As defined by the American Academy of Pediatrics, a goal of the pediatrician is the promotion of children’s optimal growth and development. Efforts at the state and national levels to enhance the effectiveness of child health supervision services have focused on such strategies as the early detection of developmental and behavioral concerns through effective monitoring, the provision of anticipatory guidance to address parental concerns and the promotion of such skills as language and literacy development. Such strategies have been informed by a wealth of new findings in neurobiology. Furthermore, enhancing practice quality may be facilitated by the effective application of basic change principles drawn from the field of organizational development, planning and change. This mini course will examine the impact on children’s development of such components of child health supervision as anticipatory guidance, developmental monitoring and developmental promotion, as well as review techniques to incorporate and promote rapid change within the practice setting. Ample time will be allotted for discussion among speakers and the audience.

The Science of Developmental Promotion
William Greenough, University of Illinois College of Medicine, Chicago, IL

Optimizing Anticipatory Guidance To Enhance Children’s Development
Paula M. Duncan, University of Vermont, Burlington, VT

Strategies for Effective Developmental Monitoring and Early Detection
Michael Regalado, Cedars-Sinai Medical Center, Los Angeles, CA

Promising Strategies To Promote Development
Neal Halfon, University of California, Los Angeles, CA

Enhancing Service Delivery Through Rapid Practice Change
Peter A. Margolis, University of North Carolina School of Medicine, Chapel Hill, NC

Substance abuse remains a critical problem for children and adolescents. This mini course will focus on current epidemiologic, neuropharmacologic and management data of these drugs: cocaine, heroin, "club" drugs (i.e., MDMA {Ecstasy}, GHB), other designer drugs and sport doping drugs. The issue of the influence of the media on drug abuse in adolescents will also be presented. Questions from the audience will be encouraged.

Introduction
Donald E. Greydanus, Michigan State University College of Human Medicine, Kalamazoo, MI

Science of Cocaine and Heroin Abuse in Adolescents
Manuel Schydlower, Texas Tech University Health Sciences Center, El Paso, TX

Science of Designer Drugs and Date Rape Drugs
Pierre Paul Tellier, McGill University, Montreal, Canada

Science of Sports Doping Drugs
Dilip R. Patel, Michigan State University College of Human Medicine, Kalamazoo Center for Medical Studies, Kalamazoo, MI

The Media and Drug Abuse in American Adolescents
Victor C. Strasburger, University of New Mexico School of Medicine, Albuquerque, NM

This mini course will set the stage for several discussions of particular issues of major importance and interest. What is "preparedness" and what are the real risks of continuing terrorism in the United States? What is the current status of preparedness in the U.S. hospital and public health systems? How do children differ from adults in terms of response to weapons of mass destruction (chemical, biological and radiological)? How do these differences matter in disaster planning? Are the needs of children being incorporated in local, state and federal disaster plans? Smallpox, anthrax and other biological threats: Where do we stand? What do we do? Nuclear power plants, nuclear weapons, dirty bombs and potassium iodide: What do we know? The mental health consequences of terrorism: What have we learned since 9/11, how do we prepare children for an increasingly vulnerable world, building resiliency and sustaining a positive vision. The new pediatric agenda: What do we have to teach students, residents and pediatricians about the pediatric aspects of terrorism planning. Children and exposure to weapons of mass destruction: science and the essential research agenda.

Introduction
Paul H. Saenger, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY

Welcome and Context
Irwin Redlener, National Center for Disaster Preparedness, Columbia University Mailman School of Public Health, New York, NY

Pediatric Preparedness for Terrorism and Disasters
David S. Markenson, Columbia University Mailman School of Public Health, New York, NY

Biological Weapons of Terror: What Pediatricians Need to Know
Theodore J. Cieslak, U.S. Army Research Institute of Infectious Diseases, Ft. Detrick, MD

Helping Children and Families Cope with Terrorism
David J. Schonfeld, Yale University School of Medicine, New Haven, CT

Radiologic Terrorism, Children and the Question of Potassium Iodide
Thomas P. Foley, University of Pittsburgh, Children's Hospital of Pittsburgh, Pittsburgh, PA

Anorexia nervosa is an eating disorder characterized by a relentless and obsessive pursuit of thinness that most commonly develops in adolescent females. The severe restriction of calories and compulsive exercising that can occur in this chronic condition may result in life-threatening weight loss. In addition to the serious medical complications associated with semi-starvation and severe energy deficits, there are often significant psychological and social problems that may precede or follow, as well as complicate the treatment during, the active phase of the illness. Practitioners and researchers in pediatrics and adolescent medicine in the field of eating disorders have generally focused on the acute and the chronic medical complications associated with anorexia nervosa. Although no organ is spared the effects of chronic malnutrition that occur with this condition, two that have the potential of long-term biological morbidity are the skeletal and reproductive systems. The long-term clinical outcomes of continued morbidity in these organs are osteoporosis and amenorrhea with reproductive failure, respectively. The latest research findings and their clinical implications relative to these organ systems will be discussed, and future research directions will be explored. In addition to the biological effects of anorexia nervosa, we shall address the biological vulnerability to developing anorexia nervosa, based on genetic predisposition. Emerging data from research studies and their clinical implications will be presented.

Overview
Richard E. Kreipe, University of Rochester School of Medicine, Golisano Children's Hospital at Strong, Rochester, NY

Morbidity of the Skeletal System in Anorexia Nervosa
Neville H. Golden, Schneider Children's Hospital, New Hyde Park, NY

Morbidity of the Reproductive System in Anorexia Nervosa
S. Jean Emans, Harvard Medical School, Children's Hospital Boston, Boston, MA

Genetic Susceptibility to Anorexia Nervosa
Wade Berrettini, University of Pennsylvania, Institute of Neurological Sciences, Center for Neurobiology and Behavior, Philadelphia, PA

Discussion
 

Pain that is recurrent or persistent can create difficulties in diagnosis and treatment. Since research in pediatric pain is relatively recent but expanding, physicians may not have sufficient state of the art knowledge upon which to evaluate and treat their patients with chronic pain. There have been significant advances in the neurobiology of pain and the many factors that magnify and maintain the pain experience, pain behaviors and pain pathophysiology. The interface between mind, body and the environment, as well as new diagnostic tools, is creating new paradigms in our understanding of pain. For example, barostat and imaging studies have revealed new models for thinking about irritable bowel syndrome (IBS) as a condition of neuroenteric dysfunction. Other conditions, such as juvenile fibromyalgia and myofascial syndromes, are thought to be caused by central neurodysregulation. Many of these conditions are magnified and confounded by co-morbid anxiety disorders, learning disabilities and family system issues, among other factors. Why do some children with chronic pain develop a downward spiral of decreasing function and develop PADS? These conditions are not as difficult to evaluate and treat once they are understood from a biopsychosocial perspective. We will discuss the neurobiology, clinical assessment and approach to treatment of chronic pain and PADS, using IBS, juvenile fibromyalgia and myofascial pain as examples.

Overview of Pain Systems: A Mind–Body Perspective
Lonnie K. Zeltzer, David Geffen School of Medicine at UCLA, Mattel Children's Hospital, Los Angeles, CA

Neurobiology of Chronic Pain: Irritable Bowel Syndrome as a Model
Carlo Di Lorenzo, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh, Pittsburgh, PA

How Do We Understand Disorders Such as Fibromyalgia and Myofascial Pain?
David D. Sherry, University of Pennsylvania School of Medicine, Children's Hospital of Philadelphia, Philadelphia, PA

Pain-Associated Disability Syndrome (PADS): What Is It and How To Evaluate and Treat It
Brenda Bursch, David Geffen School of Medicine at UCLA, UCLA Neuropsychiatric Institute & Hospital, Los Angeles, CA

Discussion
 

Children who are victims of violent behavior or merely observers of violence may learn destructive or self-destructive patterns of behavior. Violence is a major public health problem. This symposium will focus on breaking the cycle of violence and will showcase speakers who are working on violence prevention in the pediatric emergency department, school and community. The speakers will demonstrate what can be done by physicians who see the importance of this issue and the ways in which we can make a difference.

Violence Prevention in Primary Care: Moving from Public Health to Private Practice
Robert D. Sege, Tufts-New England Medical Center, Boston, MA

Beyond Treat and Street: Violence Prevention in the Emergency Department
Joel Fein, The Children’s Hospital of Philadelphia, PA

Efforts in the Community
Sheryl A. Ryan, University of Rochester School of Medicine, Rochester, NY

The BIOECOGRAM is a tool used to record child, family, social and environmental factors in a standardized method, placing the child at the very center of the consultation. The workshop will review the AAP recommendations for family-centered care and offer a number of case studies to help participants to use this graphic tool in their day-to-day practice when challenged by both simple and complex behavioral and developmental problems.
 

Last year's Developmental-Behavioral SIG held in Seattle covered a variety of developmental and behavioral screening tests and methods of developmental surveillance. This year's SIG will expand on this theme and address broader mental health issues in primary care through the use of the Bright Futures materials.

Bright Futures provides health care providers with a framework and tools for identifying and treating the mental health needs of their patients and families and utilizes a strength-based approach. The goal of this skill-building session is to inform health care providers about the essentials of mental health promotion including monitoring for, preventing and identifying psychosocial problems and providing appropriated follow-up. Participants will be able to identify available tools and resources and how health care providers can utilize them. Bright Futures materials, including the Bright Futures in Practice: Mental Health practice guide and the accompanying tool kit, will be shared. The session will use the Bright Futures Mental Health materials to assist participants in addressing the mental health needs of children and their families. Session participants will work in small groups while applying these screening, care management and health education tools to a variety of case studies. Incorporating this information into residency training programs will also be discussed. The presenters will include Joseph Hagan, chairperson of AAP's Bright Futures Education Center; Paula Duncan, chairperson of the AAP Bright Futures Pediatric Implementation Project; and Michael Jellinek, editor of Bright Futures in Practice: Mental Health practice guide.
 

The National Children’s Study is a national prospective, longitudinal study of environmental effects, including physical, chemical, biological and psychosocial effects, on child health and development. The goal of the study is to improve the health and well-being of children. The study will examine these environmental effects on the health and development of more than 100,000 children across the United States, following them from before birth until age 21. The study is led by a consortium of federal agency partners: the U.S. Department of Health and Human Services, including the National Institute of Child Health and Human Development (NICHD); the National Institute of Environmental Health Sciences (NIEHS); the Centers for Disease Control and Prevention (CDC); and the U.S. Environmental Protection Agency (EPA). For additional information, visit the website at http://www.nationalchildrensstudy.gov/.

The National Children’s Study—An Overview
Duane Alexander, NICHD, National Institutes of Health, Bethesda, MD

The National Children’s Study—Methods
Peter C. Scheidt, National Institutes of Health, Bethesda, MD

Children’s Health and Environmental Exposures: The Most Important Unanswered but Answerable Questions
Michael Weitzman, The AAP Center for Child Health Research at the University of Rochester, Rochester, NY

Despite the dramatic increase in patient and graft survival following solid organ transplantation over the past decade, complex and potent immunosuppressive regimens have led to significant complications. In this multidisciplinary symposium, the pathophysiology and therapy of infections, lymphoproliferative disease and growth abnormalities following solid organ transplantation will be reviewed. In addition, the problem of non-compliance with complex immunosuppressive regimens—a major cause of organ loss/dysfunction post transplantation—will be reviewed.

Infections Following Solid Organ Transplantation
Michael Green, University of Pittsburgh School of Medicine, Pittsburgh, PA

Post-transplant Lymphoproliferative Disease: Pathophysiology and Treatment
Vikas R. Dharnidharka, University of Florida Health Science Center, Gainesville, FL

Growth Disorders Following Solid Organ Transplantation
Leona Cuttler, Case Western Reserve University, Cleveland, OH

Compliance with Complex Medical Regimens Post-transplantation: Anticipatory Therapies
Robert Wells, Children's Hospital Central California, Fresno, CA

The application of imaging technologies to solving questions in biology and medicine is revolutionizing medicine by accelerating analyses in situ and in vivo and providing new perspectives on biological processes as diverse as development, neoplasia and injury repair. In this plenary session, three internationally recognized speakers will focus on developmental processes and discuss how these new imaging technologies are providing dynamic insights into the genetic and epigenetic mechanisms that underpin hematopoiesis and vascular development.

Introduction
Lisa M. Guay-Woodford, University of Alabama at Birmingham, Birmingham, AL

Dynamic Imaging of Fluid Forces in Developing Mouse Vasculature
Mary Dickinson, Beckman Institute–Caltech, Pasadena, CA

Microscopic Imaging of Angiogenesis
Donald M. McDonald, University of California, San Francisco, CA

Watching Hematopoietic Stem Cell Engraftment and Hematopoiesis in Living Animals
Christopher H. Contag, Stanford University School of Medicine, Stanford, CA

Questions from the audience
 

The use of psychopharmacologic agents in children and adolescents has increased significantly over the past decade. Clinicians and researchers are becoming more involved in using these various medications, and this trend will continue in the future. What is the evidence-based medicine (EBM) for these medications as they apply to children and adolescents? This mini course will review the current research as applied to antidepressants, stimulants, mood stabilizers and antipsychotics. Applications to mental disorders in children and adolescents will be discussed. Questions from the audience will be encouraged. This is a continuation to the popular session held in May 2003 in Seattle.

Introduction
Donald E. Greydanus, Michigan State University College of Human Medicine, Kalamazoo, MI

Antidepressants
Susan Smiga, Langley Porter Child and Adolescent Psychiatric Center, University of California, San Francisco, CA

Stimulants
Glen R. Elliott, Langley Porter Child and Adolescent Psychiatric Center, University of California, San Francisco, CA

Mood Stabilizers
Glen R. Elliott, Langley Porter Child and Adolescent Psychiatric Center, University of California, San Francisco, CA

Antipsychotics
Chris K. Varley, University of Washington Medical Center, Children's Hospital and Regional Medical Center, Seattle, WA

Worldwide, more than 1,500 children per day become infected with HIV through mother-to-child transmission. Currently there are 2.7 million children living with HIV infection across the globe, >90% of whom reside in developing countries. While there have been enormous successes in the prevention and treatment of pediatric AIDS in the United States and Europe, it remains an open question as to how effectively these public health gains can be replicated in the poor countries of the world, which bear the greatest burden of disease. Efforts to develop an HIV vaccine appropriate for preventing infection among the world's children and adolescents are finally under way on a global scale. We will discuss these issues and accompanying controversies as they apply to the children of the developing world.

AIDS in Children—A Global Public Health Crisis
David L. Pugatch, Hasbro Children's Hospital and Brown Medical School, Providence, RI

Preventing Mother-to-Child Transmission of HIV in Developing Countries—Successes, Failures and Challenges
Catherine M. Wilfert, Elizabeth Glaser Pediatric AIDS Foundation, Santa Monica, CA and Washington, DC

HIV Treatment for Children—Can the Successes of Rich Countries Be Duplicated in Resource-Poor Settings?
Mark W. Kline, Baylor College of Medicine, Houston, TX

Finding an AIDS Vaccine That Works for the World's Children
Richard A. Koup, Vaccine Research Center, National Institutes of Health, Bethesda, MD

This session presents the field of developmental cognitive neuroscience from a clinical perspective. Typical and atypical language development in children serves as the focus of this session. The impact of recently available magnetic resonance imaging (MRI) techniques such as volumetric MRI and functional MRI (fMRI) will be illustrated. An overview of volumetric MRI and fMRI methods will be presented with developmental and clinically relevant examples. fMRI in typically developing children as compared to adults for a single word processing task will be presented and the possibility that differences represent maturational changes in functional neuroanatomy will be discussed. The application of volumetric imaging and fMRI to the study of a clinically relevant group of children at risk for cognitive deficits, i.e. children born as premature infants, will show how fMRI for non-invasive but quantitative assessment of language processing can be utilized. Finally, results from fMRI study of children with developmental dyslexia will be presented that show disruption in posterior brain neural circuits for reading.

Introduction: Overview of Volumetric and Functional MRI Techniques
Michael Rivkin, Boston Children's Hospital, Harvard Medical School, Boston, MA

Differences in fMRI Activation Between Adults and Children in Single Word Processing
Brad Schlaggar, Washington University School of Medicine, St. Louis, MO

Use of fMRI and Volumetric Imaging To Study Language Processing and Its Cognitive Correlates in Children Born as Premature Infants
Laura R. Ment, Yale University School of Medicine, New Haven, CT

New Insights into the Functional Neuroanatomy of Developmental Dyslexia
Bennett A. Shaywitz, Yale University Medical Center, New Haven, CT
 

Contact for information:
Brian Rogers, M.D.
President, Society for Developmental Pediatrics
Director of Child Development & Rehabilitation Center
Oregon Health and Sciences University
Phone: (503)494-8362
Email: rogersbr@ohsu.edu
 

Obesity is currently one of the greatest health threats facing the health of our children and youth. Reasons for this epidemic are rooted in the changing lifestyle of Americans: one that embraces little physical activity and the consumption of large amounts of processed, high caloric foods. While problems in our societal fabric may take decades to address, pediatricians need effective ways to treat children who are already obese or are at imminent risk. Despite the significance and magnitude of this problem, most attempts at therapy have not been effective. We will discuss current dietary, pharmacologic and surgical approaches to therapy that are gaining in popularity in pediatric populations and will address what is known about the effectiveness of these approaches and the controversies associated with them. The rationale for different diets, including "popular" ones, their efficacy and safety will be discussed. Data concerning safety and efficacy of approved and experimental drug therapies in children will be presented. Finally, we will discuss when to consider bariatric surgery in children.

Novel Dietary Treatments for Obesity and Related Complications
David S. Ludwig, Children's Hospital, Boston, MA

Pharmacotherapy of Childhood Obesity
Robert H. Lustig, University of California, San Francisco, CA

Surgical Weight Loss in Pediatrics
Victor F. Garcia, Cincinnati Children's Hospital Medical Center, Cincinnati, OH

Hot Topics in General Pediatrics is a potpourri of topics of interest to all pediatricians. The topics include lead poisoning, West Nile Virus infection, sleep disorders and esophagitis. Each of these conditions has varied symptoms, signs and manifestations. For each topic there have been new findings that are in the "need to know" category for all pediatric generalists and subspecialists.

Kawasaki Disease
Jane C. Burns, University of California, San Diego, CA

West Nile Fever
Janak A. Patel, Children's Hospital, University of Texas Medical Branch, Galveston, TX

Lead Poisoning
Kevin Osterhoudt, The Children's Hospital of Philadelphia, Philadelphia, PA