Health Centers in a Middle-Income Country. Indian J Pediatr 2021;88(1):16-22. google scholar
20. Garner AS, Storfer-Isser A, Szilagyi M, Stein REK, Green CM, Kerker BD, et al. Promoting Early Brain and Child Development: Perceived Barriers and the Utilization of Resources to Address Them. Acad Pediatr 2017;17:697-705. google scholar
21. Çelen Yoldaş T, Şenel S, Abuş HM, Yücel H, Özmert EN. Identification of the Place of Developmental Issues in the Educational and Clinical Practices of Pediatric Residents and Affecting Factors Turkish J of Pediatric Disease 2021;15:59-64. google scholar
22. Committee on Psychosocial Aspects of Child and Family Health, Committee on Early Childhood, Adoption and Dependent Care, and Section on Developmental and Behavioral Pediatrics. Early Childhood Adversity, Toxic Stress, and the Role of the Pediatrician: Translating Developmental Science Into Lifelong Health. Pediatrics 2012;129:e224-e231. google scholar
23. Rushton FE, Kraft C. Building brains, forging futures: the pediatrician’s role. International Journal of Pediatrics and Adolescent Medicine 2014;1:3-7. google scholar
24. Yogman M, Garfi eld CF, AAP the Committee on Psychosocial Aspects of Child Health. Fathers’ Roles in the Care and Development of Their Children: The Role of Pediatricians. Pediatrics 2016;138(1):e20161128. google scholar