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Physiatrists and developmental pediatricians working together to improve outcomes in children with spina bifida
Mark E Swanson1, Brad E Dicianno
1Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA. cfu9@cdc.gov
Insights
This framework enhances care for children with spina bifida by integrating physiatry and developmental pediatrics. This collaboration optimizes outcomes through tailored support during childhood and adolescence.
Area of Science:
- Pediatrics
- Rehabilitation Medicine
Background:
- Children with spina bifida require multidisciplinary care to address complex medical, developmental, and psychosocial needs.
- Traditional pediatric teams may benefit from enhanced expertise in functional outcomes and lifelong participation.
Purpose of the Study:
- To propose a collaborative care framework integrating physiatry and developmental pediatrics for children with spina bifida.
- To delineate the distinct yet complementary roles of physiatrists and developmental pediatricians across different developmental stages.
Main Methods:
- Expert opinion and clinical experience from physicians in physiatry and developmental pediatrics.
- Framework development based on the progression of care needs from early childhood through adolescence and into adulthood.
Main Results:
- Developmental pediatricians are best suited to manage behavioral and educational issues in younger children.
- Physiatrists are crucial for improving functional outcomes and promoting self-management in adolescents.
- Integrating physiatry enhances focus on activity, participation, and long-term functional outcomes.
Conclusions:
- A combined physiatry and developmental pediatrics approach offers an optimized framework for managing spina bifida.
- This integrated model improves functional outcomes and promotes lifelong participation for individuals with spina bifida.
Abstract:
Based on the experience of 2 physicians from physiatry and developmental pediatrics, this article proposes a framework for improving care and outcomes for children with spina bifida. The combined skills of physiatrists and developmental pediatricians, along with other disciplines, can form the ideal team to manage the complex issues faced by this population. The developmental pediatrician is best suited for directing care for younger children through the elementary and middle school years, during which time behavioral and educational issues are prominent. As the child assumes more responsibility for self-management in adolescence, the physiatrist is ideally suited to provide major clinical input that improves functional outcomes. The addition of the discipline of physiatry to traditional, developmentally oriented pediatric interdisciplinary teams can add the much needed dimensions of activity and participation, and improve functional outcomes at the adult level by encouraging activities in adolescence that lead to full participation in adulthood.
