Commentary: First, AIDE for Pediatric Psychology

Addressing the state of pediatric psychology as a practice subspecialty, Rae (this issue) provides an excellent overview of the history and current status of the field from a perspective of fiscal travail. He bemoans the current reimbursement system for mental health ser- vices, as applied to pediatric psychology, and identifies three promising areas he hopes may lead our field to economic viability. These include: focusing our at- tention on our market niche (e.g., close alliance with pediatrics, directed toward primary care and chronic medical conditions); prevention of psychological dys- function; and demonstrating the benefits of medical-cost offset. Rae concludes on a relatively plaintive note, recalling the mournful words of a Depression-era song and urging us to keep the faith. In this author's view, Rae's commentary is partially correct, but far too passive. Pediatric psychologists cannot afford to depend on the largesse of others for the ''dime.'' We must first ''AIDE'' ourselves. Rae has essentially recognized that we already have the ability to do this. The agenda must be aggressively pursued. In this context the ''A'' is for sound clinical ap- plications. As Rae notes, our field has already developed many assessment and intervention strategies related to everything from infant feeding protocols to problem solving regarding incontinence (e.g., adherence, pain control, hospitalization preparation, school reintegra- tion, parent training). We must continue to innovate and test treatment approaches, prevention strategies, and primary care interventions for the problems most vexing to pediatric practitioners, the patients they care for, and the parents who live with the problems on a day-in/day-out basis. The ''I'' stands for integration and refers to Rae's