Widening perspectives on pediatric rehabilitation.

Pediatric Rehabilitation is a journal which until relatively recently would have been considered by many readers to be a publication aimed predominantly at those working within medicine or its allied professions. Its perceived focus was on children being ‘treated’ in hospital or clinic settings and, although it was a journal with which I was familiar as a developmental psychologist, it was not one which I consulted regularly. Over the past few years, the new editorial team, assisted by a reconstituted and more broadly-based scientific board, has been introducing a number of changes in emphasis and direction to the journal. These are now paying important dividends and Pediatric Rehabilitation can now justifiably claim to be one of only a very few journals that are truly interdisciplinary in content. This has resulted in a significant broadening in both its readership and contributor base, along with a widening of the contexts from which rehabilitative work is now being reported. Many of its articles are now of obvious relevance to most child practitioners and researchers and indeed almost anyone who works with children whose development is at risk will have been able to find something of interest and of use in recent issues. Despite recent changes, the focus of the new Pediatric Rehabilitation has remained true to its original inception in this and preceding issues: disseminating knowledge and good practice with the potential to improve recovery and outcome in childhood disorders. The journal now regularly attracts high quality articles on research carried out within a very wide range of child-linked disciplines and reporting on approaches to rehabilitation being taken across the world. These interventions are frequently driven by very different theoretical models and under-pinned by very different literature bases; they also at times reflect quite different value systems and philosophies. This diversity can only be healthy in a field which still has much to learn. It forces us to think more deeply about the key issues and to question received wisdom in an area of practice where the evidence base has not always been strong and where issues of efficacy always loom large. The central aim of Pediatric Rehabilitation in its relatively new guise is to stimulate cross-disciplinary dialogue amongst the many different kinds of professionals and researchers who work with children whose development is at risk. All of us share a common desire to find more effective ways of supporting child development and the journal is keen to foster collaborative work on all fronts: in hands-on practice, in fundamental research and in theory development. Only then will better designed, more rigorously evaluated and more ecologically meaningful interventions become more common and longer-lasting effects more frequent. As this issue demonstrates, cross-disciplinary rehabilitation teams are now far more common than in the past, with interventions being delivered across a variety of settings and tailored in timing and content according to specific child needs rather than on the basis of crude diagnostic categories. Inter-disciplinary working is not a straightforward process by any means, nor is evaluating effectiveness, but this is the only way forward. I was honoured to be asked to write the guest editorial for this education-based issue and was pleased to see such a strong issue result from the initial call for papers. Both the editors and myself were to some extent holding our collective breaths over what might—or might not—come in, but in the end we are delighted with the selection of papers this issue contains. The studies reported provide an eclectic and stimulating read, with the majority of the authors new to most Pediatric Rehabilitation regulars. The papers represent work being carried out in a number of different countries, led by a variety of disciplines and implemented by a wide range of professionals. They each focus on the specific needs of children with sometimes highly contrasting developmental difficulties, including some which until now have been rather underrepresented in the journal. This special issue on education is therefore, I believe, a particularly useful example of how improved inter-disciplinary dialogue and multi-professional working can make real and measurable differences to developmental outcomes and to children’s lives. The need for intervention comes from many directions including, amongst Pediatric Rehabilitation, April 2005; 8(2): 85–87