Delinquency and the Pediatrician
Alan D. Woolf MD, MPH1
1 Attending pediatrician at The Children's Hospital, Boston, an Instructor of Pediatrics at Harvard Medical School, the Associate Director of Community Services, and Director of the Young Adult Team in the School Function Program at The Children's Hospital
Adolescents may be predisposed to delinquency by a double-jeopardy situation of clustering of risk factors in physical health (eg, perinatal or nervous system trauma, naurodevelopmental or cognitive dysfunction, neglected health problems) and the environment (eg, poverty, disordered family dynamics, poor education). Pediatricians must be attentive to neglected or previously undiscovered health problems in this population, such as overlooked cosmetic or congential defects, nutritional problems, substance abuse, vision and hearing difficulties, dental pathology, and sex-related conditions and diseases. Delinquents, especially during the transition into detention, are at particular risk for injuries, depression, and suicidal behavior. The complete health assessment of the delinquent should include a neurodevelopmental, cognitive, and educational progress assessment. This will facilitate implementation of an appropriate individualized remediation program. The pediatrician, in the dual role of health care provider for the family and child advocate in the community, can accomplish much toward the primary, secondary, and tertiary prevention of delinquency.
