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.

Overview/Introduction
Paul H. Dworkin, Connecticut Children's Medical Center, Hartford, CT

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

Discussion

Toxic exposures to nuclear, biological and chemical (NBC) agents can be difficult to diagnose and treat. The workshop goals are to:

1. Improve clinical skills associated with diagnosing pediatric exposures to NBC toxins,
2. Teach an evidence-based approach to treatment based on pediatric pharmacology and toxicology principles, and
3. Review state of the art resources available to the pediatrician.

Emphasis is placed on current treatment modalities as well as their potential toxicities. Secondarily, the FDA's role in approving these pharmaceuticals for children is discussed. Additional NBC information from the AAP's policy statements is reviewed, with particular attention to chemical-biological terrorism and radiation disasters. Attendees will be given an information packet so they can promote educational development on the topic of NBC terrorism in children within their own communities.

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

Prevention of Prevention Hypoxic-Ischemic Brain Injury—Management Strategies in the New Millenium

Magnesium—Is There a Role?
Abbot R. Laptook

Hypothermia—What, Where and Why?
Alistair J. Gunn

Blocking Apoptotic Pathways—Is It Feasible?
Frances J. Northington, Johns Hopkins University, Baltimore, MD

Contact for information:
Jeff Perlman, M.D.
University of Texas Southwestern Medical Center
Phone: (214) 648-2060
Email: jeffery.perlman@utsouthwestern.edu

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/.

Introduction
Elena Fuentes-Afflick, University of California, San Francisco, CA

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

Discussion

Possible Protective Role of ABC Transporters in Bilirubin Encephalopathy
J. Donald Ostrow, University of Washington School of Medicine, Seattle, WA

Implications of the New AAP Guidelines for the Management of Near-Term and Term Neonates with Hyperbilirubinemia
M. Jeffrey Maisels, William Beaumont Hospital, Royal Oak, MI

Contact for information:
David K. Stevenson, M.D.
Stanford University School of Medicine
Phone: (650)723-5711
EMail: dstevenson@stanford.edu

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

Practice Parameter: Evaluation of the Child with Global Developmental Delay. A Report from the American Academy of Neurology and the Child Neurology Society
Michael Shevell, McGill University, Montreal Children's Hospital, Montreal, Canada

The Rational Evaluation of the Child with Global Developmental Delay: A Genetics Perspective
John C. Carey

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

Neonatal encephalopathy, if severe, can lead to Cerebral Palsy. Cerebral Palsy is not a diagnosis, but rather a constellation of motor signs that are non-progressive and have multiple etiologies. Unfortunately, Cerebral Palsy affects a large number of children, but its causes, especially those that might be remedial or preventable, remain obscure in the majority of cases. Since neonatal encephalopathy is thought to be one of the neonatal etiologies of cerebral palsy, this session will focus on this issue from the perspectives of an epidemiologist, neonatal neurologist and pediatric neuroradiologist who each will speak to this issue from a different perspective.

Introduction
William W. Hay, University of Colorado Health Sciences Center, Aurora, CO

Antecedents of Cerebral Palsy—Why Can't We Prevent It?
Karin Nelson, National Institute of Neurological Disorders and Stroke, Bethesda, MD

Intrapartum Asphyxia Brain Damage in the Full Term Infant
Robert C. Vannucci, Penn State University, Hershey, PA

Imaging Neonatal Encephalopathy
Anthony Barkovich, University of California, San Francisco, CA

Panel Discussion
Donna M. Ferriero, University of California, San Francisco, CA

The potential applications for using regenerated cells and tissues to treat injury and disease are unlimited. Early stem research concentrated on the hematopoietic stem cells of the bone marrow, but stem cells are now known to exist in most organs of the body. Furthermore, it may be possible to return mature, differentiated cells to a undifferentiated, stem-like state. This symposium will first provide an overview of non-hematopoietic stem cells, then focus on three rapidly-progressing areas of research – those of regenerating nervous tissue, liver and pancreas.

Neural Stem Cells: Developmental Insights May Suggest Therapeutic Options
Evan Y. Snyder,

Hepatic Stem Cells and the Potential of Liver Repopulation for Cell Therapy
Sanjeev Gupta, Albert Einstein College of Medicine, Bronx, NY

Pancreatic Precursors and Stem Cell Therapy in Diabetes
Alberto Hayek, University of California San Diego Medical School, La Jolla, CA