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Encounters with Children: Pediatric Behavior and Development
http://www.100md.com 《新英格兰医药杂志》
     It is not common to read what is clearly intended as a textbook and then find oneself eager to discover the next pearl of wisdom among many others that have been strung throughout the text. Encounters with Children must now, in its fourth edition, be placed among the classics for pediatrics. The book is intended for pediatricians at any stage in their careers, but other professionals caring for children, and even parents, will find it entirely accessible.

    In this edition, the beautiful but completely unostentatious and readable prose has been supplemented by additional summaries, tips, lists of general developmental milestones for children of various ages, and lists of red flags for important things that require further action. As I read the book, there was rarely a section in which the common questions raised by my own patients on a particular topic were not brought out and addressed. The authors provide uniformly sage advice on how to answer these questions and even model ways to phrase the discussions. The authors are never shy about giving advice to clinicians, even when supporting evidence is not necessarily clear. This approach does not seem dogmatic or inappropriate, however, because the evidence base and theoretical foundations are thoroughly discussed, albeit with elegant conciseness. The frustration one often feels when reading textbooks — of being provided with generalities but no practical approaches, all in the name of an overview — is truly obviated.

    The book begins with succinct reviews of developmental theory, cultural issues, suggestions for office practice, and the use of children's drawings as a window into development. These topics are followed by discussions of children and family development and behavior, organized according to the type of visit usually conducted in pediatric practice (e.g., the one during the neonatal period, the one at 15 to 18 months of age, and the one at 6 to 7 years of age). Although there is general continuity in the format, it is not forced on the reader or the contributing authors; each chapter includes what one really wants and needs to know about the age group being considered and does not adhere to a rigid structure. It appears that many of the contributing authors have compatible styles or that their work has been edited to eliminate any jarring transitions in content or philosophy from one chapter to the next. The book ends with the chapters "Special Families," "Encounters with Illness," "Stressful Events," and "Resources for Families" (an annotated bibliography). There is also an appendix on screening tools that, thankfully, actually provides examples.

    If there are any weaknesses in this wonderful book, they lie in its sparse referencing and its lack of rigor in the use of definitive data on clinically significant definitions of milestones for development. There are times when readers would really like to know where the information originated, even if it is provided in a footnote that can be investigated further. This also means that areas of controversy, although sometimes mentioned, are not fleshed out enough for readers to decide whether they should go along with the authors' positions. These are not serious flaws, though, in this lovely and practical summary of child development.

    Barbara J. Howard, M.D.

    Johns Hopkins University School of Medicine

    Baltimore, MD 21210(Fourth edition. Edited by)