Develop. Med. Child Neurol. 1979, 21, 283-284

EDITORIAL PAEDIATRIC NEUROLOGY PAEDIATRICS shares with geriatrics the distinction of being a sub-speciality of medicine which identifies its interests in terms of a specific age-group of people rather than in terms of a body system like neurology or cardiology. It grew up not only because there are diseases and disorders specific to the child, and children’s responses to disease processes are different from adults’, but also because children, well or sick, are developing. Paediatrics could be defined as the application of the medical sciences (including psychology and sociology) to a growing and developing organism. The normal processes of growth and development must be studied as the ‘basic science’ of paediatrics; it is not a separate subject‘developmental paediatrid-it is the lingua franca of any fully trained paediatrician. Maybe it is vanity on our part to believe that this specialisation in people rather than parts means that paediatricians have been more aware of their patients’ social and emotional needs than have some other specialities. The loss of this concentration on the whole child is a risk that we must be aware of as the sub-specialities within paediatrics proliferate. Paediatric neurology is a flourishing sub-speciality and associations of paediatric neurologists exist in many countries in the developed world, but distribution in terms of numbers is patchy, with no generally agreed ratio of paediatric neurologist per head of population. The aim in the United Kingdom is initially to reach agreement with the National Health Service for one paediatric neurologist per million population. This is a lower figure than already exists in some western countries, as the work carried out in these countries is more restrictive and may consist of running an EEG service or performing duties carried out in Britain by clinical medical officers. GORDON’ has suggested that paediatric neurology has three bases: (1) all that is understood by the term ‘neurology’, (2) a detailed knowledge of developmental paediatrics and (3) close involvement with the handicapped child. We would add that a thorough grounding in paediatric medicine is also vital if the paediatric neurologist is to be of use in consultation with his paediatric colleagues. 283

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1979, 21

GORDON sees the paediatric neurologist as playing major r8les in centres for handicapped children and in the care and management of children with learning disorders. YOUNG*goes further, and doubts if habitationists (an ill-defined group of doctors) need exist once paediatric neurologists accept and identify their full responsibility. AICARD13 opposes this view and thinks that the r81e of paediatric neurologists should be more limited, believing that they should not play a major part in the management of handicapped children-a view that would probably be shared by many North American paediatric neurologists. In that continent many handicapped children’s centres have been and are directed by orthopaedic surgeons, and a very good job some of them have made of it. This journal, with its international readership, does not want to dictate the service r6les of paediatric neurologists in different parts of the world. Whatever the outcome, paediatric neurologists need a broadly based journal to represent their views. The editorial intent is to try and maintain the present balance between pure child neurology on the one hand and developmental medicineincluding aspects of normal infant and child development and the care of the handicapped child-on the other. Our new relationship with the British Paediatric Neurology Association, who have joined the American Academy for Cerebral Palsy and Developmental Medicine in formally recognising the Journal, does not presage any change in our editorial balance, which was restated in our editorial in April 1979. We sincerely hope that people will use the Journal to express their views in the correspondence columns or through annotations in order that the continuing debate may be an informed one. MARTIN BAX KEITHBROWN REFERENCES 1. Gordon, N. (1978) ‘Paediatric neurology.’ _. Developmental Medicine and Child Neurology, 20, 670-672. 2. Young, J. A. (1978) ‘Paediatric neurology.’ Developmental Medicine and Child Neurology, 20, 806. (Letter) 3 Aicardi, J. (1979) ‘Paediatric neurology.’ Developmental Medicine and Child Neurology, 21, 264. (Letter)

The Editorial Board of Spastics International Medical Publications and the British Paediatric Neurology Association have reached an agreement by which Developmental Medicine and Child Neurology is formally acknowledged as the official journal of the British Paediatric Neurology Association. 284

Paediatric neurology.

Develop. Med. Child Neurol. 1979, 21, 283-284 EDITORIAL PAEDIATRIC NEUROLOGY PAEDIATRICS shares with geriatrics the distinction of being a sub-specia...
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