Some adult rheumatologists, internists, pediatricians, and even orthopedic surgeons treat JIA with great skill and compassion, all of the experts interviewed for this story agreed. But nonpediatric rheumatologists balk when it comes to prescribing biologic therapies, which require finesse in family communication, administration, and monitoring. As a result, practical access to biologics is spotty and many children still live with preventable pain and progressive disability. As is the case with rheumatoid arthritis in adults, early diagnosis is imperative and disease-modifying drugs must be initiated before irreparable damage occurs, they said.