Formation | 1930 |
---|---|
Type | Professional association |
Headquarters | Itasca, Illinois, United States |
Coordinates | 42°02′12″N87°58′58″W / 42.0366°N 87.9827°W |
Membership | 67,000 |
Official language | English |
AAP President | Sandy L. Chung, MD, FAAP |
Staff | 390 |
Website | www |
The American Academy of Pediatrics (AAP) is the largest professional association of pediatricians in the United States. [1] It is headquartered in Itasca, Illinois, and maintains an office in Washington, D.C. [2] The AAP has published hundreds of policy statements, ranging from advocacy issues to practice recommendations.
The Academy was founded in 1930 by 35 pediatricians to address pediatric healthcare standards. [3] As of 2022 [update] , it has 67,000 members in primary care and sub-specialist areas. [4] Qualified pediatricians can become fellows (FAAP). [5] The Academy runs continuing medical education (CME) programs for pediatricians and sub-specialists. The Academy is divided into 14 departments and 26 divisions. [6]
It has the largest pediatric publishing program in the world, with more than 300 titles for consumers and over 500 titles for physicians and other healthcare professionals. These publications include electronic products, professional references, medical textbooks, practice management publications, patient education materials, and parenting books. [7] The AAP News is the academy's official news magazine, [8] and Pediatrics is its flagship journal. [9]
The AAP issues a weekly report [10] on COVID-19 cases in the United States. States began reporting COVID-19 cases on September 17, 2020. The AAP tracked 587,948 child COVID-19 cases, 5,016 child hospitalizations, and 109 child deaths. [11]
In 2006, the Academy received a grant from the Flight Attendant Medical Research Institute (FAMRI) to plan and establish a Center of Excellence dedicated to the elimination of children's exposure to tobacco and secondhand smoke. The Richmond Center was established to help institutionalize pediatric tobacco control activities at AAP and was named in honor of Julius B. Richmond, MD, Chair of the FAMRI Medical Advisory Board and former Surgeon General of the United States Public Health Service. The Center provides the education, training, and tools needed to protect children from tobacco and secondhand smoke.[ citation needed ]
The Academy has published hundreds of policy statements, ranging from advocacy issues to practice recommendations. The academy's policy website contains all current Academy policies and clinical reports. [12] The AAP policy regarding its statements is to give each statement a five-year life, after which the statement expires unless it is reaffirmed.
The AAP is supportive of abortion rights and criticized the overturning of Roe v. Wade . [13] In June 2022, they stated that adolescents "should have the right to receive legal and confidential medical and surgical abortion care and counseling" and that "[ Dobbs v. Jackson] means that in many places in the United States, this evidence-based care will be difficult or impossible to access, threatening the health and safety of our patients and jeopardizing the patient-physician relationship". [13]
The AAP has changed positions on its age limit throughout the years. In 1988, the American Academy of Pediatrics published a statement on the age limit of pediatrics that identified the upper age limit of pediatrics as age 21. The policy had a note that exceptions could always be made when the doctor and family jointly agree to an older age. [14]
Recent studies have shown that the age of 21 years is just an arbitrary line for adolescence, because brain development does not fully reach adult levels of functioning until the early 30s. In a 2017 policy update, AAP changed its policy to discourage age limits of pediatric providers and instead have families reach an agreement with their pediatric provider as to when to transition care. [15]
In 2009, the national office and four of its State chapters provided training support to 49 pediatric practices to improve adherence to well-established asthma care guidelines. The percentage of patients at participating practices with well-controlled asthma (as defined by the National Heart, Lung, and Blood Institute) rose from 58 to 72 percent. [16]
The AAP periodically issues guidance for child passenger safety, including policy recommendations for transitioning between rear-facing car seats, front-facing car seats, belt-positioning booster seats, and vehicle safety belts. [17] These recommendations are typically published in the peer-reviewed scientific journal Pediatrics. [18] [19]
Previously, the AAP recommended that children remain rear-facing until they are two years of age. [18] In response to updated crash test, simulation, and field data, the AAP revised their guidance to exclude the age guideline entirely. [20] Current AAP Child Passenger Safety recommendations (as of August 30,2018 [update] ) state that children should remain in a rear-facing car seat for as long as possible, until they meet the maximum height or weight dictated by the car seat manufacturer. [19]
On June 29, 2020, AAP stated that it "strongly advocates that all policy considerations for the coming school year should start with a goal of having students physically present in school" as remote learning during the COVID-19 pandemic in the United States made it more difficult for education professionals to notice learning deficits, physical and sexual abuse, depression and suicidal ideation. The AAP argued that masks are probably not practical for children younger than middle school unless they can wear a mask without increased face touching. Teachers' unions opposed the AAP statement, however, saying "Our educators are overwhelmingly not comfortable returning to schools ... They fear for their lives, the lives of their students and the lives of their families." [21] Two weeks later, the AAP walked back its support, under political pressure from teachers and other groups. [22] The then-president Donald Trump cited AAP's original statement repeatedly, pressuring school leaders to reopen schools. [22]
In its 2020 statement in Pediatrics, the AAP called for banning all digital advertising that was targeted to children under the age of 7 and urged limits to advertising aimed at people under 17. This aimed to protect kids from digital tracking on social media, Tv and video games. [23]
In a 2012 position statement, the academy stated that a systematic evaluation of the medical literature shows that the "preventive health benefits of elective circumcision of male newborns outweigh the risks of the procedure" and that the health benefits "are sufficient to justify access to this procedure for families choosing it and to warrant third-party payment for circumcision of male newborns", but "are not great enough to recommend routine circumcision for all male newborns". The academy takes the position that parents should make the final decision about circumcision after appropriate information is gathered about the risks and benefits of the procedure. [24]
Electronic nicotine delivery systems (electronic cigarettes, e-hookahs, vape pens, others) are highly addictive and often candy-flavored products that are rapidly rising in popularity among middle and high school students, and appear to be serving as a gateway to other forms of tobacco, and threaten to addict a new generation to nicotine. [25]
The American Academy of Pediatrics says that although firearms-related deaths in the US have dropped since the 1990s, guns were used in more than 80 percent of teen homicides in 2009 and were the most common suicide method among US teens. [26] The AAP believes pediatricians should discuss guns and gun safety with parents before babies are born and at children's annual exams. [27] It also advocates for, among other things, more background checks, an assault weapons ban, and more federal research on gun violence. [28] [29]
The AAP warns of possible marijuana damage to children and adolescents. [30] In states that have already legalized marijuana, the Academy recommends that pediatricians and regulators treat it as they would tobacco. The Academy supports "decriminalization" of marijuana (reductions in the penalties for its use and possession) in combination with an increased commitment to substance-abuse treatment. The Academy recommends changing marijuana from a DEA Schedule I to a DEA Schedule II to facilitate research into pharmaceutical uses. [31]
Recognizing that insufficient sleep in adolescents is an important public health issue that significantly affects the health and safety, as well as academic success, the American Academy of Pediatrics strongly supports efforts of school districts to optimize sleep in students and urges high schools and middle schools to aim for start times no earlier than 8:30 a.m., to allow students the opportunity to achieve optimal levels of sleep (8.5–9.5 hours) and to improve physical and mental health, safety, academic performance, and quality of life. Although the AAP acknowledges that numerous factors may impair the amount and/or quality of sleep in adolescents—among them, biological changes in sleep associated with puberty, lifestyle choices, and academic demands—it considers school start times before 8:30 a.m. ("earlier school start times") to be a key modifiable contributor to insufficient sleep, together with circadian rhythm disruption. It also recognizes that a substantial body of research has demonstrated that delaying the start of the school day is an effective countermeasure to chronic sleep loss and has a wide range of potential benefits to the physical and mental health, safety, and academic achievement of students—including reduced obesity risk, rates of depression, and drowsy driving crashes as well as improved academic performance and quality of life. [32] Later start times also result in less frequent tardiness. [33]
There is limited medical controversy surrounded the AAP regarding abusive head trauma (AHT), also called shaken baby syndrome in infants. [34] The current skepticism is not whether violent shaking or shaking with slamming is dangerous to infants and children, but of how the scientific information is used in the legal processes. The AAP updated its policy paper in 2020. In the updated policy paper, the APP states "The AAP continues to affirm the dangers and harms of shaking infants, continues to embrace the 'shaken baby syndrome' diagnosis as a valid subset of the AHT diagnosis, and encourages pediatric practitioners to educate community stakeholders when necessary." [35]
In 2008, the AAP and the American Heart Association recommended statins for children as young as eight years with high lipid concentrations and for children as young as two years with major cardiovascular risk factors, if weight management, dietary changes, and additional physical exercise were not sufficient to reduce the risk of heart disease. [36] The organizations were criticized by bloggers and the editorial board of The New York Times , who expressed "fear that it will open the way for drug companies to bombard anxious parents with ads promoting these and other products and increase the number of parents insisting on prescriptions for their children. The ease of popping pills should not distract parents, health professionals, or policy makers from the more arduous tasks of cutting back on junk foods, promoting healthy diets, and putting physical education back into the schools." [36]
AAP recommends that tobacco control programs should change the image of tobacco by telling the truth about the substance. This includes prohibiting tobacco advertising and promotion that is accessible to children, as well as point of sale advertising, product placements in movies and other entertainment media, and promotion in print or internet-based media accessible to youth. Advertising and promotion has been shown to be a cause of tobacco use initiation in adolescents. [37]
AAP supports a minimum purchasing age of 21 years for tobacco products. Increasing age of purchase has been shown to decrease youth smoking rates. Younger age of starting tobacco use leads to lower rates of ever stopping tobacco use. [38]
According to Block (2023), the AAP and other American medical professional groups have becoming increasingly aligned in supporting gender affirming care for gender dysphoria, which may include gonadotrophin releasing hormone analogues (GnRHa) to suppress puberty; oestrogen or testosterone to promote secondary sex characteristics; and surgical removal or augmentation of breasts, genitals, or other physical features. [39]
In 2018, the AAP issued a policy statement putting forward a model of gender affirmative care. [40] [41] Gender affirmative care is based in the idea that transgender identities and diverse gender expressions do not constitute a mental disorder, that variations in gender identity and expression are normal aspects of human diversity, and binary definitions of gender do not always reflect emerging gender identities, that gender identity evolves as an interplay of biology, development, socialization, and culture, and that if a mental health issue exists, it most often stems from stigma and negative experiences rather than being intrinsic to the child. [42]
The AAP also describe conversion therapy as "unsuccessful", "deleterious" and "outside the mainstream of traditional medical practice". Finally, the AAP recommends that youth identifying as transgender have access to comprehensive and development-appropriate healthcare provided in safe and inclusive clinics but also that family based therapy be available. The AAP also recommend that the medical field and federal government prioritize research that is dedicated to improving the quality of evidence-based care for transgender youth. [42]
Brush, Book, Bed (BBB) is an American Academy of Pediatrics program aimed at improving children's health by creating a nighttime routine of brushing the child's teeth, reading together, and setting a bedtime. It was developed to help pediatricians communicate a simple message to families. [43] [44] [45] [46]
Pediatrics is the branch of medicine that involves the medical care of infants, children, adolescents, and young adults. In the United Kingdom, paediatrics covers many of their youth until the age of 18. 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. Worldwide age limits of pediatrics have been trending upward year after year. 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: παῖς and ἰατρός. Pediatricians work in clinics, research centers, universities, general hospitals and children's hospitals, including those who practice pediatric subspecialties.
Spanking is a form of corporal punishment involving the act of striking, with either the palm of the hand or an implement, the buttocks of a person to cause physical pain. The term spanking broadly encompasses the use of either the hand or implement, the use of implements can also refer to the administration of more specific types of corporal punishment such as belting, caning, paddling and slippering.
Male circumcision is the surgical removal of the foreskin (prepuce) from the human penis.
Gender dysphoria in children (GD), also known as gender incongruence of childhood, is a formal diagnosis for children who experience significant discontent due to a mismatch between their assigned sex and gender identity. The diagnostic label gender identity disorder in children (GIDC) was used by the Diagnostic and Statistical Manual of Mental Disorders (DSM) until it was renamed gender dysphoria in children in 2013 with the release of the DSM-5. The diagnosis was renamed to remove the stigma associated with the term disorder.
The Denver Developmental Screening Test (DDST) was introduced in 1967 to identify young children, up to age six, with developmental problems. A revised version, Denver II, was released in 1992 to provide needed improvements. These screening tests provide information about a range of ages during which normally developing children acquire certain abilities and skills. By comparing a child’s development to the developmental age ranges in this tool, it allows providers to identify young children with developmental problems so that they can be referred for help.
Alternative therapies for developmental and learning disabilities include a range of practices used in the treatment of dyslexia, ADHD, autism spectrum disorders, Down syndrome and other developmental and learning disabilities. Treatments include changes in diet, dietary supplements, biofeedback, chelation therapy, homeopathy, massage and yoga. These therapies generally rely on theories that have little scientific basis, lacking well-controlled, large, randomized trials to demonstrate safety and efficacy; small trials that have reported beneficial effects can be generally explained by the ordinary waxing and waning of the underlying conditions.
The American College of Pediatricians (ACPeds) is a socially conservative advocacy group of pediatricians and other healthcare professionals in the United States, founded in 2002. The group advocates against abortion rights and rights for LGBT people. ACPeds promotes conversion therapy. As of 2022, its membership has been reported at about 700 physicians.
Calvin C.J. Sia was a primary care pediatrician from Hawaii who developed innovative programs to improve the quality of medical care for children in the United States and Asia. Two particular programs have been implemented throughout America: the Medical Home concept for primary care that has been promoted by the American Academy of Pediatrics and the federal Emergency Medical Services for Children program administered by the U.S. Department of Health and Human Services’ Health Resources and Services Administration, Maternal and Child Health Bureau. His Medical Home model for pediatric care and early childhood development began to take root in several Asian countries in 2003.
Puberty blockers are medicines used to postpone puberty in children. The most commonly used puberty blockers are gonadotropin-releasing hormone (GnRH) agonists, which suppress the natural production of sex hormones, such as androgens and estrogens. Puberty blockers are used to delay the development of unwanted secondary sex characteristics in transgender children, so as to allow transgender youth more time to explore their gender identity. The same drugs are also used to treat other conditions, such as precocious puberty in young children and some hormone-sensitive cancers in adults.
Children with Special Healthcare Needs (CSHCN) are defined by the Maternal and Child Health Bureau as:
Start School Later, aka Healthy Hours, is a non-profit organization in the United States. Founded in 2011 after Maryland-based science writer Terra Ziporyn Snider started an online petition via We the People that brought together grassroots advocates, sleep researchers, pediatricians, social workers, and educators, the coalition aims to help communities delay school starting times; ensure safe, healthy school hours; and provide sleep education programs for students and school communities.
Michael Weitzman is an American pediatrician specializing in public health and policy. He is known for his research focusing on the social and environmental determinants of child health. He has published over 150 articles in medical and scientific journals on the damaging effects of second-hand smoke, lead exposure, and countless other determinants of children's health and behavior. From 1999-2005 he served as the executive director of the Center for Child Health Research, a national research institute created by the American Academy of Pediatrics.
Dimitri Alexander Christakis is an American pediatrician, researcher, and author from Seattle, Washington.
Nadia Lauren Dowshen is an American pediatrician and adolescent medicine physician. She specializes in the care of youth living with HIV infection and medical care to transgender and gender-diverse youth. Dowshen researches health inequality, access to care, and promoting resilience in LGBT youth. As an associate professor at the Perelman School of Medicine at the University of Pennsylvania, she is also the medical director and co-founder of the Gender and Sexuality Development Clinic.
Adolescent and young adult oncology is a branch of medicine that deals with the prevention, diagnosis, and treatment of cancer in adolescent and young adult (AYA) patients aged 16–40. Studies have continuously shown that while pediatric cancer survival rates have gone up, the survival rate for adolescents and young adults has remained stagnant. While many clinical trials exist for adults with cancer and children with cancer, AYAs underutilize clinical trials. Most pediatric clinical trials serve patients up to age 21. Additionally, AYAs face problems that adults and children rarely see including college concerns, fertility, and sense of aloneness. Studies have often shown that treating young adults with the same protocols used in pediatrics is more effective than adult oriented treatments.
Rhea W. Boyd is an American pediatrician and child and community health advocate. Boyd is a popular science communicator, making use of social media to amplify a diverse range of voices in an effort to improve the heath of communities of colour.
Timothy Brei is a professor of neurodevelopmental pediatrics at the University of Washington and a developmental pediatrician at Seattle Children's Hospital. He is also the medical director of the Spina Bifida Association of America. Brei's research has focused on healthcare outcomes for children with spina bifida and as an adult with spina bifida who is an uncommon leader, he has also served as an advocate.
Eliana Perrin is an American pediatrician, researcher, and Bloomberg Distinguished Professor of Primary Care with joint appointments with tenure in the Department of Pediatrics in the School of Medicine and in the School of Nursing at Johns Hopkins University. She was elected a member of the American Pediatric Society in 2021.
Clifford Grosselle Grulee was an American pediatrician and a founding member of the American Academy of Pediatrics.
The Society For Evidence-Based Gender Medicine (SEGM) is a non-profit organization that is known for its opposition to gender-affirming care for transgender youth and for engaging in political lobbying. The group routinely cites the unproven concept of rapid-onset gender dysphoria and has falsely claimed that conversion therapy techniques are only practiced on the basis of sexual orientation rather than gender identity. SEGM is often cited in anti-transgender legislation and court cases, sometimes filing court briefs. It is not recognized as a scientific organization by the international medical community.
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