Editor's Note - May 2019

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By Andrea Spridgen

Optimal provision of healthcare services requires looking beyond just treating the specific disorder, disease, or mobility issue the patient presents with—it requires understanding the patient as an individual, including the day-to-day factors that may impact his or her condition and treatment. This is especially true whenever care for children and adolescents is concerned. Within the realm of pediatric healthcare, family dynamics, peer interactions, and the patients' maturity and emotional ability to process elements of their treatment options are essential considerations in providing the most effective care. This issue provides insight into the importance of this holistic approach as well as giving context to regulations regarding cranial remolding helmets.

While congenital limb difference is more common in pediatric patients than acquired amputations, cancer is the most common among biologic causes for amputation. "Preparing Young Patients With Cancer for Amputation" explores ways in which the healthcare team can provide preparatory care by working with parents, patients, and peer mentors to reduce pre- and post-amputation distress. Key in this process is looking beyond strictly medical considerations and acknowledging the maturity and temperament of the patient, allowing parents the opportunity to absorb the emotional impact of the impending surgery prior to talking to their child, and connecting the patient with peer mentors who can provide a glimpse of what life after amputation may be like.

One recurring frustration for many practitioners who work with pediatric patients is parental non-compliance with the treatment protocol. "How Does Caring for a Child With Disabilities Impact Quality of Life?" delves into the relationship parents of children with disabilities have with the healthcare system, management of their own health and well-being, financial obligations, and parenting their non-disabled children. Understanding the nuanced experience of parents in their past relationships with the healthcare system and their overall quality of life can help clinicians take a more holistic approach to pediatric treatment and design interventions that work for the child and the family support system.

This month's American Academy of Orthotists and Prosthetists Society Spotlight, "Regulations and Remolding: Where Cranial Remolding and the FDA Meet," explains criteria that classify cranial remolding helmets (CROs) as U.S. Food and Drug Administration Class II medical devices. In pointing out the stringent U.S. requirements on the manufacture of CROs, this article sheds light on how research in other countries about their efficacy may not reflect outcomes in the United States.

Pediatric care comes with complex challenges, but as many clinicians have told me, it also comes with many rewards.

Happy reading.