Pediatric diagnosis and management of children with developmental disabilities

Mail surveys were conducted in 1976 and 1980 with Oregon primary care pediatricians to determine patterns of in-depth evaluations, followup, and availability of diagnostic and treatment services for children with developmental disabilities. It was assumed that changes might reflect the impact of recent federal legislation. Patterns of referral were related more to the type and disorder than to the location of the physician's practice. The majority of pediatricians referred children for evaluation for mental retardation, cerebral palsy, learning disabilities, autism, and multihandicapping conditions. Over half reported doing their own evaluations for convulsive disorders. Referrals were most often to multidiscipline teams except for learning disabilities and convulsive disorders. The present study emphasizes the pediatricians' utilization of specialized interdisciplinary centers for diagnosis of children with major developmental disabilities. There was little change in practice patterns during the study period, but some significant shifts in perceived service needs were observed. The most significant change seems to be a heightened awareness of these children's needs for services. Pediatricians continue to express a need for more training in diagnosis and care of developmental disabilities.