Pediatricians: Child care is inadequate today

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Pediatricians are calling for better checkups

Germany's pediatricians are calling for reform of the preventive medical check-ups. The problems of the children are different today than they were 40 years ago. According to the professional association of children and adolescents, the current prevention programs are “no longer up to date”.

Children today are exposed to a high-fat and high-sugar diet. Excessively high media consumption also increasingly leads to massive behavioral problems. The Association of German Pediatricians therefore warns in an appeal against the consequences of these (incorrect) developments. When children and adolescents go to the doctor these days, the problems are different than they were forty years ago. Therefore, preventive care programs urgently need to be adapted and reformed, the pediatricians warned.

Early illness detection program is more than 40 years old The inclusion of the early illness detection program for children in the benefits catalog of the statutory health insurance in 1971 revolutionized the health development of children. Germany was a pioneer in childcare at the time. Many countries then oriented themselves towards the creation of regular examination appointments, the so-called U-examinations, and also developed programs of equal value. The aim of the preventive examinations was to identify undesirable developments or malfunctions in good time in order to treat them as early as possible. This prevented chronic diseases and malpositions in hundreds of thousands of children. The main focus was on recognizing metabolic diseases, developmental delays, behavioral problems, diseases of the nervous system, sensory organs such as eyes, ears and nose, as well as the timely detection and treatment of malformations of the teeth. It was therefore primarily about health checks and timely child protection vaccinations.

Pediatricians call for reform of child care. It has been over 40 years since then. Society and thus the growing up of children has changed fundamentally since then. The doctors are therefore calling for reform of the preventive medical check-ups from infancy to adolescence. "We have to move away from the old concept of early detection, ie the earliest possible detection of existing diseases (so-called secondary prevention), to the concept of preventing the development of diseases, ie primary prevention". Because the preventive programs are more contemporary, said the chair of the professional association of pediatricians, Dr. Wolfram Hartmann, on Friday in Berlin.

Behavioral and overweight
The diseases of children in 2011 differ in some cases from children 40 years ago. Adolescent doctors therefore speak of "new diseases" in young patients. According to a scientific study, around 14 percent of all children suffer from obesity. Six percent showed pathological obesity at a young age. The most serious complication is type II diabetes. At the time, when the program was launched, it was not possible to think that even small children could suffer from “age-related diabetes”. Psychological ailments such as depression were also unimaginable. According to child and adolescent psychiatry, up to 7 percent of children already suffer from depressive episodes. If parents are not very committed and children are more oriented to media models from the Internet or television, episodes can even lead to manifested behavioral disorders. Another seven percent show impaired social behavior, develop social phobias, suffer from difficulty concentrating or show attention deficits. If the children come from socially disadvantaged families, motor problems as well as speech and language disorders are often observed.

After all, 90 percent of parents regularly go to the examinations with their children. However, "the 20 minute consultations with the pediatrician" were no longer sufficient for today's indicators. "We are very concerned about the increasing number of children with developmental deficits, especially language, cognition, social behavior, but also motor skills, who largely fail at school with these handicaps," said Dr. Dr. Hartmann. Accordingly, doctors should bring parents closer to reading and explaining how to read a book with their children. Daycare centers and schools should also become partners of the pediatricians in order to compensate for any problems that may arise. "A good daycare is better for a child's language development than a speech therapist," said the spokesman for the association, Dr. Fegeler. If a youth center is well looked after, this saves some therapists.

Gaps in primary school age
The professional association sees the supply gap in primary school as unacceptable. Because not all statutory health insurance companies are already financed for the examinations (U10 and U11). The U-Checks are primarily about spelling, reading and arithmetic weaknesses. Doctors also focus on social skills and media consumption during preventive examinations. Although children from socially disadvantaged families are particularly affected, they are considered to be particularly underserved. "Between the ages of 6 and 10 years, patients have no legal entitlement to such examinations". Only children of privately insured parents are entitled to an annual check-up between 2 and 14 years of age. This is a two-class medicine that the association has been fighting for decades.

"The large number of overweight children with metabolic disorders who are suffering early from heart and vascular diseases or diabetes mellitus are also of great concern." Primary preventive care could prolong life and also save costs in the health care system because later long-term therapies are no longer necessary. The association therefore called for the precautionary concept that had already been designed to be implemented, even if it was more complex and expensive than the previous one. But in the future it will save costs. The doctors also noticed increasing vaccination fatigue. Two children had already died of measles in the current year. Therefore, speak out for a general obligation to vaccinate. In Germany, there is voluntary vaccination. (sb)

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