>>Dr. Alan Guttmacher: I'm Alan Guttmacher, and I'm the director of the Eunice Kennedy
Shriver National Institute of Child Health and Human Development at the National
Institutes of Health.
Well, we have a very broad kind of mission,
but a core part of it, which really relates to the conference that we're having here,
is to give every child the opportunity to have a life in which they are free of
disease and disability, in which they can really have the optimal achievement of
their life goals.
Because we care so much about all children having lives that are free of
illness and disability, certainly there are many children the U.S.
who are parts of military families.
So the issues that they have, some of them are similar to all children,
but there are specific issues of kids involved in military families that we've
long been interested in.
We had a funding announcement, opportunity for grants,
a couple of years ago that began to explore this in more detail.
And this conference really builds on that to help us understand more both about the
problems of military children that are similar to other children,
but perhaps might vary a little bit depending on where their parents are
serving -- those kinds of things -- but then to also look at the particular
stresses that are parts of the lives of kids in military families,
the kind of stresses if you're -- one or both parents are in deployment overseas,
the kinds of stresses of worrying about whether your parents will be okay if
they're in an area of active warfare, for instance;
those kinds of things that we know occur for children in military families,
but we don't really understand them in the depth that we need to,
to enable those kids and their families to be able to really plan things,
to be able to take care of problems before they become more severe,
for instance.
When we think about the NICHD mission, there are a number of questions within the
area of the lives of children in military families that I think we need to explore
more.
We need, first of all, to understand, what's the magnitude of the problem?
That is, how many kids are there today in military families who have special
health care needs?
And then we need, way beyond understanding the size,
the numbers, we need to understand the nature of those issues.
What are the problems in terms of intellectual developmental disabilities
for kids in military families?
What are the problems in terms of other kinds of health care issues,
both in terms of their childhood, but also we're learning more and more about how
childhood sets the tone, really begins you on the path towards adult health and/or
illness.
So when you understand more about the special circumstances of kids in military
families, and how does that contribute not just to their health and developmental
issues perhaps as children, but also, does it create any kinds of things in terms of
their adult health that we need to be aware of so we can make interventions
while they're in childhood that will help their lifelong health?
I'm a pediatrician and medical geneticist by background,
so really almost every child that I saw in my practice was a child with special
health needs.
They had an inherited problem, or they had what's called often a birth defect,
and that sets up a kid for any number of a range of problems.
I think one of the things that I saw during the years that I was in practice was the
concept of the medical home became more well established,
and that's the idea that kids with special health needs,
they really need to have coordinated care.
If it's piecemeal, first of all, it's not as effective;
and second of all, it puts way too much responsibility on the parents to navigate
a very difficult system.
The idea of the medical home, where the child's primary care pediatrician would
really help coordinate and facilitate what can be very complicated care, makes a
difference in the lives both of the children and of their families.
Part of what we're enjoying about this conference is working with many other
organizations, because the particular challenges of the lives of children in
military families is something that many different kinds of organizations -- some
of them in the federal government -- the Department of Defense obviously is
intimately involved in.
So we enjoy working with them on this.
We also enjoy working with others, such as the HSC Foundation,
that are interested in these kinds of issues,
because clearly, each organization, while having this as part of their mission,
can work more effectively if we work with others.
The other thing that I think that's important here is there are lessons to
learn from kids in military families that are generalizable to all children.
For instance, questions about resilience.
What is it that allows many children, whose parents may be gone for prolonged
period of time, who may be in, you know, situations of danger,
what allows so many children to be able to function very well despite those
challenges?
What can we learn from that that tells us about resilience in all children,
that are things that we can work with children to increase their resilience?