Specialists in the field of Developmental and Behavioral Pediatrics (DB peds) evaluate, diagnose and provide educational and medical management of children with developmental disorders or children who are at risk of not meeting expected developmental milestones. In addition, Developmental and Behavioral Pediatricians work with children and adolescents who present with typical development, but display difficulties related to their mood or behavior.
Infants and toddlers commonly present with developmental delays related to prematurity or require evaluation of difficulties related to sleep, feeding, elimination or overall development (e.g., speech, fine motor skills, gross motor skills). Toddlers and preschool children commonly present due to delays in communication/socialization, which may raise concern for a disorder of social communication, such as autism spectrum disorder. Children in this age range also may present with behavioral or toileting difficulties. School-aged children and adolescents often present with difficulties in learning, self-regulation, attention or mood.
Parents often seek a consultation with a Developmental and Behavioral Pediatrician when they are concerned with their child’s overall mood, social skills or behavior. DB Peds can assist families in making a developmental or mental health diagnosis, providing medication management, suggesting behavioral interventions and advocating for the child within the school system (e.g., reviewing IEPs, making school placement decisions). DBPs also help parents of adolescents who will require long-term familial support in seeking guardianship with the courts.
In all cases, Developmental Pediatricians evaluate a child in the context of the family. Child development is impacted by multiple factors including genetics, home/school environment, culture, social interactions, etc. All factors need to be taken into account when best determining a diagnosis and a comprehensive and individualized treatment plan. DB Peds also consider a child/family’s strengths which can be capitalized to provide an optimal environment for growth and developmental gains.
Typical examples of patients cared for in the practice of DB peds are the following:
- A six month old infant born 3 months prematurely who is irritable and fussy and displays poor sleep and feeding patterns.
- An 18 month who is not yet speaking and seems preoccupied with lining up his trucks, rather than playing with them.
- A 3rd grader with poor handwriting, short attention span, low grades and few friends.
- A teenager with suddenly failing grades.
- Parents of a child diagnosed with autism come in because they have been bombarded with advice about treatments and possible “cures”. They would like guidance in making the best decisions in choosing interventions most likely to benefit their child without harming her.
- Adolescents with worrisome changes in mood.
- Children of any age with pervasive anxiety, fears, sleep disturbance or obsessive-compulsive patterns of behavior.
Initial visits include detailed histories, structured family interviews, developmental testing and physical/neurological exams, as indicated. In all cases, multiple sources of information including parental history, school reports, child behavioral observations, etc. are evaluated to formulate a diagnostic impression. Further testing, such as genetic screening, imaging studies and neuropsychological/educational testing may be requested as part of this formulation.
Recommendations for intervention may include psychological, educational, rehabilitative, nutritional or medical measures. Careful follow-up is the norm. Most initial evaluations take place over 1-2 days with a typical visit lasting 60-90 minutes.
Developmental and Behavioral Pediatricians are certified as sub-specialists by the American Board of Pediatrics and are required to maintain professional medical certification in their specialty.
Frequently Asked Questions
- My child is on an IEP (individualized educational plan). I’m not sure it’s meeting his needs. Can you help me?
Yes. Specialists in DB peds are often asked to review interventions for children and provide input into school educational plans (IEP, Section 504 Plan). We work together with educational advocates, teachers and other specialists to arrive at decisions in the best interest of the child.
- I’ve been told my son has attention deficit hyperactivity disorder (ADHD) and that medication may help him. I’m worried about side effects and whether he’ll feel “drugged”. Can you help with this?
Yes. DB peds specialists are trained to implement and oversee medical treatments for these conditions. We are especially concerned with ensuring that the child/adolescent and their family agrees that any treatment chosen is effective and beneficial to the child without bringing about any unwanted side effects. DB peds specialists also look at ALL options for treatment to find what is best for a given child.
- Do you do IQ testing?
No. This kind of evaluation is done typically by clinical and educational psychologists.
- What kind of tests DO you do?
Evaluations done by DB peds specialists begin with a careful, structured and quite detailed interview. Questionnaires often provide further clarification. Standardized tests of developmental functions (language processing, motor skills, visual processing, memory, academic/learning, etc.) are combined with assessments of emotional status, socialization and a complete physical and neurological examination. Other information, such as previous evaluations, blood tests, imaging studies, etc. is then considered as part of a diagnostic formulation that is then shared with parents.