11^th World Pediatric Congress August 16-17, 2018 Singapore City, singapore

Biography:

I have been working in the Department of General Paediatrics in KK Women’s and Children’s Hospital, Singapore, since 2007, with keen interest in general paediatric patient care, and both undergraduate and postgraduate education.

 At present, I am also involved in KidSTART, a pilot collaboration between Early Childhood Development Agency (ECDA) and KK Women’s and Children’s Hospital aiming to help disadvantaged families and children by identifying early developmental issues, growth delays, maternal mental health issues. Through early interventions, the pilot project hopes to achieve better integration of such families into the community agencies, rectifying paediatric growth and developmental delays through counselling and referral to tertiary institutions, to ensure good outcomes for them.

 

Abstract:

Community Paediatrics is a recognized subspecialty overseas, and is a relatively new concept in Singapore. The American Academy of Pediatrics (AAP) defines it as the philosophy of delivery of child health care with the principles of high accessibility, holistic vision, collaboration with parents, interagency care and teamwork, advocacy directed at the needs of all children, and a preventive orientation. It synthesizes clinical practice with public health principles directed towards providing optimal health care to a given child within the context of the family, school, and community.

Research has also shown that experiences in a child’s early years can significantly influence his/her physical, cognitive and social development. In particular, children from vulnerable circumstances may face developmental challenges compared to their peers. On the other hand, a stronger parent-child relationship and holistic early childhood development can bring about positive impact on the child’s lifelong outcomes and narrow the developmental gaps.

KidSTART is a pilot program which aims to provide support and create a conducive environment for learning and development for Singaporean children from economically disadvantaged families. The components include a home visitation programme, a supported playgroup programme and enhanced support to pre-schools. Children from eligible families can attend one or more of these components. Through these interventions, KidSTART hopes to ensure that children benefit from warm and nurturing relationships, age-appropriate and holistic child development, and a safe and secure home environment to grow up in. For home visitation, each at-risk expectant mother and her child will be given integrated support in the domains of health, child development and social services.

In summary, there is a need to give children from these families in Singapore a good start in life. The programme is currently at the pilot stage. The creation of an integrated sustainable working model will allow for future up-scaling of such model across the entire country.

 

Biography:

Lourdes Mary Daniel has been a Pediatrician in Singapore and a full-time Neonatologist. She is currently working as the Head of the Department of Child Development in KK Women’s and Children’s Hospital. She has received her Child Development training at the Kennedy Krieger Institute in Johns Hopkins Hospital, Boston Children’s Hospital and the Harvard Graduate School of Education in USA.

 

Abstract:

Children in poverty have worse cognitive, socio-behavioral and health outcomes than their more affluent peers. Poverty affects the brain in 4 main ways: Language and reading, memory, Executive Functions (EF) and socio-emotional processing. Numerous studies have demonstrated differences in brain structure and function between children from high and low socio-economic status. Income and total hippocampal gray matter, which are important for learning and memory, have been shown to be correlated, as well as frontal and prefrontal regions which affect emotion and stress. Poor cognitive and academic performance among children in poverty has been shown to be mediated by a small hippocampus and frontal and temporal lobes, with the decrease in the latter 2 areas explaining as much as 15-20% of the achievement deficits. The relationship between poverty and the brain has been shown to be logarithmic and not linear. Income related, most strongly to brain structure among the most disadvantaged children with the effect seen as early as 6-9 months of age. Children’s EF skills have been shown to be robustly predicted by chronic exposure to poverty and the associated environmental hazards. In adults, EF skills (which start developing in childhood) are core capabilities that are important for managing life, work and effective parenting. Bridging the achievement gap between children of low socio-economic status and their more affluent peers requires co-ordinated public policy measures. This is a huge challenge, but addressing it is necessary to protect these children from the long-term effects of poverty. This talk will also summarize the effects of various intervention programs.