Andrea F. Duncan, MD, MS, is the Medical Director of the Neonatal Follow-up Program and an attending neonatologist in the Division of Neonatology at Children's Hospital of Philadelphia. She holds the Distinguished Endowed Chair in the Department of Pediatrics.
Dr. Andrea Freeman Duncan received her medical degree from the University of Texas Southwestern Medical Center at Dallas in 2002. She completed her pediatric residency and fellowship in Neonatal-Perinatal Medicine at the University of Texas Southwestern Medical Center at Dallas. She was subsequently a clinical scientist faculty member and mentor at the University of New Mexico and the University of Texas at Houston McGovern Medical School.
Dr. Duncan joined the faculty of the University of Pennsylvania and Children's Hospital of Philadelphia in 2019 and is the Medical Director of the Neonatal Follow-up Program there. She is the Principal Investigator for Neurodevelopmental Follow-up for the Children's Hospital of Philadelphia site of the Eunice Kennedy Shriver National Institute of Child Health and Development Neonatal Research Network. She is also the Principal Investigator for the Children's Hospital of Philadelphia site of the Cerebral Palsy Foundation Early Detection of Cerebral Palsy (CP) Network.
Dr. Duncan's main research interest is in long-term medical and neurodevelopmental outcomes of NICU graduates. This has included previous research in the effects of very-low-birth weight and postnatal growth on blood pressure during the first three years of life, the role of ethnic and social factors on Bayley Scales of Infant Development Cognitive and Language Scale scores in children born extremely premature, the effect of parenting style on self-regulation in children born preterm, the correlation of neuroimaging with outcomes in children born extremely preterm, motor outcomes in high-risk children, and the effects of implementation of the international guidelines for early assessment for CP on diagnoses and outcomes in high risk infants. Her current research involves evaluation of executive functioning and brain connectivity in high-risk infants and infants with CP, parenting style in high risk infant development, and the use of implementation science to translate evidence to practice.
Education and Training
MD - University of Texas Southwestern at Dallas, Dallas, TX
Pediatrics - University of Texas Southwestern at Dallas, Dallas, TX
Neonatal-Perinatal Medicine - University of Texas Southwestern at Dallas, Dallas, TX
Neonatal-Perinatal Medicine – American Board of PediatricsPediatrics – American Board of Pediatrics
MS in Clinical Research - University of New Mexico, Albuquerque, NM
Titles and Academic Titles
Medical Director, Neonatal Follow-up Program
Distinguished Endowed Chair in the Department of Pediatrics
Associate Chair for Diversity and Equity, Department of Pediatrics
Associate Division Chief for Diversity, Equity and Inclusion, Division of Neonatology
Associate Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania
Long-term medical and neurodevelopmental outcomes of NICU graduates
Evaluation of executive functioning and brain connectivity in high-risk infants and infants with CP
Parenting style in high risk infant development
Use of implementation science to translate evidence to practice
Montoya-Williams D, Wallis KE, Duncan AF. Best practices for the conduct of antiracist research: Time for formal, tailored curriculums. JAMA Pediatr. 2022 Feb 14. doi: 10.1001/jamapediatrics.2021.6315.
Duncan AF, Malleske DT, Maitre NL. Use of Antenatal Corticosteroids for Risk of Preterm Birth-Is Timing Everything? JAMA Pediatr. 2022 Apr 11:e220480. doi: 10.1001/jamapediatrics.2022.0480. Epub ahead of print. PMID: 35404440.61.
DeMauro SB, Merhar SL, Peralta-Carcelen M, Vohr BR, Duncan AF, Hintz SR. The critical importance of follow-up to school age: Contributions of the NICHD Neonatal Research Network. Semin Perinatol. 2022 Jun 10:151643.
Montoya-Williams D, Duncan AF, Burris HH. Racial and ethnic perinatal and infant disparities: a comprehensive, diverse and actionable compendium [published online ahead of print, 2022 Aug 31]. Semin Perinatol. 2022;151655.
Montoya-Williams D, Gualy S, Mazur M, Huber M, Peña MM, DeMauro SB, Duncan AF. Impact of COVID-19 on Infants Followed After Discharge from the NICU Using a Telemedicine Model. American Journal of Perinatology. 2022 Nov 30.
Maitre NL, Byrne R, Duncan A, et al. "High-risk for cerebral palsy" designation: A clinical consensus statement. Journal of Pediatric Rehabilitation Medicine. 2022 ;15(1):165-174. DOI: 10.3233/prm-220030. PMID: 35275579.
Waller R, Kornfield SL, White LW, Chaiyachati BH, Barzilay R, Njoroge WF, Parish-Morris J, Duncan AF, Himes MM, Rodriguez Y, Seidlitz J, Riis V, Burris HH, Gur RE, Elovitz. Clinician-reported childbirth outcomes, patient-reported childbirth trauma, and risk for postpartum depression. Arch Womens Ment Health. 2022;25(5):985-993.
Laptook AR, Shankaran S, Barnes P, Rollins N, Do BT, Parikh NA, Hamrick S, Hintz SR, Tyson JE, Bell EF, Ambalavanan N, Goldberg RN, Pappas A, Huitema C, Pedroza C, Chaudhary AS, Hensman AM, Das A, Wyckoff M, Khan A, Walsh MC, Watterberg KL, Faix R, Truog W, Guillet R, Sokol GM, Poindexter BB, Higgins RD; Limitations of Conventional Magnetic Resonance Imaging as a Predictor of Death or Disability Following Neonatal Hypoxic-Ischemic Encephalopathy in the Late Hypothermia Trial. Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network.J Pediatr. 2021 Mar;230:106-111.e6. doi: 10.1016/j.jpeds.2020.11.015. Epub 2020 Nov 13.PMID: 33189747
DeMaster D, Bick J, Johnson J, Montroy J, Landry S, Duncan, A: Nurturing the preterm infant brain: Leveraging neuroplasticity to improve neurobehavioral outcomes. Pediatr Res. 2019 Jan;85(2):166-175. doi: 10.1038/s41390-018-0203-9. Epub 2018 Oct 16.
Duncan AF, Bann CM, Dempsey AG, Peralta-Carcelen M, Hintz S: Behavioral Deficits at 18-22 Months of Age are Associated with Early Cerebellar Injury and Cognitive and Language Performance in Extremely Preterm Children. J Pediatr. 2019 Jan;204:148-156.e4. doi: 10.1016/j.jpeds.2018.08.059. Epub 2018 Oct 3.
Dempsey AG, Barton AK, Duncan AF: Differences in performance on developmental tasks in young children across digital and paper-based modalities: a feasibility trial. J Dev Behav Pediatr. 2018 Dec;39(9):726-735. doi: 10.1097/DBP.0000000000000618.
Hintz SR, Vohr BR, Bann CM, Taylor HG, Das A, Ball MB, Gustafson KE, Yolton K, Watson V, Lowe J, DeAnda ME, Hack M*, Finer N, Van Meurs KP, Shankaran S, Pappas A, Barnes PD, Bulas D, Slovis TL, Wilson-Costello DE, Heyne RJ, Harmon H, Peralta-Carcelen M, Adams-Chapman I, Duncan AF, et al and for the Eunice Kennedy Shriver NICHD Neonatal Research Network: Preterm Neuroimaging and School-Age Cognitive Outcomes. Pediatrics 142(1), July 2018 Notes: DOI: 10.1542/peds.2017-4058.
Vohr BR, Heyne R, Bann CM, Das A, Higgins RD, Hintz SR; Eunice Kennedy Shriver National Institute of Child Health, and Development Neonatal Research Network: Extreme Preterm Infant Rates of Overweight and Obesity at School Age in the SUPPORT Neuroimaging and Neurodevelopmental Outcomes Cohort. J Pediatr May 2018 Notes: pii: S0022-3476(18)30627-9. doi: 10.1016/j.jpeds.2018.04.073.
Adams-Chapman I, Heyne R, DeMauro S, Duncan AF, Hintz S, Pappas A, Vohr B, McDonald S, Das A, Newman J, Higgins R: Neurodevelopmental Impairment Among Extremely Preterm Infants in the Neonatal Research Network. Pediatrics 141(5): 2017-3091, May 2018.
Sarkar S, Shankaran S, Barks J, Do BT, Laptook AR, Das A et al for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network: Outcome of Preterm Infants with Transient Cystic Periventricular Leukomalacia on Serial Cranial Imaging Up to Term Equivalent Age J Pediatr 195: 59-65, April 2018.
Findley T, Patel M, Chapman J, Brown D, Duncan AF: Acquired versus congenital neonatal purpura fulminans: a case report and literature review. J Pediatr Hematol Oncol April 2018 Notes: DOI: 10.1097/MPH.0000000000001150.
Younge N, Goldstein RF, Bann CM, Hintz SR, Patel RM, Smith PB, Bell EF, Rysavy MA, Duncan AF, Vohr BR, Das A, Goldberg RN, Higgins RD, Cotton CM, for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network: Survival and Neurodevelopmental Outcomes of Periviable Infants NEJM 376(7): 617-628, 2017.
Watterberg KL, Fernandez E, Walsh MC, Truog WE, Stoll BJ, Sokol GM, Kennedy KA, Fraga MV, Beauman SS, Carper B, Das A, Duncan AF, Buss WF, Gauldin C, Lacy CB, Sanchez PJ, Chawla S, Lakshminrusimha S, Cotten CM, Van Meurs KP, Poindexter BB, Bell EF, Carlo WA, Devaskar U, Wyckoff MH, Higgins RD: Barriers to enrollment in a randomized controlled trial of hydrocortisone for cardiovascular insufficiency in term and late preterm newborn infants J Perinatol 37(11), November 2017 Notes: doi: 10.1038/jp.2017.131.
James J, Munson D, DeMauro SB, Langer JC, Dworetz AR, Natarajan G, et al and Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network: Outcomes of Preterm Infants following Discussions about Withdrawal or Withholding of Life Support J Pediatr November 2017 Notes: doi: 10.1016/j.jpeds.2017.05.056. Epub 2017 Jun 21.
Peralta-Carcelen M, Carlo WA, Pappas A, Vaucher YE, Yeates KO, Phillips VA, Gustafson KE, Payne AF, Duncan AF, Newman JE, Bann C, and other follow up PI for the NICHD Neonatal Network: Behavioral problems and socioemotional competence at 18-22 months of extremely premature children. Pediatrics May 2017.
Duncan AF, Frankfurt JA, Heyne RJ, Rosenfeld CR: Biomarkers of Adiposity are Elevated in Preterm Very-Low-Birth-Weight Infants at 1, 2 and 3 Years of Age. Pediatr Res 81(5): 780-786, May 2017 Notes: DOI: 10.1038/pr.2017.11.
Meyers J, Bann CM, Stoll BJ, D'Angio C, Bell E, Duncan AF, Guillet R: Neurodevelopmental Outcomes in Postnatal Growth-Restricted Preterm Infants with Postnatal Head-Sparing J Perinatol 36(12): 1116-1121, Dec 2016.
Hoffman L, Bann C, Higgins R, Vohr B, et al and for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network: Developmental outcomes of extremely preterm infants born to adolescent mothers. Pediatrics 135(6): 1082-92, 2015.
Duncan A F, Bann C, Boatman C, Hintz S R, Vaucher Y E, Vohr B R, Yolton K, Heyne R J: Do currently recommended Bayley-III cutoffs overestimate motor impairment in infants born <27 weeks gestation? Journal of perinatology : official journal of the California Perinatal Association 35(7): 516-21, Jul 2015.
Lowe Jean, Erickson Sarah J, MacLean Peggy, Duvall Susanne W, Ohls Robin K, Duncan Andrea F: Associations between maternal scaffolding and executive functioning in 3 and 4 year olds born very low birth weight and normal birth weight. Early human development 90(10): 587-93, Oct 2014.
Morriss Frank H, Saha Shampa, Bell Edward F, Colaizy Tarah T, Stoll Barbara J, Hintz Susan R, Shankaran Seetha, Vohr Betty R, Hamrick Shannon E G, Pappas Athina, Jones Patrick M, Carlo Waldemar A, Laptook Abbot R, Van Meurs Krisa P, Sánchez Pablo J, Hale Ellen C, Newman Nancy S, Das Abhik, Higgins Rosemary D: Surgery and neurodevelopmental outcome of very low-birth-weight infants. JAMA pediatrics 168(8): 746-54, Aug 2014.
Duncan A F, Caprihan A, Montague E Q, Lowe J, Schrader R, Phillips J P: Regional cerebral blood flow in children from 3 to 5 months of age. AJNR. American journal of neuroradiology 35(3): 593-8, Mar 2014.
Lowe Jean R, Duncan Andrea Freeman, Bann Carla M, Fuller Janell, Hintz Susan R, Das Abhik, Higgins Rosemary D, Watterberg Kristi L: Early working memory as a racially and ethnically neutral measure of outcome in extremely preterm children at 18-22 months. Early human development 89(12): 1055-61, Dec 2013.
Lowe Jean R, Nolen Tracy L, Vohr Betty, Adams-Chapman Ira, Duncan Andrea F, Watterberg Kristi: Effect of primary language on developmental testing in children born extremely preterm. Acta paediatrica (Oslo, Norway : 1992) 102(9): 896-900, Sep 2013.
Frankfurt Joshua A, Duncan Andrea F, Heyne Roy J, Rosenfeld Charles R: Renal function and systolic blood pressure in very-low-birth-weight infants 1-3 years of age. Pediatric nephrology (Berlin, Germany) 27(12): 2285-91, Dec 2012.
Duncan Andrea Freeman, Watterberg Kristi L, Nolen Tracy L, Vohr Betty R, Adams-Chapman Ira, Das Abhik, Lowe Jean: Effect of ethnicity and race on cognitive and language testing at age 18-22 months in extremely preterm infants. The Journal of pediatrics 160(6): 966-71.e2, Jun 2012.
Lowe Jean R, MacLean Peggy C, Duncan Andrea F, Aragón Crystal, Schrader Ronald M, Caprihan Arvind, Phillips John P: Association of maternal interaction with emotional regulation in 4- and 9-month infants during the Still Face Paradigm. Infant behavior & development 35(2): 295-302, Apr 2012.
Lowe Jean R, Erickson Sarah J, Schrader Ron, Duncan Andrea F: Comparison of the Bayley II Mental Developmental Index and the Bayley III Cognitive Scale: are we measuring the same thing? Acta paediatrica (Oslo, Norway : 1992) 101(2): e55-8, Feb 2012.
Duncan Andrea F, Heyne Roy J, Morgan Janet S, Ahmad Naveed, Rosenfeld Charles R: Elevated systolic blood pressure in preterm very-low-birth-weight infants u88043 years of life. Pediatric nephrology (Berlin, Germany) 26(7): 1115-21, Jul 2011.
Duncan Andrea Freeman, Caughy Margaret O'Brien: Parenting style and the vulnerable child syndrome. Journal of child and adolescent psychiatric nursing : official publication of the Association of Child and Adolescent Psychiatric Nurses, Inc 22(4): 228-34, Nov 2009.
Duncan Andrea F, Rosenfeld Charles R, Morgan Janet S, Ahmad Naveed, Heyne Roy J: Interrater reliability and effect of state on blood pressure measurements in infants 1 to 3 years of age. Pediatrics 122(3): e590-4, Sep 2008.
Stewart J, Hernandez F, Duncan A: Follow-up Care of Very Preterm and Very Low Birthweight Infants. Cloherty and Stark's Manual of Neonatal Care, 8th ed. Eric Eichenwald, Ann Hansen, Camilia Martin and Ann Stark (eds.). 2016.
Posters and Presentations
Sabates RS, Bell CS, Dempsey AG, Duncan AF: Predictive Validity of the Ages and Stages Questionnaire in Toddlers Born Less than 28 Weeks Gestation. Poster presentation, Pediatric Academic Societies' Meeting, Toronto, Canada. May 2018.
Peralta-Carcelen M, Hintz SR, Higgins RD, Duncan AF, Vohr BR, Bann C: Factors associated with autism spectrum disorder features at early school age among extremely preterm children. Poster Presentation, Pediatric Academic Society Meeting, Toronto Ontario, Canada May 2018.
McKay S, Domonoske C, McKay K, Duncan AF. : Immunization practices in the NICU and adverse events following vaccination in infants admitted to the NICU Poster presentation, Pediatric Academic Societies' Meeting, Toronto, Canada May 2018.
Jensen EA, Dysart K, Bamat NA, Kirpalani H, Eichenwald E, DeMauro SB, Gantz M, McDonald S, Keszler M, Laughon M, Poindexter B, Duncan AF, Yoder BA: Development of a Revised Severity Based Definition of Bronchopulmonary Dysplasia: Accounting for Modern Respiratory Care. Poster Presentation, Pediatric Academic Societies' Meeting, Toronto, Canada. May 2018.
Brumbaugh JE, Sridhar A, Hansen NI, Das A, Bell EF, Colaizy T, Rysavy MA, Carlo W, Hintz SR, Vohr BR, Duncan AF, Stoll B, Wyckoff M, Baack ML, DeMauro SB, Higgins RD: The Tiniest Babies: Outcomes of Infants with Birth Weight Less than 400 Grams. Poster Presentation, Pediatric Academic Societies' Meeting, Toronto, Canada May 2018.
Boghossian N, Tan S, Bell EF, Rysavy MA, Carlo W, Hintz SR, Ambalavanan N, Stoll B, Tyson J, Lantos JD, Duncan AF, Das A, Higgins RD: Sex Differences in Extremely Preterm Infant Outcomes over Time. Poster presentation, Pediatric Academic Societies' Meeting, Toronto, Canada. May 2018.
Sabates R, Bell C, Dempsey A, Duncan AF: Predictive Validity of the Ages and Stages Questionnaire in Toddlers Born Less than 28 Weeks Gestation. Poster Presentation, Society for Developmental and Behavioral Pediatrics (SDBP) annual meeting, Cleveland, OH October 2017.
Duncan A: Neurodevelopmental Outcomes in Premature Infants with Short Bowel Syndrome. Poster Presentation, American Academy of Pediatrics Section on Neonatal-Perinatal Medicine September 2017.
Rysavy MA, Colaizy TT, Bann CM, Hintz SR, DeMauro SB, Duncan AF, Vohr BR, Peralta-Carcelen AM, Bell EF, and the Eunice Kennedy Shriver NICHD Neonatal Research Network: Expanding the Frame- Outcomes Following Extremely Preterm Birth Beyond Neurodevelopmental Impairment. Poster presentation, Pediatric Academic Societies' Meeting, San Francisco, CA May 2017.
Meyers JM, Guillet R, Tan S, Bell EF, Duncan AF, Stoll BJ, D'Angio CT for the NICHD Neonatal Research Network: Neurodevelopmental Outcomes in Extremely Premature Infants with Linear Growth Restriction. Poster presentation,Pediatric Academic Societies' Meeting. San Francisco CA May 2017.
Adams-Chapman I, Heyne R, Duncan AF, Peralta M, Purdy I, McDonald SA for the NICHD Neonatal Research Network: Changing Prevalence and Severity of Cerebral Palsy Among ELBW Infants in NRN Over Ten Years Poster presentation, Pediatric Academic Societies' Meeting, San Francisco CA, May 2017.
Findley T, Patel M, Chapman J, Brown D, Duncan AF: Case Report: Acquired versus congenital neonatal purpura fulminans. Poster presentation, Southern Society for Pediatric Research Meeting, New Orleans, LA February 2017.
Duncan AF. "Early Diagnosis and Intervention for Cerebral Palsy: Translation of the 2017 International Guidelines into Clinical Practice", Pediatric Academic Societies' Meeting, Toronto, Canada. May, 2018.
Duncan AF. "Early Detection of Cerebral Palsy SWOT World Café", Cerebral Palsy Foundation, Implementation of Early Detection and Intervention for Cerebral Palsy Conference, Columbus, OH. Mar, 2018.
Duncan AF. "Neuroimaging in the Detection of Cerebral Palsy", Cerebral Palsy Foundation, Implementation of Early Detection and Intervention for Cerebral Palsy Conference, Columbus, OH. Mar, 2018.
Duncan AF. "Implementation of the Early Intervention and Assessment for Cerebral Palsy Guidelines", Regional Neonatal Evaluation and Outcomes Network Annual Meeting, Temple, Texas. Feb, 2018.
Duncan AF. "Predictive Validity of the Ages and Stages Questionnaire in Toddlers Born Less than 28 Weeks Gestation", Oral presentation, Southern Society for Pediatric Research, New Orleans, LA. Feb, 2018.
Duncan AF. "Cerebral Palsy: Improvising Outcomes Through Early Diagnosis and Intervention", Society for Developmental and Behavioral Pediatrics, Workshop Presentation, Cleveland, OH. Oct, 2017.
Duncan AF. "Digital Screening in Child Development", Society for Developmental and Behavioral Pediatrics, Workshop Presentation, Cleveland, OH. Oct, 2017.
Duncan AF. "Standardization of Developmental Assessments", Regional Neonatal Evaluation and Outcomes Network Annual Meeting, Houston, Texas. Feb, 2017.
Awards and Honors
2022, Distinguished Endowed Chair in the Department of Pediatrics
2017-2018, PRIDE Mentor Development Program, National Institute of Health and National Heart Lung and Blood Institute
2015, Mid-Career Minority Faculty Development Program, Association of American Medical Colleges (AAMC)
2014, Scientific Review Early Career Reviewer Awardee, National Institute of Health Center
2013, University of New Mexico Limited Competition Winner - Dana Foundation Neuroimaging Grant, University of New Mexico
2013, Junior Faculty Research Excellence Award Nominee, University of New Mexico
2013, Maternal-Fetal Medicine Awardee, National Institute of Child Health and Human Development (NICHD) conference
2012-2014, 2 year (PRIDE) Program to Increase Diversity in Behavioral Medicine Research Scholar, National Institute of Health and National Heart Lung and Blood Institute
2012, Junior Faculty Research Excellence Award Nominee, University of New Mexico
2012-2014, Selected for 1st University of New Mexico 2-year Medical Leadership Academy, University of New Mexico
2010-2011, Graduate Student of Excellence Award, University of New Mexico
2007, Marshall Klaus Perinatal Research Award, American Academy of Pediatrics
2007, Fellow's Travel Award, American Academy of Pediatrics Section on Perinatal Pediatrics Conference
1999, National Medical Association Scholarship
1999, Mayo Clinic Summer Clinical Fellowship, Mayo Clinic
1999, Departmental Pediatric Scholar, Mayo Clinic
Editorial and Academic Positions
2018-present, Reviewer, Neonatology
2017-present, Reviewer, Health and Development
2016-present, Ad-hoc Reviewer, Cognition and Perception Study Section- National Institute of Child Health and Human Development
2011-present, Reviewer, Pediatrics
2011-present, Invited Abstract Reviewer, Pediatric Academic Society Annual Conference
2010-present, Reviewer, Archives of Pediatric and Adolescent Medicine
2010-present, Reviewer, Journal of Pediatrics
2009-present, Reviewer, Early Human Development
Leadership and Memberships
Memberships in Professional Organizations
2015-present, Society for Pediatric Research
2011-present, National Institute of Child Health and Human Development
- 2011-present, Neonatal Research Network (NRN) Term Control Protocol Subcommittee
- 2011-present, Neonatal Research Network (NRN) Follow-up Protocol Review Subcommittee
2003-present, American Academy of Pediatrics
- 2016-present, Social Media Chair, MID Career Neonatologists (MidCaN), sub group of the Section on Neonatal-Perinatal Medicine
- 2016-present, Mid- Career Neonatology Group Executive Council
- 2015-present, Section on Neonatal- Perinatal Medicine Membership Committee
- 2008-present, Section on Neonatal- Perinatal Medicine
Patient Experience Ratings
About the Patient Experience Rating System
The Patient Experience Rating is an average of all responses to the care provider related questions shown above from our nationally-recognized Press Ganey Patient Satisfaction Survey. Patients that are treated in outpatient or hospital environments may receive different surveys, and the volume of responses will vary by question.
Responses are measured on a scale of 1 to 5 with 5 being the best score.
We are committed to true transparency. However, to ensure the comments are fair and correctly attributed, we review each one before posting to the website. We exclude entire comments that disclose patient's protected health information, are off-topic, or include other confidential or inappropriate content. Comments will appear on provider bios only if providers have a minimum number of comments.
Comments are shared internally for education purposes to ensure that we are doing our very best for the patients and families for whom we are privileged to care.
The comments are submitted by patients and families and reflect their views and opinions. The comments are not endorsed by and do not reflect the views of Children’s Hospital of Philadelphia.