Our society professes the ideal that every child should grow up in a household under the care of a pair of loving adults who possess appropriate parenting skills. The reality today is that divorce, single parenting, and step-parenting are common. Adoption and foster-parenting are also not uncommon. The historically traditional biological mother/father household is not the only type of household in which children are growing up today.

The provision of adequate child care and supervision — and the prevention of child abuse and neglect — need to be openly addressed. One of the most tragic situations is the physical injury, emotional damage, or even death that occurs because a caregiver has shaken, burned, hit, or sexually assaulted a child.  It is important to emphasize that children are not simply small adults and should not be treated as such. Child health care and the specialty of pediatrics are concerned with providing optimal and appropriate care to all children. The specialty of pediatrics has expanded its role to include not only young children and adolescents but young adults, as well, since a large portion of our 18- to 21-year-olds continue to be dependent on their parents into their 20s.