Pediatrics is the medical specialty most directly concerned with child health.
Its origins as a separate medical practice date from approximately a century
ago. From its beginning, pediatrics was concerned with infant feeding and
with the prevention of nutritionally related diseases such as rickets. It was
also involved in the treatment of various devastating infectious diseases of
childhood such as smallpox, diptheria, whooping cough, and poliomyelitis.
Basic science discoveries and new technology have, however, revolutionized
the practice of pediatrics in recent years. Many diseases such as those just
listed have essentially been conquered by proper child nutrition, vaccina-
tions, and antibiotics. Pediatricians now spend less time working in hospitals
and considerably more time in ambulatory care. Much of their work is now
preventive in orientation. Increasingly, they also spend their time dealing
with issues of child development and behavior and with the relation of these
to child health ( Haggerty, 1986).

It is not new of course for parents to look to pediatricians for evaluations
and advice regarding their children's development, behavior, and the rela-
tionship of behavioral, emotional, and family factors to health and illness.
Some physicians were in fact among the pioneers of child development re-
search. One of the most notable of these was Arnold Gesell, who received his
Ph.D. in psychology in 1906 under G. Stanley Hall and his M.D. at Yale in
1915, and founded the Yale Clinic for Child Development in 1911, long be-
fore the various university-based child development institutes were estab-
lished. He pioneered in many areas of research on infancy, among them the
documentation of the sequential development of infant motor skills, and he
developed some of the earliest formal clinical procedures for evaluating in-
fants' behavioral development. Gesell saw early on that pediatrics needed to
be concerned with young children's development, mental hygiene, and psy-
chosomatic illness in childhood ( Gesell, 1948). Gesell was a basic scientist,
but one who hoped to influence practice. Unfortunately, he did not succeed
in training any pediatricians or other medical scientists to take his place. Per-
haps in this respect he was simply ahead of his time.

There are a number of signs that, in recent years, some new aspects of
pediatrics have finally come into focus, namely what is now being called
developmental-behavioral pediatrics. The Society for Behavioral Pediatrics
was founded in 1982 and now has about 300 interdisciplinary members
( Routh, 1986). It sponsors meetings and publishes the Journal of Develop-
mental and Behavioral Pediatrics. Developmental pediatrics is the medical
field concerned with mental retardation and developmental disabilities.
Interdisciplinary training in developmental pediatrics has long been available
through the U.S. government-sponsored University Affiliated Programs.
Behavioral pediatrics deals with children's emotional and behavioral prob-

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