Beyond the nuclear family. Resources and implications for pediatricians.

In the United States, the shift from traditional nuclear families to diverse family forms has been dramatic. As a result, it is estimated that only 50% of children will live with their biologic parents until their 18th birthday. Consequently, many of the children seen by pediatricians live in non-nuclear family homes. Despite society's difficulty in accepting family diversity, research indicates it is not the form of the family that leads to problems for children, but it is conflict in the family that can produce lasting emotional difficulties. The family's task is to create emotionally supportive interactions within the family, regardless of family type. The pediatrician is a major societal contact for many families. As such, pediatricians are in a position to make a meaningful difference in the health of children and families. This can bring rewards to the family and to the pediatrician. By being more knowledgeable about the child's form of family, its intrinsic strengths and potential problems, and more specifically about the nature of relationships within the family, a pediatrician can play a major role in the anticipation, early detection, and intervention of problems. The knowledge and techniques suggested in this article, when used appropriately, will assure a better outcome for children and their families.