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Pediatricians' approaches to developmental problems: has the gap been narrowed?
A E Dobos1, P H Dworkin, B A Bernstein
1Department of Pediatrics, University of Connecticut, School of Medicine, Farmington.
Insights
Pediatricians now use more advanced methods for developmental problems, moving beyond basic exams. This reflects improved training in developmental pediatrics and better patient outcomes.
Area of Science:
- Pediatric Practice
- Developmental Pediatrics
Background:
- Uncertainty regarding the impact of recent advances in developmental pediatrics on clinical practice.
- Need to assess current pediatricians' approaches to developmental issues.
Purpose of the Study:
- To explore attitudes and clinical approaches of primary care pediatricians to developmental problems.
- To compare current practices with those from 15 years prior.
Main Methods:
- Survey of 41 randomly selected, board-certified, primary care pediatricians in Connecticut.
- Comparison of responses with a previous survey of 97 New England pediatricians.
Main Results:
- Pediatricians are less reliant on history and physical examination alone for diagnosing mental retardation.
- Increased likelihood of referral for further assessment in cases of suspected mental retardation (p < .01).
- Higher rates of hearing screening for delayed speech (p < .05) and school contact/referral for failing children (p < .01).
Conclusions:
- Favorable changes observed in pediatricians' approaches to developmental problems.
- Evidence supports the increased emphasis on developmental issues in pediatric education.
Abstract:
Whether recent advances in developmental pediatrics have influenced pediatric practice is uncertain. We interviewed, in their offices, 41 randomly selected, board-certified, primary care pediatricians in Connecticut to explore their attitudes and clinical approaches to developmental problems. Responses were compared with those from a similar survey of 97 New England pediatricians performed 15 years ago. Important changes in certain clinical approaches were found. For example, pediatricians are currently less likely to rely on history and physical examination alone to confirm a suspicion of mental retardation (p < .01) and are more likely to refer such a child for further assessment (p < .01); they are more likely to perform hearing screening in evaluating a child with delayed speech (p < .05); they are more likely to contact the school in evaluating a failing child (p < .01), and are more likely to refer such a child for further assessment (p < .01). Results indicate favorable changes in pediatricians' approaches to developmental problems and support the greater emphasis on developmental issues in pediatric education.