Pediatrician’s Role

The American Academy of Pediatrics (AAP) recently issued a policy statement regarding preventing expulsion in early education and childcare. The article highlights factors such as poverty, systemic racism, and implicit bias, resulting in an unequal amount of minority children being expelled from preschool and childcare settings. The policy statement offers a resource for pediatricians to help diminish this unfavorable situation.

According to the AAP, pediatricians and other medical professionals can play a critical role in preventing expulsion. The article recognizes that to help avoid early education expulsion; pediatricians must learn more about childhood mental health and the outcomes of aggravating factors of systemic racism, poverty, and toxic stress. The AAP suggests that with more education in these areas, pediatricians would be more equipped to connect families to resources and inform them of the qualities of high-quality childcare.

The article goes on to make links between adult mental health issues and the emotional and behavioral issues of early childhood. It connects the rate of diagnosis for emotional and behavioral disorders such as anxiety and attention-deficit/hyperactivity, which are typically diagnosed between 3-5 years old. While these diagnoses are treatable, sometimes, there are behavioral issues that do not rise to the level of needing a diagnosis; this can cause additional disruptions that increase expulsions. Other situations that may increase the risk for expulsion are children who are diagnosed with developmental delays or Autism. Their inability to communicate effectively and teachers who may not know how to handle their situation can reveal a lack of training and support. The article also references a 2005 survey that indicated the significant disparities of ‘who’ gets expelled, citing several existing structural and systemic issues.

Several solutions are suggested to prevent the practice of expelling children. One is that teachers should have access to early childhood mental health programs. However, another is that pediatricians already have an embedded relationship with families and can help encourage healthy parent-child interaction. Pediatricians are also more qualified to distinguish between problematic temperaments, monitor for developmental and behavioral concerns, and collaborate with other community advocates and organizations at various levels to educate and promote positive disciplinary approaches instead of expulsions.

Read more here: https://pubmed.ncbi.nlm.nih.gov/37899732/