Understanding Malocclusions in Everyday Orthodontics

Understanding Malocclusions in Everyday Orthodontics

Types of Malocclusions: Overview of common types such as overbite, underbite, and crossbite in pediatric patients.

In the realm of everyday orthodontics, understanding the various types of malocclusions is crucial for both practitioners and patients, especially when it involves pediatric care. Malocclusions, or misalignments of the teeth, are common issues that can affect not only the aesthetics of a smile but also the overall oral health and function. Among the most frequently encountered types of malocclusions in children are overbites, underbites, and crossbites.


An overbite, often referred to as a "deep bite," occurs when the upper front teeth significantly overlap the lower front teeth. This condition can lead to the lower teeth biting into the roof of the mouth, causing discomfort and potential wear on the teeth. In pediatric patients, an overbite might be due to thumb sucking or genetic factors, and early intervention can help guide the teeth into a more favorable position.


Conversely, an underbite is characterized by the lower teeth protruding in front of the upper teeth. Some orthodontic issues are inherited while others develop over time Child-friendly orthodontic solutions disease. This misalignment can be inherited or result from prolonged use of a pacifier or bottle. In young children, an underbite can affect speech development and may lead to jaw pain if not addressed. Orthodontists often recommend early treatment to prevent the need for more invasive procedures later in life.


A crossbite is another common malocclusion, where one or more of the upper teeth sit inside the lower teeth when biting down. This misalignment can occur on either side of the mouth and can lead to uneven wear on the teeth, gum disease, and jaw asymmetry. In pediatric patients, a crossbite can also impact the growth of the jaw, making early detection and treatment essential.


Understanding these types of malocclusions in pediatric patients is vital for effective orthodontic care. Early detection and intervention can significantly improve outcomes, reducing the need for more complex treatments in adulthood. By addressing these issues in childhood, orthodontists can help ensure a healthier, more functional smile for their young patients, setting the foundation for lifelong oral health.

Understanding malocclusions in everyday orthodontics involves delving into a variety of factors that contribute to the misalignment of teeth in children. Among these, genetic factors, habits such as thumb sucking, and environmental influences play significant roles.


Genetic factors are often the primary cause of malocclusions. A child may inherit traits from their parents that lead to crowded teeth, misaligned jaws, or other orthodontic issues. For instance, if a parent had a narrow jaw or an overbite, their child might be predisposed to similar conditions. Genetic predispositions can set the stage for malocclusions, making it crucial for orthodontists to consider family dental histories when assessing a child's orthodontic needs.


Habits, particularly thumb sucking, are another common cause of malocclusions in kids. Prolonged thumb sucking can exert pressure on the teeth and jaw, leading to protrusion of the front teeth or narrowing of the upper jaw. This habit is most influential if it continues past the age of three, as the permanent teeth begin to erupt and are more susceptible to misalignment. Educating parents and children about the potential orthodontic consequences of thumb sucking can help mitigate its impact.


Environmental influences also contribute to the development of malocclusions. These can include early loss of baby teeth due to decay, which can cause adjacent teeth to shift into the vacant space. Additionally, mouth breathing, often caused by enlarged adenoids or allergies, can affect the position of the jaw and teeth. Orthodontists must consider these environmental factors and work collaboratively with other healthcare providers to address underlying issues that may be contributing to a child's malocclusion.


In everyday orthodontics, understanding the interplay between genetic, habitual, and environmental factors is essential for developing effective treatment plans. By addressing these causes, orthodontists can help children achieve healthier, more aligned smiles, improving both their dental function and overall well-being.

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Orthodontic Experts Discuss the Impact of Overbites on Overall Health

Orthodontic Experts Discuss the Impact of Overbites on Overall Health

Overbites, a common dental condition where the upper front teeth significantly overlap the lower front teeth, can have more than just aesthetic implications.. Orthodontic experts have increasingly recognized the broader impact of overbites on overall health, prompting a discussion on various treatment options and their effectiveness in enhancing well-being. One of the primary treatment options for overbites is the use of traditional braces.

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Advancements in Clear Aligners Transform Traditional Treatment Approaches

Advancements in Clear Aligners Transform Traditional Treatment Approaches

The future of clear aligner technology holds promising developments that are poised to further revolutionize orthodontic practices and enhance patient care globally.. As we look ahead, several key areas are expected to drive advancements in this field, ultimately transforming traditional treatment approaches. One significant prediction is the integration of advanced digital technologies, such as artificial intelligence (AI) and machine learning, into the design and treatment planning of clear aligners.

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Study Shows Braces Improve Not Just Smiles but Mental Well Being

Study Shows Braces Improve Not Just Smiles but Mental Well Being

The study highlighting the positive impact of braces on mental well-being opens new avenues for integrating orthodontic care into holistic mental health programs.. As orthodontic treatments not only enhance smiles but also boost self-esteem and overall mental health, it's crucial to consider how these benefits can be maximized within broader wellness initiatives. First and foremost, mental health programs should collaborate closely with orthodontic professionals to ensure that patients receive comprehensive care.

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Orthodontists Report Increase in Early Diagnoses of Crossbite

Orthodontists Report Increase in Early Diagnoses of Crossbite

Orthodontists across the nation have noted a significant uptick in the early diagnoses of crossbite, a condition that can have long-term implications on dental health and facial development.. This trend has sparked a range of expert opinions on the benefits and challenges of detecting crossbite at an early stage. Dr.

Posted by on 2025-02-12

Early Detection and Diagnosis: The importance of regular dental check-ups for identifying malocclusions in children.

Understanding malocclusions in everyday orthodontics is crucial for maintaining optimal oral health, especially in children. One of the key aspects of managing malocclusions effectively is early detection and diagnosis, which underscores the importance of regular dental check-ups.


Malocclusions, or misalignments of the teeth and jaws, can lead to a variety of issues if left untreated. These can range from aesthetic concerns to more serious problems such as difficulty in chewing, speech impediments, and even increased risk of dental diseases. Early detection plays a pivotal role in preventing these issues from escalating.




Understanding Malocclusions in Everyday Orthodontics - Clinton Township

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Regular dental check-ups, ideally starting from a young age, provide the perfect opportunity for dentists and orthodontists to identify signs of malocclusions. During these visits, professionals can observe the growth and development of a child's teeth and jaws. They can spot subtle irregularities that might not be noticeable to the untrained eye, such as crowded teeth, misaligned bites, or abnormal jaw growth.


By catching these issues early, orthodontists can intervene with timely treatments that are often less invasive and more effective than those required for adults. For instance, orthodontic appliances like braces or expanders can guide the growth of the jaw and the alignment of the teeth, correcting malocclusions before they become severe.


Moreover, early diagnosis can also help in managing the psychological impact of malocclusions. Children who feel self-conscious about their teeth may benefit from early interventions that boost their confidence and improve their quality of life.


In conclusion, the importance of regular dental check-ups cannot be overstated when it comes to identifying malocclusions in children. These routine visits are essential for early detection and diagnosis, paving the way for timely and effective orthodontic treatments. By prioritizing these check-ups, parents can help ensure their children enjoy a lifetime of healthy smiles.

Orthodontic Treatment Options for Kids: Discussing braces, aligners, and other corrective measures suitable for young patients.

Understanding Malocclusions in Everyday Orthodontics: Orthodontic Treatment Options for Kids


Malocclusions, or misalignments of the teeth and jaws, are a common dental issue that can affect people of all ages, including children. When it comes to young patients, it's crucial to address these problems early on to ensure proper dental development and avoid more complex issues later in life. In this essay, we will explore various orthodontic treatment options for kids, focusing on braces, aligners, and other corrective measures suitable for young patients.


Braces have long been a go-to solution for correcting malocclusions in children. These orthodontic devices consist of brackets bonded to the teeth and connected by wires, which gradually apply pressure to guide the teeth into their proper positions. For kids, traditional metal braces are often the most cost-effective and reliable option. However, many orthodontists now offer more aesthetically pleasing alternatives, such as ceramic braces or even gold-plated braces, which can be more appealing to young patients.


In recent years, clear aligners have gained popularity as a more discreet alternative to braces. Brands like Invisalign have developed aligner systems specifically designed for teenagers, known as Invisalign Teen. These clear, removable trays can be an attractive option for kids who may feel self-conscious about wearing braces. However, aligners require a higher level of responsibility from young patients, as they must be worn for at least 22 hours per day and removed for eating and cleaning.


Beyond braces and aligners, there are other orthodontic appliances that can help correct malocclusions in children. Palatal expanders, for instance, are used to widen the upper jaw in patients with crossbites or crowded teeth. These devices are typically cemented to the upper molars and gradually widened over time using a special key. Headgear, another option, applies pressure to the upper teeth and jaw from outside the mouth, helping to correct overbites and other jaw discrepancies.


In some cases, early orthodontic treatment can be beneficial for young children, even before all their permanent teeth have erupted. This approach, known as interceptive orthodontics, aims to guide the growth of the jaws and teeth, potentially reducing the need for more extensive treatment later on. For example, a child with a severe overbite might benefit from a functional appliance like a bionator or twin-block, which encourages the lower jaw to grow forward and improve the bite.


When considering orthodontic treatment options for kids, it's essential to work closely with an experienced orthodontist who can assess each child's unique needs and recommend the most appropriate course of action. Factors such as the severity of the malocclusion, the child's age, and their level of cooperation will all play a role in determining the best treatment plan.


In conclusion, a variety of orthodontic treatment options are available for kids with malocclusions, ranging from traditional braces to clear aligners and specialized appliances. By addressing these issues early on and working with a skilled orthodontist, parents can help ensure their children develop healthy, properly aligned smiles that will benefit them for a lifetime.

The Role of Parents in Orthodontic Care: How parents can support their child's orthodontic treatment and encourage good oral habits.

In the realm of everyday orthodontics, understanding malocclusions is crucial, but equally important is the role parents play in supporting their child's orthodontic care. Malocclusions, or misalignments of the teeth and jaws, can affect not only the aesthetics of a smile but also the functionality of the oral cavity.

Understanding Malocclusions in Everyday Orthodontics - Clinton Township

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Parents are pivotal in ensuring that their children receive the necessary support and guidance to navigate through orthodontic treatment successfully.


First and foremost, parents must be actively involved in their child's orthodontic journey. This begins with regular visits to the orthodontist, where parents can gain insights into their child's specific malocclusion and the treatment plan designed to address it. Whether it's braces, aligners, or other orthodontic appliances, understanding the purpose and maintenance of these tools is essential. Parents can reinforce the orthodontist's instructions at home, ensuring that their child adheres to the treatment schedule and wears any removable devices as prescribed.


Encouraging good oral habits is another critical aspect of parental involvement. Orthodontic treatment often requires meticulous oral hygiene to prevent issues like tooth decay and gum disease, which can be exacerbated by orthodontic appliances. Parents can help by establishing a routine that includes thorough brushing and flossing after every meal. Special orthodontic brushes and floss threaders can be introduced to make cleaning around braces easier and more effective. By turning these habits into a fun and engaging part of the daily routine, parents can ensure that their child maintains excellent oral health throughout the treatment.


Moreover, parents can play a significant role in boosting their child's confidence during orthodontic treatment. Malocclusions can sometimes lead to self-consciousness, especially in the adolescent years. By offering positive reinforcement and celebrating small milestones, parents can help their child feel proud of their progress and more comfortable with their appearance. Open communication about any discomfort or challenges faced during treatment can also make the experience less daunting for the child.


In addition to emotional support, parents can advocate for their child's dietary needs. Certain foods can be detrimental to orthodontic appliances, and parents can guide their children in making healthier choices. Avoiding sticky, hard, or overly sugary foods can prevent damage to braces and reduce the risk of cavities. Instead, parents can introduce a variety of nutritious options that support overall health and orthodontic care.


In conclusion, the role of parents in orthodontic care is multifaceted and indispensable. By understanding malocclusions and actively participating in their child's treatment, parents can significantly enhance the effectiveness of orthodontic care. Through encouragement, education, and support, parents can help their children achieve not only a healthier smile but also a more confident and positive outlook on their orthodontic journey.

Long-term Benefits of Early Orthodontic Intervention: How treating malocclusions in childhood can prevent more serious issues in adulthood.

Understanding malocclusions is crucial in everyday orthodontics, as these dental misalignments can significantly impact oral health and aesthetics. One of the most compelling aspects of orthodontic care is the long-term benefits of early intervention, particularly in childhood. Treating malocclusions at a young age can prevent more serious issues in adulthood, making it an essential consideration for both patients and practitioners.


Malocclusions, or improper bites, can arise from genetic factors, habits like thumb sucking, or even developmental issues. When left untreated, these misalignments can lead to a host of problems as an individual grows older. For instance, crowded or crooked teeth can make oral hygiene more challenging, increasing the risk of tooth decay and gum disease. Additionally, misaligned jaws can cause difficulties in chewing and speaking, and may even contribute to chronic pain in the jaw and headaches.


Early orthodontic intervention can mitigate these risks effectively. By addressing malocclusions during childhood, orthodontists can guide the growth of the jaw and the alignment of teeth, often with less invasive treatments than would be necessary in adulthood.

Understanding Malocclusions in Everyday Orthodontics - patient portal

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For example, a child with a crossbite might benefit from a palatal expander, which can correct the issue by widening the upper jaw. This not only prevents the need for more complex surgery later in life but also promotes healthier dental development overall.


Moreover, early treatment can enhance a child's self-esteem. A pleasing smile can boost confidence, which is particularly important during the formative years of school and social development. By addressing malocclusions early, orthodontists can help children feel more comfortable and confident in their appearance, which can have lasting positive effects on their mental and emotional well-being.


In conclusion, the long-term benefits of early orthodontic intervention for malocclusions are substantial. By treating these issues in childhood, orthodontists can prevent more severe problems in adulthood, promote better oral health, and support a child's overall development. Understanding the importance of early intervention is key to providing effective orthodontic care and ensuring the best possible outcomes for patients.

 

Pediatrics
A pediatrician examines a neonate.
Focus Infants, Children, Adolescents, and Young Adults
Subdivisions Paediatric cardiology, neonatology, critical care, pediatric oncology, hospital medicine, primary care, others (see below)
Significant diseases Congenital diseases, Infectious diseases, Childhood cancer, Mental disorders
Significant tests World Health Organization Child Growth Standards
Specialist Pediatrician
Glossary Glossary of medicine

Pediatrics (American English) also spelled paediatrics (British English), is the branch of medicine that involves the medical care of infants, children, adolescents, and young adults. In the United Kingdom, pediatrics covers many of their youth until the age of 18.[1] The American Academy of Pediatrics recommends people seek pediatric care through the age of 21, but some pediatric subspecialists continue to care for adults up to 25.[2][3] Worldwide age limits of pediatrics have been trending upward year after year.[4] A medical doctor who specializes in this area is known as a pediatrician, or paediatrician. The word pediatrics and its cognates mean "healer of children", derived from the two Greek words: παá¿–ς (pais "child") and á¼°ατρÏŒς (iatros "doctor, healer"). Pediatricians work in clinics, research centers, universities, general hospitals and children's hospitals, including those who practice pediatric subspecialties (e.g. neonatology requires resources available in a NICU).

History

[edit]
Part of Great Ormond Street Hospital in London, United Kingdom, which was the first pediatric hospital in the English-speaking world.

The earliest mentions of child-specific medical problems appear in the Hippocratic Corpus, published in the fifth century B.C., and the famous Sacred Disease. These publications discussed topics such as childhood epilepsy and premature births. From the first to fourth centuries A.D., Greek philosophers and physicians Celsus, Soranus of Ephesus, Aretaeus, Galen, and Oribasius, also discussed specific illnesses affecting children in their works, such as rashes, epilepsy, and meningitis.[5] Already Hippocrates, Aristotle, Celsus, Soranus, and Galen[6] understood the differences in growing and maturing organisms that necessitated different treatment: Ex toto non sic pueri ut viri curari debent ("In general, boys should not be treated in the same way as men").[7] Some of the oldest traces of pediatrics can be discovered in Ancient India where children's doctors were called kumara bhrtya.[6]

Even though some pediatric works existed during this time, they were scarce and rarely published due to a lack of knowledge in pediatric medicine. Sushruta Samhita, an ayurvedic text composed during the sixth century BCE, contains the text about pediatrics.[8] Another ayurvedic text from this period is Kashyapa Samhita.[9][10] A second century AD manuscript by the Greek physician and gynecologist Soranus of Ephesus dealt with neonatal pediatrics.[11] Byzantine physicians Oribasius, Aëtius of Amida, Alexander Trallianus, and Paulus Aegineta contributed to the field.[6] The Byzantines also built brephotrophia (crêches).[6] Islamic Golden Age writers served as a bridge for Greco-Roman and Byzantine medicine and added ideas of their own, especially Haly Abbas, Yahya Serapion, Abulcasis, Avicenna, and Averroes. The Persian philosopher and physician al-Razi (865–925), sometimes called the father of pediatrics, published a monograph on pediatrics titled Diseases in Children.[12][13] Also among the first books about pediatrics was Libellus [Opusculum] de aegritudinibus et remediis infantium 1472 ("Little Book on Children Diseases and Treatment"), by the Italian pediatrician Paolo Bagellardo.[14][5] In sequence came Bartholomäus Metlinger's Ein Regiment der Jungerkinder 1473, Cornelius Roelans (1450–1525) no title Buchlein, or Latin compendium, 1483, and Heinrich von Louffenburg (1391–1460) Versehung des Leibs written in 1429 (published 1491), together form the Pediatric Incunabula, four great medical treatises on children's physiology and pathology.[6]

While more information about childhood diseases became available, there was little evidence that children received the same kind of medical care that adults did.[15] It was during the seventeenth and eighteenth centuries that medical experts started offering specialized care for children.[5] The Swedish physician Nils Rosén von Rosenstein (1706–1773) is considered to be the founder of modern pediatrics as a medical specialty,[16][17] while his work The diseases of children, and their remedies (1764) is considered to be "the first modern textbook on the subject".[18] However, it was not until the nineteenth century that medical professionals acknowledged pediatrics as a separate field of medicine. The first pediatric-specific publications appeared between the 1790s and the 1920s.[19]

Etymology

[edit]

The term pediatrics was first introduced in English in 1859 by Abraham Jacobi. In 1860, he became "the first dedicated professor of pediatrics in the world."[20] Jacobi is known as the father of American pediatrics because of his many contributions to the field.[21][22] He received his medical training in Germany and later practiced in New York City.[23]

The first generally accepted pediatric hospital is the Hôpital des Enfants Malades (French: Hospital for Sick Children), which opened in Paris in June 1802 on the site of a previous orphanage.[24] From its beginning, this famous hospital accepted patients up to the age of fifteen years,[25] and it continues to this day as the pediatric division of the Necker-Enfants Malades Hospital, created in 1920 by merging with the nearby Necker Hospital, founded in 1778.[26]

In other European countries, the Charité (a hospital founded in 1710) in Berlin established a separate Pediatric Pavilion in 1830, followed by similar institutions at Saint Petersburg in 1834, and at Vienna and Breslau (now WrocÅ‚aw), both in 1837. In 1852 Britain's first pediatric hospital, the Hospital for Sick Children, Great Ormond Street was founded by Charles West.[24] The first Children's hospital in Scotland opened in 1860 in Edinburgh.[27] In the US, the first similar institutions were the Children's Hospital of Philadelphia, which opened in 1855, and then Boston Children's Hospital (1869).[28] Subspecialties in pediatrics were created at the Harriet Lane Home at Johns Hopkins by Edwards A. Park.[29]

Differences between adult and pediatric medicine

[edit]

The body size differences are paralleled by maturation changes. The smaller body of an infant or neonate is substantially different physiologically from that of an adult. Congenital defects, genetic variance, and developmental issues are of greater concern to pediatricians than they often are to adult physicians. A common adage is that children are not simply "little adults". The clinician must take into account the immature physiology of the infant or child when considering symptoms, prescribing medications, and diagnosing illnesses.[30]

Pediatric physiology directly impacts the pharmacokinetic properties of drugs that enter the body. The absorption, distribution, metabolism, and elimination of medications differ between developing children and grown adults.[30][31][32] Despite completed studies and reviews, continual research is needed to better understand how these factors should affect the decisions of healthcare providers when prescribing and administering medications to the pediatric population.[30]

Absorption

[edit]

Many drug absorption differences between pediatric and adult populations revolve around the stomach. Neonates and young infants have increased stomach pH due to decreased acid secretion, thereby creating a more basic environment for drugs that are taken by mouth.[31][30][32] Acid is essential to degrading certain oral drugs before systemic absorption. Therefore, the absorption of these drugs in children is greater than in adults due to decreased breakdown and increased preservation in a less acidic gastric space.[31]

Children also have an extended rate of gastric emptying, which slows the rate of drug absorption.[31][32]

Drug absorption also depends on specific enzymes that come in contact with the oral drug as it travels through the body. Supply of these enzymes increase as children continue to develop their gastrointestinal tract.[31][32] Pediatric patients have underdeveloped proteins, which leads to decreased metabolism and increased serum concentrations of specific drugs. However, prodrugs experience the opposite effect because enzymes are necessary for allowing their active form to enter systemic circulation.[31]

Distribution

[edit]

Percentage of total body water and extracellular fluid volume both decrease as children grow and develop with time. Pediatric patients thus have a larger volume of distribution than adults, which directly affects the dosing of hydrophilic drugs such as beta-lactam antibiotics like ampicillin.[31] Thus, these drugs are administered at greater weight-based doses or with adjusted dosing intervals in children to account for this key difference in body composition.[31][30]

Infants and neonates also have fewer plasma proteins. Thus, highly protein-bound drugs have fewer opportunities for protein binding, leading to increased distribution.[30]

Metabolism

[edit]

Drug metabolism primarily occurs via enzymes in the liver and can vary according to which specific enzymes are affected in a specific stage of development.[31] Phase I and Phase II enzymes have different rates of maturation and development, depending on their specific mechanism of action (i.e. oxidation, hydrolysis, acetylation, methylation, etc.). Enzyme capacity, clearance, and half-life are all factors that contribute to metabolism differences between children and adults.[31][32] Drug metabolism can even differ within the pediatric population, separating neonates and infants from young children.[30]

Elimination

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Drug elimination is primarily facilitated via the liver and kidneys.[31] In infants and young children, the larger relative size of their kidneys leads to increased renal clearance of medications that are eliminated through urine.[32] In preterm neonates and infants, their kidneys are slower to mature and thus are unable to clear as much drug as fully developed kidneys. This can cause unwanted drug build-up, which is why it is important to consider lower doses and greater dosing intervals for this population.[30][31] Diseases that negatively affect kidney function can also have the same effect and thus warrant similar considerations.[31]

Pediatric autonomy in healthcare

[edit]

A major difference between the practice of pediatric and adult medicine is that children, in most jurisdictions and with certain exceptions, cannot make decisions for themselves. The issues of guardianship, privacy, legal responsibility, and informed consent must always be considered in every pediatric procedure. Pediatricians often have to treat the parents and sometimes, the family, rather than just the child. Adolescents are in their own legal class, having rights to their own health care decisions in certain circumstances. The concept of legal consent combined with the non-legal consent (assent) of the child when considering treatment options, especially in the face of conditions with poor prognosis or complicated and painful procedures/surgeries, means the pediatrician must take into account the desires of many people, in addition to those of the patient.[citation needed]

History of pediatric autonomy

[edit]

The term autonomy is traceable to ethical theory and law, where it states that autonomous individuals can make decisions based on their own logic.[33] Hippocrates was the first to use the term in a medical setting. He created a code of ethics for doctors called the Hippocratic Oath that highlighted the importance of putting patients' interests first, making autonomy for patients a top priority in health care.[34]  

In ancient times, society did not view pediatric medicine as essential or scientific.[35] Experts considered professional medicine unsuitable for treating children. Children also had no rights. Fathers regarded their children as property, so their children's health decisions were entrusted to them.[5] As a result, mothers, midwives, "wise women", and general practitioners treated the children instead of doctors.[35] Since mothers could not rely on professional medicine to take care of their children, they developed their own methods, such as using alkaline soda ash to remove the vernix at birth and treating teething pain with opium or wine. The absence of proper pediatric care, rights, and laws in health care to prioritize children's health led to many of their deaths. Ancient Greeks and Romans sometimes even killed healthy female babies and infants with deformities since they had no adequate medical treatment and no laws prohibiting infanticide.[5]

In the twentieth century, medical experts began to put more emphasis on children's rights. In 1989, in the United Nations Rights of the Child Convention, medical experts developed the Best Interest Standard of Child to prioritize children's rights and best interests. This event marked the onset of pediatric autonomy. In 1995, the American Academy of Pediatrics (AAP) finally acknowledged the Best Interest Standard of a Child as an ethical principle for pediatric decision-making, and it is still being used today.[34]

Parental authority and current medical issues

[edit]

The majority of the time, parents have the authority to decide what happens to their child. Philosopher John Locke argued that it is the responsibility of parents to raise their children and that God gave them this authority. In modern society, Jeffrey Blustein, modern philosopher and author of the book Parents and Children: The Ethics of Family, argues that parental authority is granted because the child requires parents to satisfy their needs. He believes that parental autonomy is more about parents providing good care for their children and treating them with respect than parents having rights.[36] The researcher Kyriakos Martakis, MD, MSc, explains that research shows parental influence negatively affects children's ability to form autonomy. However, involving children in the decision-making process allows children to develop their cognitive skills and create their own opinions and, thus, decisions about their health. Parental authority affects the degree of autonomy the child patient has. As a result, in Argentina, the new National Civil and Commercial Code has enacted various changes to the healthcare system to encourage children and adolescents to develop autonomy. It has become more crucial to let children take accountability for their own health decisions.[37]

In most cases, the pediatrician, parent, and child work as a team to make the best possible medical decision. The pediatrician has the right to intervene for the child's welfare and seek advice from an ethics committee. However, in recent studies, authors have denied that complete autonomy is present in pediatric healthcare. The same moral standards should apply to children as they do to adults. In support of this idea is the concept of paternalism, which negates autonomy when it is in the patient's interests. This concept aims to keep the child's best interests in mind regarding autonomy. Pediatricians can interact with patients and help them make decisions that will benefit them, thus enhancing their autonomy. However, radical theories that question a child's moral worth continue to be debated today.[37] Authors often question whether the treatment and equality of a child and an adult should be the same. Author Tamar Schapiro notes that children need nurturing and cannot exercise the same level of authority as adults.[38] Hence, continuing the discussion on whether children are capable of making important health decisions until this day.

Modern advancements

[edit]

According to the Subcommittee of Clinical Ethics of the Argentinean Pediatric Society (SAP), children can understand moral feelings at all ages and can make reasonable decisions based on those feelings. Therefore, children and teens are deemed capable of making their own health decisions when they reach the age of 13. Recently, studies made on the decision-making of children have challenged that age to be 12.[37]

Technology has made several modern advancements that contribute to the future development of child autonomy, for example, unsolicited findings (U.F.s) of pediatric exome sequencing. They are findings based on pediatric exome sequencing that explain in greater detail the intellectual disability of a child and predict to what extent it will affect the child in the future. Genetic and intellectual disorders in children make them incapable of making moral decisions, so people look down upon this kind of testing because the child's future autonomy is at risk. It is still in question whether parents should request these types of testing for their children. Medical experts argue that it could endanger the autonomous rights the child will possess in the future. However, the parents contend that genetic testing would benefit the welfare of their children since it would allow them to make better health care decisions.[39] Exome sequencing for children and the decision to grant parents the right to request them is a medically ethical issue that many still debate today.

Education requirements

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Aspiring medical students will need 4 years of undergraduate courses at a college or university, which will get them a BS, BA or other bachelor's degree. After completing college, future pediatricians will need to attend 4 years of medical school (MD/DO/MBBS) and later do 3 more years of residency training, the first year of which is called "internship." After completing the 3 years of residency, physicians are eligible to become certified in pediatrics by passing a rigorous test that deals with medical conditions related to young children.[citation needed]

In high school, future pediatricians are required to take basic science classes such as biology, chemistry, physics, algebra, geometry, and calculus. It is also advisable to learn a foreign language (preferably Spanish in the United States) and be involved in high school organizations and extracurricular activities. After high school, college students simply need to fulfill the basic science course requirements that most medical schools recommend and will need to prepare to take the MCAT (Medical College Admission Test) in their junior or early senior year in college. Once attending medical school, student courses will focus on basic medical sciences like human anatomy, physiology, chemistry, etc., for the first three years, the second year of which is when medical students start to get hands-on experience with actual patients.[40]

Training of pediatricians

[edit]
Pediatrics
Occupation
Names
  • Pediatrician
  • Paediatrician
Occupation type
Specialty
Activity sectors
Medicine
Description
Education required
  • Doctor of Medicine
  • Doctor of Osteopathic Medicine
  • Bachelor of Medicine, Bachelor of Surgery (MBBS/MBChB)
Fields of
employment
Hospitals, Clinics

The training of pediatricians varies considerably across the world. Depending on jurisdiction and university, a medical degree course may be either undergraduate-entry or graduate-entry. The former commonly takes five or six years and has been usual in the Commonwealth. Entrants to graduate-entry courses (as in the US), usually lasting four or five years, have previously completed a three- or four-year university degree, commonly but by no means always in sciences. Medical graduates hold a degree specific to the country and university in and from which they graduated. This degree qualifies that medical practitioner to become licensed or registered under the laws of that particular country, and sometimes of several countries, subject to requirements for "internship" or "conditional registration".

Pediatricians must undertake further training in their chosen field. This may take from four to eleven or more years depending on jurisdiction and the degree of specialization.

In the United States, a medical school graduate wishing to specialize in pediatrics must undergo a three-year residency composed of outpatient, inpatient, and critical care rotations. Subspecialties within pediatrics require further training in the form of 3-year fellowships. Subspecialties include critical care, gastroenterology, neurology, infectious disease, hematology/oncology, rheumatology, pulmonology, child abuse, emergency medicine, endocrinology, neonatology, and others.[41]

In most jurisdictions, entry-level degrees are common to all branches of the medical profession, but in some jurisdictions, specialization in pediatrics may begin before completion of this degree. In some jurisdictions, pediatric training is begun immediately following the completion of entry-level training. In other jurisdictions, junior medical doctors must undertake generalist (unstreamed) training for a number of years before commencing pediatric (or any other) specialization. Specialist training is often largely under the control of 'pediatric organizations (see below) rather than universities and depends on the jurisdiction.

Subspecialties

[edit]

Subspecialties of pediatrics include:

(not an exhaustive list)

  • Addiction medicine (multidisciplinary)
  • Adolescent medicine
  • Child abuse pediatrics
  • Clinical genetics
  • Clinical informatics
  • Developmental-behavioral pediatrics
  • Headache medicine
  • Hospital medicine
  • Medical toxicology
  • Metabolic medicine
  • Neonatology/Perinatology
  • Pain medicine (multidisciplinary)
  • Palliative care (multidisciplinary)
  • Pediatric allergy and immunology
  • Pediatric cardiology
    • Pediatric cardiac critical care
  • Pediatric critical care
    • Neurocritical care
    • Pediatric cardiac critical care
  • Pediatric emergency medicine
  • Pediatric endocrinology
  • Pediatric gastroenterology
    • Transplant hepatology
  • Pediatric hematology
  • Pediatric infectious disease
  • Pediatric nephrology
  • Pediatric oncology
    • Pediatric neuro-oncology
  • Pediatric pulmonology
  • Primary care
  • Pediatric rheumatology
  • Sleep medicine (multidisciplinary)
  • Social pediatrics
  • Sports medicine

Other specialties that care for children

[edit]

(not an exhaustive list)

  • Child neurology
    • Addiction medicine (multidisciplinary)
    • Brain injury medicine
    • Clinical neurophysiology
    • Epilepsy
    • Headache medicine
    • Neurocritical care
    • Neuroimmunology
    • Neuromuscular medicine
    • Pain medicine (multidisciplinary)
    • Palliative care (multidisciplinary)
    • Pediatric neuro-oncology
    • Sleep medicine (multidisciplinary)
  • Child and adolescent psychiatry, subspecialty of psychiatry
  • Neurodevelopmental disabilities
  • Pediatric anesthesiology, subspecialty of anesthesiology
  • Pediatric dentistry, subspecialty of dentistry
  • Pediatric dermatology, subspecialty of dermatology
  • Pediatric gynecology
  • Pediatric neurosurgery, subspecialty of neurosurgery
  • Pediatric ophthalmology, subspecialty of ophthalmology
  • Pediatric orthopedic surgery, subspecialty of orthopedic surgery
  • Pediatric otolaryngology, subspecialty of otolaryngology
  • Pediatric plastic surgery, subspecialty of plastic surgery
  • Pediatric radiology, subspecialty of radiology
  • Pediatric rehabilitation medicine, subspecialty of physical medicine and rehabilitation
  • Pediatric surgery, subspecialty of general surgery
  • Pediatric urology, subspecialty of urology

See also

[edit]
  • American Academy of Pediatrics
  • American Osteopathic Board of Pediatrics
  • Center on Media and Child Health (CMCH)
  • Children's hospital
  • List of pediatric organizations
  • List of pediatrics journals
  • Medical specialty
  • Pediatric Oncall
  • Pain in babies
  • Royal College of Paediatrics and Child Health
  • Pediatric environmental health

References

[edit]
  1. ^ "Paediatrics" (PDF). nhs.uk. Archived (PDF) from the original on 13 July 2020. Retrieved 2 July 2020.
  2. ^ "Choosing a Pediatrician for Your New Baby (for Parents) - Nemours KidsHealth". kidshealth.org. Archived from the original on 14 July 2020. Retrieved 13 July 2020.
  3. ^ "Age limits of pediatrics". Pediatrics. 81 (5): 736. May 1988. doi:10.1542/peds.81.5.736. PMID 3357740. S2CID 245164191. Archived from the original on 19 April 2017. Retrieved 18 April 2017.
  4. ^ Sawyer, Susan M.; McNeil, Robyn; Francis, Kate L.; Matskarofski, Juliet Z.; Patton, George C.; Bhutta, Zulfiqar A.; Esangbedo, Dorothy O.; Klein, Jonathan D. (1 November 2019). "The age of paediatrics". The Lancet Child & Adolescent Health. 3 (11): 822–830. doi:10.1016/S2352-4642(19)30266-4. ISSN 2352-4642. PMID 31542355. S2CID 202732818.
  5. ^ a b c d e Duffin, Jacalyn (2010). History of Medicine, Second Edition: A Scandalously Short Introduction. University of Toronto Press.
  6. ^ a b c d e Colón, A. R.; Colón, P. A. (January 1999). Nurturing children: a history of pediatrics. Greenwood Press. ISBN 978-0-313-31080-5. Retrieved 20 October 2012.
  7. ^ Celsus, De Medicina, Book 3, Chapter 7, § 1.
  8. ^ John G. Raffensperger. Children's Surgery: A Worldwide History. McFarland. p. 21.
  9. ^ David Levinson; Karen Christensen. Encyclopedia of modern Asia. Vol. 4. Charles Scribner's Sons. p. 116.
  10. ^ Desai, A.B. Textbook Of Paediatrics. Orient blackswan. p. 1.
  11. ^ Dunn, P. M. (1995). "Soranus of Ephesus (Circa AD 98-138) and perinatal care in Roman times". Archives of Disease in Childhood. Fetal and Neonatal Edition. 73 (1): F51 – F52. doi:10.1136/fn.73.1.f51. PMC 2528358. PMID 7552600.
  12. ^ Elgood, Cyril (2010). A Medical History of Persia and The Eastern Caliphate (1st ed.). London: Cambridge. pp. 202–203. ISBN 978-1-108-01588-2. By writing a monograph on 'Diseases in Children' he may also be looked upon as the father of paediatrics.
  13. ^ U.S. National Library of Medicine, "Islamic Culture and the Medical Arts, Al-Razi, the Clinician" [1] Archived 5 January 2018 at the Wayback Machine
  14. ^ "Achar S Textbook Of Pediatrics (Third Edition)". A. B. Desai (ed.) (1989). p.1. ISBN 81-250-0440-8
  15. ^ Stern, Alexandra Minna; Markel, Howard (2002). Formative Years: Children's Health in the United States, 1880-2000. University of Michigan Press. pp. 23–24. doi:10.3998/mpub.17065. ISBN 978-0-472-02503-9. Archived from the original on 30 November 2021. Retrieved 30 November 2021.
  16. ^ Lock, Stephen; John M. Last; George Dunea (2001). The Oxford illustrated companion to medicine. Oxford University Press US. p. 173. ISBN 978-0-19-262950-0. Retrieved 9 July 2010. Rosen von Rosenstein.
  17. ^ Roberts, Michael (2003). The Age of Liberty: Sweden 1719–1772. Cambridge University Press. p. 216. ISBN 978-0-521-52707-1. Retrieved 9 July 2010.
  18. ^ Dallas, John. "Classics of Child Care". Royal College of Physicians of Edinburgh. Archived from the original on 27 July 2011. Retrieved 9 July 2010.
  19. ^ Duffin, Jacalyn (29 May 2010). History of Medicine, Second Edition: A Scandalously Short Introduction. University of Toronto Press.
  20. ^ Stern, Alexandra Minna; Markel, Howard (2002). Formative Years: Children's Health in the United States, 1880-2000. University of Michigan Press. pp. 23–24. doi:10.3998/mpub.17065. ISBN 978-0-472-02503-9. Archived from the original on 30 November 2021. Retrieved 30 November 2021.
  21. ^ "Broadribb's Introductory Pediatric Nursing". Nancy T. Hatfield (2007). p.4. ISBN 0-7817-7706-2
  22. ^ "Jacobi Medical Center - General Information". Archived from the original on 18 April 2006. Retrieved 6 April 2006.
  23. ^ Kutzsche, Stefan (8 April 2021). "Abraham Jacobi (1830–1919) and his transition from political to medical activist". Acta Paediatrica. 110 (8): 2303–2305. doi:10.1111/apa.15887. ISSN 0803-5253. PMID 33963612. S2CID 233998658. Archived from the original on 7 May 2023. Retrieved 7 May 2023.
  24. ^ a b Ballbriga, Angel (1991). "One century of pediatrics in Europe (section: development of pediatric hospitals in Europe)". In Nichols, Burford L.; et al. (eds.). History of Paediatrics 1850–1950. Nestlé Nutrition Workshop Series. Vol. 22. New York: Raven Press. pp. 6–8. ISBN 0-88167-695-0.
  25. ^ official history site (in French) of nineteenth century paediatric hospitals in Paris
  26. ^ "Introducing the Necker-Enfants Malades Hospital". Hôpital des Necker-Enfants Malades.
  27. ^ Young, D.G. (August 1999). "The Mason Brown Lecture: Scots and paediatric surgery". Journal of the Royal College of Surgeons Edinburgh. 44 (4): 211–5. PMID 10453141. Archived from the original on 14 July 2014.
  28. ^ Pearson, Howard A. (1991). "Pediatrics in the United States". In Nichols, Burford L.; et al. (eds.). History of Paediatrics 1850–1950. Nestlé Nutrition Workshop Series. Vol. 22. New York: Raven Press. pp. 55–63. ISBN 0-88167-695-0.
  29. ^ "Commentaries: Edwards A Park". Pediatrics. 44 (6). American Academy of Pediatrics: 897–901. 1969. doi:10.1542/peds.44.6.897. PMID 4903838. S2CID 43298798.
  30. ^ a b c d e f g h O'Hara, Kate (2016). "Paediatric pharmacokinetics and drug doses". Australian Prescriber. 39 (6): 208–210. doi:10.18773/austprescr.2016.071. ISSN 0312-8008. PMC 5155058. PMID 27990048.
  31. ^ a b c d e f g h i j k l m Wagner, Jonathan; Abdel-Rahman, Susan M. (2013). "Pediatric pharmacokinetics". Pediatrics in Review. 34 (6): 258–269. doi:10.1542/pir.34-6-258. ISSN 1526-3347. PMID 23729775.
  32. ^ a b c d e f Batchelor, Hannah Katharine; Marriott, John Francis (2015). "Paediatric pharmacokinetics: key considerations". British Journal of Clinical Pharmacology. 79 (3): 395–404. doi:10.1111/bcp.12267. ISSN 1365-2125. PMC 4345950. PMID 25855821.
  33. ^ Katz, Aviva L.; Webb, Sally A.; COMMITTEE ON BIOETHICS; Macauley, Robert C.; Mercurio, Mark R.; Moon, Margaret R.; Okun, Alexander L.; Opel, Douglas J.; Statter, Mindy B. (1 August 2016). "Informed Consent in Decision-Making in Pediatric Practice". Pediatrics. 138 (2): e20161485. doi:10.1542/peds.2016-1485. ISSN 0031-4005. PMID 27456510. S2CID 7951515.
  34. ^ a b Mazur, Kate A.; Berg, Stacey L., eds. (2020). Ethical Issues in Pediatric Hematology/Oncology. pp. 13–21. doi:10.1007/978-3-030-22684-8. ISBN 978-3-030-22683-1. S2CID 208302429.
  35. ^ a b Stern, Alexandra Minna; Markel, Howard (2002). Formative Years: Children's Health in the United States, 1880-2000. University of Michigan Press. pp. 23–24. doi:10.3998/mpub.17065. ISBN 978-0-472-02503-9. Archived from the original on 30 November 2021. Retrieved 30 November 2021.
  36. ^ Friedman, Lainie Ross (2004). Children, families, and health care decision making. Clarendon Press. ISBN 0-19-925154-1. OCLC 756393117.
  37. ^ a b c Martakis, K.; Schröder-Bäck, P.; Brand, H. (1 June 2018). "Developing child autonomy in pediatric healthcare: towards an ethical model". Archivos Argentinos de Pediatria. 116 (3): e401 – e408. doi:10.5546/aap.2018.eng.e401. ISSN 0325-0075. PMID 29756714. S2CID 46889502.
  38. ^ Schapiro, Tamar (1 July 1999). "What Is a Child?". Ethics. 109 (4): 715–738. doi:10.1086/233943. ISSN 0014-1704. S2CID 170129444. Archived from the original on 30 November 2021. Retrieved 30 November 2021.
  39. ^ Dondorp, W.; Bolt, I.; Tibben, A.; De Wert, G.; Van Summeren, M. (1 September 2021). "'We Should View Him as an Individual': The Role of the Child's Future Autonomy in Shared Decision-Making About Unsolicited Findings in Pediatric Exome Sequencing". Health Care Analysis. 29 (3): 249–261. doi:10.1007/s10728-020-00425-7. ISSN 1573-3394. PMID 33389383. S2CID 230112761.
  40. ^ "What Education Is Required to Be a Pediatrician?". Archived from the original on 7 June 2017. Retrieved 14 June 2017.
  41. ^ "CoPS". www.pedsubs.org. Archived from the original on 18 September 2013. Retrieved 14 August 2015.

Further reading

[edit]
  • BMC Pediatrics - open access
  • Clinical Pediatrics
  • Developmental Review - partial open access
  • JAMA Pediatrics
  • The Journal of Pediatrics - partial open access
[edit]
  • Pediatrics Directory at Curlie
  • Pediatric Health Directory at OpenMD

 

 

International children in traditional clothing at Liberty Weekend

A child (pl.children) is a human being between the stages of birth and puberty,[1][2] or between the developmental period of infancy and puberty.[3] The term may also refer to an unborn human being.[4][5] In English-speaking countries, the legal definition of child generally refers to a minor, in this case as a person younger than the local age of majority (there are exceptions like, for example, the consume and purchase of alcoholic beverage even after said age of majority[6]), regardless of their physical, mental and sexual development as biological adults.[1][7][8] Children generally have fewer rights and responsibilities than adults. They are generally classed as unable to make serious decisions.

Child may also describe a relationship with a parent (such as sons and daughters of any age)[9] or, metaphorically, an authority figure, or signify group membership in a clan, tribe, or religion; it can also signify being strongly affected by a specific time, place, or circumstance, as in "a child of nature" or "a child of the Sixties."[10]

[edit]
Children playing ball games, Roman artwork, 2nd century AD

In the biological sciences, a child is usually defined as a person between birth and puberty,[1][2] or between the developmental period of infancy and puberty.[3] Legally, the term child may refer to anyone below the age of majority or some other age limit.

The United Nations Convention on the Rights of the Child defines child as, "A human being below the age of 18 years unless under the law applicable to the child, majority is attained earlier."[11] This is ratified by 192 of 194 member countries. The term child may also refer to someone below another legally defined age limit unconnected to the age of majority. In Singapore, for example, a child is legally defined as someone under the age of 14 under the "Children and Young Persons Act" whereas the age of majority is 21.[12][13] In U.S. Immigration Law, a child refers to anyone who is under the age of 21.[14]

Some English definitions of the word child include the fetus (sometimes termed the unborn).[15] In many cultures, a child is considered an adult after undergoing a rite of passage, which may or may not correspond to the time of puberty.

Children generally have fewer rights than adults and are classed as unable to make serious decisions, and legally must always be under the care of a responsible adult or child custody, whether their parents divorce or not.

Developmental stages of childhood

[edit]

Early childhood

[edit]
Children playing the violin in a group recital, Ithaca, New York, 2011
Children in Madagascar, 2011
Child playing piano, 1984

Early childhood follows the infancy stage and begins with toddlerhood when the child begins speaking or taking steps independently.[16][17] While toddlerhood ends around age 3 when the child becomes less dependent on parental assistance for basic needs, early childhood continues approximately until the age of 5 or 6. However, according to the National Association for the Education of Young Children, early childhood also includes infancy. At this stage children are learning through observing, experimenting and communicating with others. Adults supervise and support the development process of the child, which then will lead to the child's autonomy. Also during this stage, a strong emotional bond is created between the child and the care providers. The children also start preschool and kindergarten at this age: and hence their social lives.

Middle childhood

[edit]

Middle childhood begins at around age 7, and ends at around age 9 or 10.[18] Together, early and middle childhood are called formative years. In this middle period, children develop socially and mentally. They are at a stage where they make new friends and gain new skills, which will enable them to become more independent and enhance their individuality. During middle childhood, children enter the school years, where they are presented with a different setting than they are used to. This new setting creates new challenges and faces for children.[19] Upon the entrance of school, mental disorders that would normally not be noticed come to light. Many of these disorders include: autism, dyslexia, dyscalculia, and ADHD.[20]: 303–309  Special education, least restrictive environment, response to intervention and individualized education plans are all specialized plans to help children with disabilities.[20]: 310–311 

Middle childhood is the time when children begin to understand responsibility and are beginning to be shaped by their peers and parents. Chores and more responsible decisions come at this time, as do social comparison and social play.[20]: 338  During social play, children learn from and teach each other, often through observation.[21]

Late childhood

[edit]

Preadolescence is a stage of human development following early childhood and preceding adolescence. Preadolescence is commonly defined as ages 9–12, ending with the major onset of puberty, with markers such as menarche, spermarche, and the peak of height velocity occurring. These changes usually occur between ages 11 and 14. It may also be defined as the 2-year period before the major onset of puberty.[22] Preadolescence can bring its own challenges and anxieties. Preadolescent children have a different view of the world from younger children in many significant ways. Typically, theirs is a more realistic view of life than the intense, fantasy-oriented world of earliest childhood. Preadolescents have more mature, sensible, realistic thoughts and actions: 'the most "sensible" stage of development...the child is a much less emotional being now.'[23] Preadolescents may well view human relationships differently (e.g. they may notice the flawed, human side of authority figures). Alongside that, they may begin to develop a sense of self-identity, and to have increased feelings of independence: 'may feel an individual, no longer "just one of the family."'[24]

Developmental stages post-childhood

[edit]

Adolescence

[edit]
An adolescent girl, photographed by Paolo Monti

Adolescence is usually determined to be between the onset of puberty and legal adulthood: mostly corresponding to the teenage years (13–19). However, puberty usually begins before the teenage years (10—11 for girls and 11—12 for boys). Although biologically a child is a human being between the stages of birth and puberty,[1][2] adolescents are legally considered children, as they tend to lack adult rights and are still required to attend compulsory schooling in many cultures, though this varies. The onset of adolescence brings about various physical, psychological and behavioral changes. The end of adolescence and the beginning of adulthood varies by country and by function, and even within a single nation-state or culture there may be different ages at which an individual is considered to be mature enough to be entrusted by society with certain tasks.

History

[edit]
Playing Children, by Song dynasty Chinese artist Su Hanchen, c. 1150 AD.

During the European Renaissance, artistic depictions of children increased dramatically, which did not have much effect on the social attitude toward children, however.[25]

The French historian Philippe Ariès argued that during the 1600s, the concept of childhood began to emerge in Europe,[26] however other historians like Nicholas Orme have challenged this view and argued that childhood has been seen as a separate stage since at least the medieval period.[27] Adults saw children as separate beings, innocent and in need of protection and training by the adults around them. The English philosopher John Locke was particularly influential in defining this new attitude towards children, especially with regard to his theory of the tabula rasa, which considered the mind at birth to be a "blank slate". A corollary of this doctrine was that the mind of the child was born blank, and that it was the duty of the parents to imbue the child with correct notions. During the early period of capitalism, the rise of a large, commercial middle class, mainly in the Protestant countries of the Dutch Republic and England, brought about a new family ideology centred around the upbringing of children. Puritanism stressed the importance of individual salvation and concern for the spiritual welfare of children.[28]

The Age of Innocence c. 1785/8. Reynolds emphasized the natural grace of children in his paintings.

The modern notion of childhood with its own autonomy and goals began to emerge during the 18th-century Enlightenment and the Romantic period that followed it.[29][30] Jean Jacques Rousseau formulated the romantic attitude towards children in his famous 1762 novel Emile: or, On Education. Building on the ideas of John Locke and other 17th-century thinkers, Jean-Jaques Rousseau described childhood as a brief period of sanctuary before people encounter the perils and hardships of adulthood.[29] Sir Joshua Reynolds' extensive children portraiture demonstrated the new enlightened attitudes toward young children. His 1788 painting The Age of Innocence emphasizes the innocence and natural grace of the posing child and soon became a public favourite.[31]

Brazilian princesses Leopoldina (left) and Isabel (center) with an unidentified friend, c. 1860.

The idea of childhood as a locus of divinity, purity, and innocence is further expounded upon in William Wordsworth's "Ode: Intimations of Immortality from Recollections of Early Childhood", the imagery of which he "fashioned from a complex mix of pastoral aesthetics, pantheistic views of divinity, and an idea of spiritual purity based on an Edenic notion of pastoral innocence infused with Neoplatonic notions of reincarnation".[30] This Romantic conception of childhood, historian Margaret Reeves suggests, has a longer history than generally recognized, with its roots traceable to similarly imaginative constructions of childhood circulating, for example, in the neo-platonic poetry of seventeenth-century metaphysical poet Henry Vaughan (e.g., "The Retreate", 1650; "Childe-hood", 1655). Such views contrasted with the stridently didactic, Calvinist views of infant depravity.[32]

Armenian scouts in 1918

With the onset of industrialisation in England in 1760, the divergence between high-minded romantic ideals of childhood and the reality of the growing magnitude of child exploitation in the workplace, became increasingly apparent. By the late 18th century, British children were specially employed in factories and mines and as chimney sweeps,[33] often working long hours in dangerous jobs for low pay.[34] As the century wore on, the contradiction between the conditions on the ground for poor children and the middle-class notion of childhood as a time of simplicity and innocence led to the first campaigns for the imposition of legal protection for children.

British reformers attacked child labor from the 1830s onward, bolstered by the horrific descriptions of London street life by Charles Dickens.[35] The campaign eventually led to the Factory Acts, which mitigated the exploitation of children at the workplace[33][36]

Modern concepts of childhood

[edit]
Children play in a fountain in a summer evening, Davis, California.
An old man and his granddaughter in Turkey.
Nepalese children playing with cats.
Harari girls in Ethiopia.

The modern attitude to children emerged by the late 19th century; the Victorian middle and upper classes emphasized the role of the family and the sanctity of the child – an attitude that has remained dominant in Western societies ever since.[37] The genre of children's literature took off, with a proliferation of humorous, child-oriented books attuned to the child's imagination. Lewis Carroll's fantasy Alice's Adventures in Wonderland, published in 1865 in England, was a landmark in the genre; regarded as the first "English masterpiece written for children", its publication opened the "First Golden Age" of children's literature.

The latter half of the 19th century saw the introduction of compulsory state schooling of children across Europe, which decisively removed children from the workplace into schools.[38][39]

The market economy of the 19th century enabled the concept of childhood as a time of fun, happiness, and imagination. Factory-made dolls and doll houses delighted the girls and organized sports and activities were played by the boys.[40] The Boy Scouts was founded by Sir Robert Baden-Powell in 1908,[41][42] which provided young boys with outdoor activities aiming at developing character, citizenship, and personal fitness qualities.[43]

In the 20th century, Philippe Ariès, a French historian specializing in medieval history, suggested that childhood was not a natural phenomenon, but a creation of society in his 1960 book Centuries of Childhood. In 1961 he published a study of paintings, gravestones, furniture, and school records, finding that before the 17th century, children were represented as mini-adults.

In 1966, the American philosopher George Boas published the book The Cult of Childhood. Since then, historians have increasingly researched childhood in past times.[44]

In 2006, Hugh Cunningham published the book Invention of Childhood, looking at British childhood from the year 1000, the Middle Ages, to what he refers to as the Post War Period of the 1950s, 1960s and 1970s.[45]

Childhood evolves and changes as lifestyles change and adult expectations alter. In the modern era, many adults believe that children should not have any worries or work, as life should be happy and trouble-free. Childhood is seen as a mixture of simplicity, innocence, happiness, fun, imagination, and wonder. It is thought of as a time of playing, learning, socializing, exploring, and worrying in a world without much adult interference.[29][30]

A "loss of innocence" is a common concept, and is often seen as an integral part of coming of age. It is usually thought of as an experience or period in a child's life that widens their awareness of evil, pain or the world around them. This theme is demonstrated in the novels To Kill a Mockingbird and Lord of the Flies. The fictional character Peter Pan was the embodiment of a childhood that never ends.[46][47]

Healthy childhoods

[edit]

Role of parents

[edit]

Children's health

[edit]

Children's health includes the physical, mental and social well-being of children. Maintaining children's health implies offering them healthy foods, insuring they get enough sleep and exercise, and protecting their safety.[48] Children in certain parts of the world often suffer from malnutrition, which is often associated with other conditions, such diarrhea, pneumonia and malaria.[49]

Child protection

[edit]

Child protection, according to UNICEF, refers to "preventing and responding to violence, exploitation and abuse against children – including commercial sexual exploitation, trafficking, child labour and harmful traditional practices, such as female genital mutilation/cutting and child marriage".[50] The Convention on the Rights of the Child protects the fundamental rights of children.

Play

[edit]
Dancing at Mother of Peace AIDs orphanage, Zimbabwe

Play is essential to the cognitive, physical, social, and emotional well-being of children.[51] It offers children opportunities for physical (running, jumping, climbing, etc.), intellectual (social skills, community norms, ethics and general knowledge) and emotional development (empathy, compassion, and friendships). Unstructured play encourages creativity and imagination. Playing and interacting with other children, as well as some adults, provides opportunities for friendships, social interactions, conflicts and resolutions. However, adults tend to (often mistakenly) assume that virtually all children's social activities can be understood as "play" and, furthermore, that children's play activities do not involve much skill or effort.[52][53][54][55]

It is through play that children at a very early age engage and interact in the world around them. Play allows children to create and explore a world they can master, conquering their fears while practicing adult roles, sometimes in conjunction with other children or adult caregivers.[51] Undirected play allows children to learn how to work in groups, to share, to negotiate, to resolve conflicts, and to learn self-advocacy skills. However, when play is controlled by adults, children acquiesce to adult rules and concerns and lose some of the benefits play offers them. This is especially true in developing creativity, leadership, and group skills.[51]

Ralph Hedley, The Tournament, 1898. It depicts poorer boys playing outdoors in a rural part of the Northeast of England.

Play is considered to be very important to optimal child development that it has been recognized by the United Nations Commission on Human Rights as a right of every child.[11] Children who are being raised in a hurried and pressured style may limit the protective benefits they would gain from child-driven play.[51]

The initiation of play in a classroom setting allows teachers and students to interact through playfulness associated with a learning experience. Therefore, playfulness aids the interactions between adults and children in a learning environment. “Playful Structure” means to combine informal learning with formal learning to produce an effective learning experience for children at a young age.[56]

Even though play is considered to be the most important to optimal child development, the environment affects their play and therefore their development. Poor children confront widespread environmental inequities as they experience less social support, and their parents are less responsive and more authoritarian. Children from low income families are less likely to have access to books and computers which would enhance their development.[57]

Street culture

[edit]
Children in front of a movie theatre, Toronto, 1920s.

Children's street culture refers to the cumulative culture created by young children and is sometimes referred to as their secret world. It is most common in children between the ages of seven and twelve. It is strongest in urban working class industrial districts where children are traditionally free to play out in the streets for long periods without supervision. It is invented and largely sustained by children themselves with little adult interference.

Young children's street culture usually takes place on quiet backstreets and pavements, and along routes that venture out into local parks, playgrounds, scrub and wasteland, and to local shops. It often imposes imaginative status on certain sections of the urban realm (local buildings, kerbs, street objects, etc.). Children designate specific areas that serve as informal meeting and relaxation places (see: Sobel, 2001). An urban area that looks faceless or neglected to an adult may have deep 'spirit of place' meanings in to children. Since the advent of indoor distractions such as video games, and television, concerns have been expressed about the vitality – or even the survival – of children's street culture.

Geographies of childhood

[edit]

The geographies of childhood involves how (adult) society perceives the idea of childhood, the many ways adult attitudes and behaviors affect children's lives, including the environment which surrounds children and its implications.[58]

The geographies of childhood is similar in some respects to children's geographies which examines the places and spaces in which children live.[59]

Nature deficit disorder

[edit]

Nature Deficit Disorder, a term coined by Richard Louv in his 2005 book Last Child in the Woods, refers to the trend in the United States and Canada towards less time for outdoor play,[60][61] resulting in a wide range of behavioral problems.[62]

With increasing use of cellphones, computers, video games and television, children have more reasons to stay inside rather than outdoors exploring. “The average American child spends 44 hours a week with electronic media”.[63] Research in 2007 has drawn a correlation between the declining number of National Park visits in the U.S. and increasing consumption of electronic media by children.[64] The media has accelerated the trend for children's nature disconnection by deemphasizing views of nature, as in Disney films.[65]

Age of responsibility

[edit]

The age at which children are considered responsible for their society-bound actions (e. g. marriage, voting, etc.) has also changed over time,[66] and this is reflected in the way they are treated in courts of law. In Roman times, children were regarded as not culpable for crimes, a position later adopted by the Church. In the 19th century, children younger than seven years old were believed incapable of crime. Children from the age of seven forward were considered responsible for their actions. Therefore, they could face criminal charges, be sent to adult prison, and be punished like adults by whipping, branding or hanging. However, courts at the time would consider the offender's age when deliberating sentencing.[citation needed] Minimum employment age and marriage age also vary. The age limit of voluntary/involuntary military service is also disputed at the international level.[67]

Education

[edit]
Children in an outdoor classroom in Bié, Angola
Children seated in a Finnish classroom at the school of Torvinen in Sodankylä, Finland, in the 1920s

Education, in the general sense, refers to the act or process of imparting or acquiring general knowledge, developing the powers of reasoning and judgment, and preparing intellectually for mature life.[68] Formal education most often takes place through schooling. A right to education has been recognized by some governments. At the global level, Article 13 of the United Nations' 1966 International Covenant on Economic, Social and Cultural Rights (ICESCR) recognizes the right of everyone to an education.[69] Education is compulsory in most places up to a certain age, but attendance at school may not be, with alternative options such as home-schooling or e-learning being recognized as valid forms of education in certain jurisdictions.

Children in some countries (especially in parts of Africa and Asia) are often kept out of school, or attend only for short periods. Data from UNICEF indicate that in 2011, 57 million children were out of school; and more than 20% of African children have never attended primary school or have left without completing primary education.[70] According to a UN report, warfare is preventing 28 million children worldwide from receiving an education, due to the risk of sexual violence and attacks in schools.[71] Other factors that keep children out of school include poverty, child labor, social attitudes, and long distances to school.[72][73]

Attitudes toward children

[edit]
Group of breaker boys in Pittston, Pennsylvania, 1911. Child labor was widespread until the early 20th century. In the 21st century, child labor rates are highest in Africa.

Social attitudes toward children differ around the world in various cultures and change over time. A 1988 study on European attitudes toward the centrality of children found that Italy was more child-centric and the Netherlands less child-centric, with other countries, such as Austria, Great Britain, Ireland and West Germany falling in between.[74]

Child marriage

[edit]

In 2013, child marriage rates of female children under the age of 18 reached 75% in Niger, 68% in Central African Republic and Chad, 66% in Bangladesh, and 47% in India.[75] According to a 2019 UNICEF report on child marriage, 37% of females were married before the age of 18 in sub-Saharan Africa, followed by South Asia at 30%. Lower levels were found in Latin America and Caribbean (25%), the Middle East and North Africa (18%), and Eastern Europe and Central Asia (11%), while rates in Western Europe and North America were minimal.[76] Child marriage is more prevalent with girls, but also involves boys. A 2018 study in the journal Vulnerable Children and Youth Studies found that, worldwide, 4.5% of males are married before age 18, with the Central African Republic having the highest average rate at 27.9%.[77]

Fertility and number of children per woman

[edit]

Before contraception became widely available in the 20th century, women had little choice other than abstinence or having often many children. In fact, current population growth concerns have only become possible with drastically reduced child mortality and sustained fertility. In 2017 the global total fertility rate was estimated to be 2.37 children per woman,[78] adding about 80 million people to the world population per year. In order to measure the total number of children, scientists often prefer the completed cohort fertility at age 50 years (CCF50).[78] Although the number of children is also influenced by cultural norms, religion, peer pressure and other social factors, the CCF50 appears to be most heavily dependent on the educational level of women, ranging from 5–8 children in women without education to less than 2 in women with 12 or more years of education.[78]

Issues

[edit]

Emergencies and conflicts

[edit]

Emergencies and conflicts pose detrimental risks to the health, safety, and well-being of children. There are many different kinds of conflicts and emergencies, e.g. wars and natural disasters. As of 2010 approximately 13 million children are displaced by armed conflicts and violence around the world.[79] Where violent conflicts are the norm, the lives of young children are significantly disrupted and their families have great difficulty in offering the sensitive and consistent care that young children need for their healthy development.[79] Studies on the effect of emergencies and conflict on the physical and mental health of children between birth and 8 years old show that where the disaster is natural, the rate of PTSD occurs in anywhere from 3 to 87 percent of affected children.[80] However, rates of PTSD for children living in chronic conflict conditions varies from 15 to 50 percent.[81][82]

Child protection

[edit]
 

Child protection (also called child welfare) is the safeguarding of children from violence, exploitation, abuse, abandonment, and neglect.[83][84][85][86] It involves identifying signs of potential harm. This includes responding to allegations or suspicions of abuse, providing support and services to protect children, and holding those who have harmed them accountable.[87]

The primary goal of child protection is to ensure that all children are safe and free from harm or danger.[86][88] Child protection also works to prevent future harm by creating policies and systems that identify and respond to risks before they lead to harm.[89]

In order to achieve these goals, research suggests that child protection services should be provided in a holistic way.[90][91][92] This means taking into account the social, economic, cultural, psychological, and environmental factors that can contribute to the risk of harm for individual children and their families. Collaboration across sectors and disciplines to create a comprehensive system of support and safety for children is required.[93][94]

It is the responsibility of individuals, organizations, and governments to ensure that children are protected from harm and their rights are respected.[95] This includes providing a safe environment for children to grow and develop, protecting them from physical, emotional and sexual abuse, and ensuring they have access to education, healthcare, and resources to fulfill their basic needs.[96]

Child protection systems are a set of services, usually government-run, designed to protect children and young people who are underage and to encourage family stability. UNICEF defines[97] a 'child protection system' as:

"The set of laws, policies, regulations and services needed across all social sectors – especially social welfare, education, health, security and justice – to support prevention and response to protection-related risks. These systems are part of social protection, and extend beyond it. At the level of prevention, their aim includes supporting and strengthening families to reduce social exclusion, and to lower the risk of separation, violence and exploitation. Responsibilities are often spread across government agencies, with services delivered by local authorities, non-State providers, and community groups, making coordination between sectors and levels, including routine referral systems etc.., a necessary component of effective child protection systems."

— United Nations Economic and Social Council (2008), UNICEF Child Protection Strategy, E/ICEF/2008/5/Rev.1, par. 12–13.

Under Article 19 of the UN Convention on the Rights of the Child, a 'child protection system' provides for the protection of children in and out of the home. One of the ways this can be enabled is through the provision of quality education, the fourth of the United Nations Sustainable Development Goals, in addition to other child protection systems. Some literature argues that child protection begins at conception; even how the conception took place can affect the child's development.[98]

Child abuse and child labor

[edit]

Protection of children from abuse is considered an important contemporary goal. This includes protecting children from exploitation such as child labor, child trafficking and child selling, child sexual abuse, including child prostitution and child pornography, military use of children, and child laundering in illegal adoptions. There exist several international instruments for these purposes, such as:

  • Worst Forms of Child Labour Convention
  • Minimum Age Convention, 1973
  • Optional Protocol on the Sale of Children, Child Prostitution and Child Pornography
  • Council of Europe Convention on the Protection of Children against Sexual Exploitation and Sexual Abuse
  • Optional Protocol on the Involvement of Children in Armed Conflict
  • Hague Adoption Convention

Climate change

[edit]
 
A child at a climate demonstration in Juneau, Alaska

Children are more vulnerable to the effects of climate change than adults. The World Health Organization estimated that 88% of the existing global burden of disease caused by climate change affects children under five years of age.[99] A Lancet review on health and climate change lists children as the worst-affected category by climate change.[100] Children under 14 are 44 percent more likely to die from environmental factors,[101] and those in urban areas are disproportionately impacted by lower air quality and overcrowding.[102]

Children are physically more vulnerable to climate change in all its forms.[103] Climate change affects the physical health of children and their well-being. Prevailing inequalities, between and within countries, determine how climate change impacts children.[104] Children often have no voice in terms of global responses to climate change.[103]

People living in low-income countries experience a higher burden of disease and are less capable of coping with climate change-related threats.[105] Nearly every child in the world is at risk from climate change and pollution, while almost half are at extreme risk.[106]

Health

[edit]

Child mortality

[edit]
World infant mortality rates in 2012.[107]

During the early 17th century in England, about two-thirds of all children died before the age of four.[108] During the Industrial Revolution, the life expectancy of children increased dramatically.[109] This has continued in England, and in the 21st century child mortality rates have fallen across the world. About 12.6 million under-five infants died worldwide in 1990, which declined to 6.6 million in 2012. The infant mortality rate dropped from 90 deaths per 1,000 live births in 1990, to 48 in 2012. The highest average infant mortality rates are in sub-Saharan Africa, at 98 deaths per 1,000 live births – over double the world's average.[107]

See also

[edit]
Listen to this article (3 minutes)
 
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This audio file was created from a revision of this article dated 24 June 2008 (2008-06-24), and does not reflect subsequent edits.
  • Outline of childhood
  • Child slavery
  • Childlessness
  • Depression in childhood and adolescence
  • One-child policy
  • Religion and children
  • Youth rights
  • Archaeology of childhood

Sources

[edit]
  •  This article incorporates text from a free content work. Licensed under CC-BY-SA IGO 3.0 (license statement/permission). Text taken from Investing against Evidence: The Global State of Early Childhood Care and Education​, 118–125, Marope PT, Kaga Y, UNESCO. UNESCO.
  •  This article incorporates text from a free content work. Licensed under CC-BY-SA IGO 3.0 (license statement/permission). Text taken from Creating sustainable futures for all; Global education monitoring report, 2016; Gender review​, 20, UNESCO, UNESCO. UNESCO.

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Further reading

[edit]
  • Cook, Daniel Thomas. The moral project of childhood: Motherhood, material life, and early children's consumer culture (NYU Press, 2020). online book see also online review
  • Fawcett, Barbara, Brid Featherstone, and Jim Goddard. Contemporary child care policy and practice (Bloomsbury Publishing, 2017) online
  • Hutchison, Elizabeth D., and Leanne W. Charlesworth. "Securing the welfare of children: Policies past, present, and future." Families in Society 81.6 (2000): 576–585.
  • Fass, Paula S. The end of American childhood: A history of parenting from life on the frontier to the managed child (Princeton University Press, 2016).
  • Fass, Paula S. ed. The Routledge History of Childhood in the Western World (2012) online
  • Klass, Perri. The Best Medicine: How Science and Public Health Gave Children a Future (WW Norton & Company, 2020) online
  • Michail, Samia. "Understanding school responses to students’ challenging behaviour: A review of literature." Improving schools 14.2 (2011): 156–171. online
  • Sorin, Reesa. Changing images of childhood: Reconceptualising early childhood practice (Faculty of Education, University of Melbourne, 2005) online.
  • Sorin, Reesa. "Childhood through the eyes of the child and parent." Journal of Australian Research in Early Childhood Education 14.1 (2007). online
  • Vissing, Yvonne. "History of Children’s Human Rights in the USA." in Children's Human Rights in the USA: Challenges and Opportunities (Cham: Springer International Publishing, 2023) pp. 181–212.
  • Yuen, Francis K.O. Social work practice with children and families: a family health approach (Routledge, 2014) online.
Preceded by
Toddlerhood
Stages of human development
Childhood
Succeeded by
Preadolescence

 

Frequently Asked Questions

A malocclusion is a misalignment or incorrect relation between the teeth of the two dental arches when they approach each other as the jaws close. It can affect a childs ability to chew properly, speak clearly, and may impact their self-esteem due to aesthetic concerns.
The American Association of Orthodontists recommends that children have their first orthodontic check-up no later than age 7. Early evaluation allows for timely intervention if necessary.
Common types include overbite (upper teeth excessively overlap the lower teeth), underbite (lower teeth protrude past the upper teeth), crossbite (upper teeth fit inside the lower teeth), and overcrowding (too many teeth for the dental arch to accommodate).
Treatment options can include orthodontic appliances such as braces or aligners, removable devices like headgear or palate expanders, and in some cases, surgical intervention if the malocclusion is severe.
The duration of treatment varies depending on the severity of the malocclusion and the chosen treatment method. On average, orthodontic treatment can last from 1 to 3 years, with regular follow-up appointments to monitor progress.