Developmental-Behavioral Pediatrics

UCLA Pediatric Residency Rotation

Abbreviated Interpretation of ACGME Dictated Goals for Pediatrics Residency Rotation

  1. Prevention of developmental-behavioral problems:
  2. Know how to educate families, identify at-risk kids, and obtain early intervention services
  3. Developmental screening lecture
  4. Educational Law
  5. Observe various attendings develop intervention plans during developmental evaluations
  6. Prenatal / Postnatal
  7. Environmental / Social / Family Influence
  8. Appropriate Early Intervention Referrals / Services:
  9. Advocate for children with developmental, behavioral and educational needs
  1. Differentiate normal development from abnormal development from birth to adolescence:
  2. Predict and observe developmental milestones during clinic assessments
  3. Normal infant development lecture
  4. Observe normal population of children at play and approximate ages based on skills
  5. Perform Denver II Developmental Screening Tests at UCLA Child-Care Center
  6. Developmental Domains – 1) cognitive skills, 2) gross motor skills, 3) fine motor skills, 4) receptive language, 5) expressive language, 6) social-emotional development
  7. Behavioral Domains – 1) attachment, 2) autonomy, 3) elimination and eating, 4) temperament, 5) sexuality, 6) sleep
  8. Major theories of development
  9. Skills to counsel families
  10. Identify red flags
  11. Developmentally-appropriate coping strategies vs ineffective coping strategies
  12. Familiarity with testing for learning differences
  13. Use developmental and behavioral screening instruments
  14. Vanderbilt, Connors, SNAP – ADHD
  15. PEDS & ASQ-SE – Behavioral screening questionnaire
  16. Denver II, Gesell, Mullen, Bayley III – Developmental screening tool
  17. OAE, BAR, Tympanogram – hearing and anatomical screening
  1. Anticipatory guidance for families
  2. Understand what types of guidance for which pediatricians are responsible
  3. Know where to obtain parental education materials for families when needed

Developmental milestones

Expected behaviors

Injury prevention

Feeding

Early Intervention Programs

Eating disorders

Domestic violence

Gifted children

Sibling rivalry

Discipline

Language development

Abuse / Neglect

Substance abuse

Media exposure

Behavioral management

Day care

Death / Loss

Toilet training

School readiness

Study skills

Adoption / Family dynamics

Bullying

Low socioeconomic status

  1. Recognize and manage common developmental and behavioral conditions that do not require referral
  • Learn what happens at an average Developmental-Behavioral Pediatric diagnostic clinic
  • Understand what types of patients can benefit from specific developmental-behavioral pediatric knowledge
  • Be comfortable with handling the care of common minor D-B issues
  • Practice developmental evaluations in the newborn follow-up clinic

School avoidance / Refusal

Parent training / Discipline

Enuresis

Fears and Anxiety

Head banging

Separation anxiety

Mild depression

Adoption / Family dynamics

Bullying

Low socioeconomic status

ADHD

Colic

Adjustment reactions

Breath holding spells

Oppositional behavior

Encopresis

Failure to thrive

Normal habits

Temper tantrums

Simple motor tic

Functional pain

  1. Recognize, appropriately refer and provide primary case management for common developmental or behavioral conditions
  • Be able to identify and coordinate care for major Developmental Behavioral Diganosis
  • Recognize the need to refer these patients and how to do so, maintaining communication
  • Review Sample Pediatric Board Questions

Spina Bifuda

Paraplegia / Amputation

Tourette’s Disorder

Mental Retardation

Language Disorders

Cerebral Palsy

Autistic Spectrum Disorder

Conduct Disorder

School Failure

Mood Disorders

Substance Abuse

Gender Identity Issues

Cleft lip / palate

Sensory Impairment

Prematurity

Mild Cognitive Disabilities

Learning Disorders

Muscular Dystrophy

Attention Problems / ADHD

Oppositional Defiant Disorder

Anxiety Disorder

Suicidality

Physical / Sexual Abuse or Neglect

Psychosis

Resources:

Visit website at :

  • Find links to >200 review articles on DB Pediatric topics
  • Milestone summaries
  • Find links to resources for developmental screening (including free M-CHAT interview, free ADHD tests and measures to follow, treatment of depression, recognition of fetal-alcohol syndrome and more)
  • Find links to websites with valuable information for doctors and patients (including find your Regional Center by ZIP code, genetics lectures, resources for child abuse, adoption, learning disability and more)