STATEMENT BY ROBERT R. SEARS, STANFORD UNIVERSITY, CALIFORNIA I wish to present support for this bill. I am presently dean of the School of Humanities and Sciences at Stanford University, and have been an active researcher in the field of child psychology for the last 25 years, and still retain my title at Stanford as director of the Laboratory of Human Development in which I am engaged in research 2 days a week. I have been strongly impressed with the need for greater support of research training in the field of child development and child health. It has become increasingly clear in the last decade that many of the illnesses of adults, and many of the crippling emotional qualities that develop in adult life, are the product of experiences that occurred in early childhood. In a few instances, particularly those of purely organic character, this general principle has been clearly demonstrated already. However, the less easily measured and somewhat intangible psychological characteristics of adult disorder seem to be equally related to experiences that children have in their families and in their play groups during their early years. This is an extraordinarily difficult field in which to develop the same degree of power for research methods that exist in some of the more biological and physical sciences. The cost in both money and investigative time is very high, and needs special support from the Public Health Service to insure that such work can go forward efficiently. I call attention particularly to problems of emotional disorder in adolescents and the commonly recognized problems usually labeled "juvenile delinquency." The conditions under which the aggressive and rebellious behaviors of adolescents develop are but imperfectly understood so far. Part of the reason for this lies in the fact that there are so few researchers who are actively engaged in the problems of human development. It is a rather surprising thing that in any large department of psychology, for example, psychological research on human development is one of the least well supported research areas. There are two reasons for this. One is that there has been relatively little financial support available for graduate students who will specialize in this area, and the other is that the methods of research are so very time consuming and expensive. One research man in this field can complete much less research in a given length of time than in some other areas where the research methods have already been worked out quite thoroughly. What is needed is a marked increase in the number of trained researchers going into the study of human development, and also larger research grants made available for the support of studies of research methods in this field. These kinds of tasks took place in certain of the biological and physical sciences quite a few years ago, and much of the extraordinary progress, both in medicine and in physics, that we have seen since World War II, are a direct product of the Government's support of research methodology during these last 15 years. I have every confidence that the same kind of scientific endeavor will bring about a marked increase in our ability to do effective research on human development and in the actual findings that will result from this type of study, if we are able to increase the able manpower in this field. STATEMENT FROM THE GERONTOLOGICAL SOCIETY PRESENTED BY ROBERT J' HAVIGHURST, CHAIRMAN, RESEARCH COMMITTEE The Gerontological Society is pleased to note the proposal to establish an Institute of Child Health and Human Development (H.R. 8398). Since the proposed Institute accords with the principles previously made public by the Gerontological Society, the society endorses this forward-looking proposal. The establishment of a National Institute of Child Health and Human Development should accelerate the gain of knowledge of basic developmental processes throughout the lifespan. Research on the normal changes in individuals over the lifespan will provide fundamental information leading toward improved professional services for the prevention or alleviation of problems associated with various periods of human life. Such problems are properly viewed as psychological, social, or welfare as well as medical in nature. VIEW OF THE GERONTOLOGICAL SOCIETY The Gerontological Society was founded in 1945 as a multidisciplinary scientific society for research into aging. Its membership, of approximately 2,000 members, contains most of the active research investigators on aging in the United States. Members include representatives from medicine, anatomy, physiology, biochemistry, psychiatry, psychology, sociology, anthropology, and others; in brief, there is representation from the broad spectrum of sciences and professions ranging from biological and medical to the social sciences and welfare fields. There is no other society which can speak as authoritatively about the research, training, and the state of information about adult changes and aging. At the White House Conference on Aging of 1961, the Gerontological Society endorsed a statement calling for the establishment of a National Institute of Gerontology. This position is maintained in principle with the present endorsement of H.R. 8398, since this bill accords with the previously expressed views of the society. The society wishes to urge that the proposed Institute give appropriate and proportionate attention to the basic problems of the adult phase and latter half of the lifespan. Changes of the growth phase of human life, the first 25 percent merge into those of middle age and later life. Progress in understanding and control over optimum human development will depend upon direct observation and longitudinal research of both children and adults of all ages. POINTS OF EMPHASIS The Gerontological Society wishes to take note of several issues relevant to the establishment of a National Institute of Child Health and Human Development. 1. It is urged that the new Institute be regarded and organized as a scientific research facility devoted to encouraging knowledge about developmental processes throughout the lifespan. 2. It is urged that the Institute be multidisciplinary in organization and program, and not be identified with any single scientific discipline or professional group. This type of organization should permit the support of single investigators in unidisciplinary settings as well as groups of investigators in collaborative efforts. 3. It is urged that the Institute have at least one intramural research center devoted to children and aging adults, such a center paralleling the development of extramural efforts which may be broader in scope and support. The principle to be emphasized here is that the scientific competence and interest of the Institute's staff will complement the extramural efforts with mutually beneficial results 4. Should it be found that the facilities and interests of the research staff concerned with development and those concerned with the adult phase and aging, are incompatible or inefficiently coupled, steps should be undertaken to establish a National Institute of Gerontology. FURTHER COMMENTS ON ORGANIZATION The intramural center and the extramural centers for research on human development should emphasize almost equally their direct research function and the utilization of their facilities and subjects for training of research workers. Opportunities are now limited for research workers and clinical investigators to develop interests and skills for studies of developmental processes and aging. There is a need for a research facility which makes the mastery of present knowledge and gathering of new knowledge a stimulating prospect for the young investigator. In establishing extramural centers for research into human development, attention should be given to the exchange of information between university departments, professional schools, and research institutes. Another consideration in locating such centers is their probable effectiveness in stimulating research in neighboring institutions. If several centers are established they might be varied in setting with one primarily in a medical school, another in a graduate school, and still another in the natural setting of a metropolitan area wherein family development and health could be observed in its most contemporary aspects. The Gerontological Society is pleased to endorse the proposal to establish a National Institute of Child Health and Human Development designed for the generation of knowledge of the many factors associated with individual development over the lifespan. [Telegram] SACRAMENTO, CALIF., February 12, 1962. Congressman KENNETH A. ROBERTS, The California Council for Retarded Children will appreciate your support and approval of the National Institute of Child Health program. This is a vital link in basic research on mental retardation and its benefits are awaited by the 5,400,000 retarded and their parents throughout our country. FRED J. KRAUSSE, Executive Director, California Council for Retarded Children. [Telegram] KENNETH A. ROBERTS, NASHVILLE, TENN., February 15, 1962. Chairman, Subcommittee on Health and Safety, Interstate and Foreign Commerce Committee, House Office Building, Washington, D.C.: Tennessee, with more than 102,000 mentally retarded, desperately and sacrificially striving to provide community and residential services, is keenly aware of the urgent need for basic research into the causes and prevention of mental retardation. Although great strides have been made in services, we are only scratching surface of problem and more retarded are born daily. We strongly urge favorable action by your committee on bill to establish National Institute of Child Health and Human Development. MICHAEL KUREK, President, Tennessee Association for Retarded Children. KENNETH ROBERTS, [Telegram] House Office Building, Washington, D.C.: NEW YORK, N.Y., February 15, 1962. Delighted hearing being held on creation Assistant Secretaryship for International Affairs, Department of Health, Education, and Welfare. This is an integral and very important step in implementation in the Health for Peace Act which you championed and bore primary responsibility for its passage in the House. This, to me, is fundamental if the potential contribution of the Health for Peace Act, improved medical and rehabilitation knowledge, is to be realized. If I can be helpful in any way let me know. Best personal regards. [TELEGRAM] HOWARD A. RUSK, M.D. Hon. KENNETH A. ROBERTS, PALO ALTO, CALIF., February 13, 1962. Chairman, Subcommittee of the Committee on Interstate and Foreign Commerce, Washington, D.C. SIR: The Department of Pediatrics at Stanford University School of Medicine strongly urges your support of H. R. 8398, a bill to create a new National Institute of Child Health and Human Development. We are supporting this bill for the following reasons: 1. Implicit in the structure of a new institute is emphasis for the prevention of ill health in children in contrast to disease oriented programs. A unified approach to the individual and environmental problems of the healthy child would represent a new and vitally needed concept in the structure of the National Institutes of Health. The prevention of disease and preservation of optimal emotional and physical health requires an extensive detailed and coordinated scientific study of normal human development and the different stages of development. Only from such an overall approach can significant advances in the prevention of mental retardation for example be attained. 2. The study of human development encompasses many disciplines and methodological approaches. With proper leadership the proposed institute would be able to stimulate the necessary cross fertilization among scientists in various fields, provide support for optimal training in human development, and aid in the more efficient application of scientific discoveries to the health of the Nation. In our judgment the creation of an Institute of Child Health and Human Development would lead to major contributions in scientific research and to the health and welfare of our people. Very truly yours, NORMAN KRETCHMER, M.D., HARVARD UNIVERSITY, SCHOOL OF PUBLIC HEALTH, Hon. KENNETH ROBERTS, DEAR CONGRESSMAN ROBERTS: I know that hearings on H.R. 8398, a bill to establish an Institute of Child Health and Human Development are to open tomorrow, February 13. I am writing in connection with this bill. This bill was introduced at the same time S. 2269 was introduced into the Senate by Senator Hill for himself and Senator Kerr. Companion bills H.R. 9299 and S. 2273 were also introduced, the former by Congressman Mills in September 1961, the latter by Senator Hill in behalf of himself and Senator Kerr in July 1961. These two sets of bills complement each other and if both were enacted would put forward research in the total field of child life immeasurably. In order that there may be no confusion between the purposes of H.R. 8398 and H.R. 9299, I would like to point out that I hope it will be made clear in the report of your committee and in the report of the House Ways and Means Committee that the research to be undertaken under these two bills is differently focused. It is my understanding that it is the intent of H.R. 8398 that the research undertaken in the proposed Institute of Child Health and Human Development will be focused on the basic research required to increase our knowledge of child growth and development, and the processes of human growth and development throughout life. In other words, the focus of this bill is basic science research. On the other hand, the focus of research under H.R. 9299 is program related and in particular research related to the maternal and child health and crippled children's State and local services that are assisted by grants-in-aid from the Federal Government (through the Children's Bureau) to State health agencies and State health crippled children's agencies. This research would be for the principal purpose of improving the quality of the programs conducted under these grantsin-aid. In order to clarify this question I would suggest section 441 on page 2 of H.R. 8398 be amended to read as follows: "Sec. 441. The Surgeon General is authorized, with the approval of the Secretary, to establish in the Public Health Service an institute for the conduct and support of research and training in the basic sciences relating to child health and human development, including research and training in the special health problems and requirements of children or aged persons and in the basic sciences relating to the processes of human growth and development." With such a clarification of language I would support the passage of H.R. 8398. Very sincerely yours, MARTHA M. ELIOT, M.D. Hon. OREN HARRIS, HAHNEMANN MEDICAL COLLEGE AND HOSPItal, Member of the House of Representatives, DEAR MR. HARRIS: I am writing to you on behalf of H.R. 8398, the bill to create a new Institute for Child Health and Human Development and to elevate the level of general medical sciences to institute status. I am interested in this bill first of all as a parent who has raised three children and appreciate the value of these measures to children in general, secondly, as a life-long resident of the Commonwealth of Pennsylvania recognizing the needs of children in our Commonwealth, thirdly as a pediatrician for more than 30 years and finally as both a professor of pediatrics and as president of the American Academy of Pediatrics. As I am sure you are well aware, the present setup of the program of the National Institute of Health is based primarily upon a system or specific disease orientation such as heart disease, cancer, neurological disease, blindness, etc. Their primary function then is the stimulation of the development of research and training grants in institutes and to a lesser extent to other parts of the world. In view of the fact that the specialty of pediatrics deals with all the problems of human growth and development and is concerned with an age period rather than specific organ entities or disease entity, it is, therefore, very little involved in the present Institutes of Health. Inasmuch as the future of our Nation depends primarily upon the health and welfare of our children, it would seem that any step of this nature which certainly should stimulate research in the areas of human growth and development and of the many factors which tend to deleteriously influence it would be a major step forward. I sincerely hope, therefore, that you will find it possible to support this measure which in my considered judgment is one of the most important which has come before the Congress in many years on the matter of child care. If I can be of any assistance to you in supplying further information, I would be pleased to do so. Sincerely yours, CARL C. FISCHER, M.D., Professor and Chairman, Department of Pediatrics. AMERICAN GYNECOLOGICAL SOCIETY, Mr. W. E. WILLIAMSON, Chief Clerk, House Committee on Interstate and Foreign Commerce, DEAR SIR: As president of the American Gynecological Society, I urge strongly that the title of H.R. 8398 be changed to "National Institute of Maternal and Child Health." It is obvious that a healthy infant cannot be produced by other than a healthy mother. The prenatal maternal factors which determine prenatal intrauterine health of the unborn child require infinite and detailed study. Chief among these are the factors leading to premature birth, which is now the leading cause of infant mortality. Further study of the causes of the toxemias of pregnancy may well be instrumental in the avoidance of prematurity. The health of the mother is so intimately linked to that of the embryo and child that an Institute for the study of both has much to offer in human development. There is no doubt that obstetricians and pediatricians can work harmoniously together in this broad field. Dr. Duncan E. Reid, professor of obstetrics at Harvard, has been asked to represent the American Gynecological Society in the hearings on H.R. 8398. Sincerely yours, ROBERT A. KIMBROUGH, M.D., President. |