Henry S. Roane, PhD, Editor
At the time of this writing, we are dealing with the COVID-19 pandemic. Our society is constantly being reminded of preventative procedures against exposure to this virus: hand washing, covering your cough, social distancing. These types of prevention behavior represent primary prevention in that their intent is to prevent spread of a disease to an unaffected population (see Morley and Reyes, this issue), and it is primary prevention that readers likely have the greatest familiarity with. However, preventative care may also involve the application of empirically derived practices to those precursor behaviors that might develop into a larger health concern by mitigating the risk of worsening outcomes. Such secondary and tertiary prevention is the focus of the current issue.
Within the context of pediatric behavioral concerns and remediating those factors that place a child at risk for developing behavioral concerns, prevention focuses not only on intervention early during a child’s development (to prevent worsening) but also on decreasing the long-term sequela of the targeted concern. The articles presented in this issue address behaviorally based preventative measures that have a history of evidence-based care in pediatric populations. The content includes prevention of problematic behavior associated with foster care placement as well as the prevention of child abuse. Both are conditions that can give rise to a range of childhood behavior disorders. As well, there are condition-specific disorders for which there is well-established literature on secondary and tertiary prevention. These include the current topics of autism spectrum disorder, feeding disorders, severe behavior problems associated with intellectual and developmental disabilities, tic disorders, and sleep disorders. Finally, some of the content of the issue addresses broader health and wellness within pediatric populations. This includes contributions on academic behavior, oral care, weight management, and substance use disorders (eg, drug consumption, excessive video game play), as well as an article on teaching a range of safety skills (eg, gun safety, abduction prevention) to children.
One common theme across these articles is their basis in the behavioral sciences, particularly applied behavior analysis (ABA), which is a clinical discipline wherein the general principles of learning and behavior are applied for the purpose of addressing socially relevant problems. One of the most notable features of ABA is its focus on direct observation and data collection to inform intervention decision making. The emphasis on data-based decision making is evident in each of the contributions to this issue. The goal of this issue is to address socially relevant behavioral problems common as referrals to pediatric practices and to make providers aware of the range of treatment options available to patients, as well as informing providers of evidence-based strategies for identifying precursors and preventing further worsening of behavior problems in children.