A Quality Improvement Network for Interdisciplinary Training in Developmental Disabilities.

Children with developmental disabilities (DD), such as autism spectrum disorder (ASD), have complex health and developmental needs that require multiple service systems and interactions with various professionals across disciplines. The growing number of children and youth identified with ASD or DD, including anxiety and depression, has increased demand for services and need for highly qualified pediatric providers. Federally funded Leadership Education in Neurodevelopmental and related Disabilities (LEND) programs across the United States address today's health care shortages by providing comprehensive, interdisciplinary training to providers from multiple pediatric disciplines who screen, diagnose, and treat those with ASD and DD.

Evidence-Informed Milestones for Developmental Surveillance Tools.

The Centers for Disease Control and Prevention's (CDC) Learn the Signs. Act Early. program, funded the American Academy of Pediatrics (AAP) to convene an expert working group to revise its developmental surveillance checklists.

Increasing Early Childhood Screening in Primary Care Through a Quality Improvement Collaborative.

Objectives: Multiple early childhood screenings are recommended, but gaps persist in implementation. Our aim for this project was to improve screening, discussion, referral, and follow-up of development, autism spectrum disorder (ASD), maternal depression, and social determinants of health (SDoH) to 90% by July 2018.

Methods: This 1-year national quality improvement collaborative involved 19 pediatric primary care practices.

Trends in Pediatricians' Developmental Screening: 2002-2016.

Background: Current guidelines from the American Academy of Pediatrics recommend screening children for developmental problems by using a standardized screening tool and referring at-risk patients to early intervention (EI) or subspecialists. Adoption of guidelines has been gradual, with research showing many children still not being screened and referred.

Methods: We analyzed American Academy of Pediatrics Periodic Survey data from 2002 (response rate = 58%; = 562), 2009 (response rate = 57%; = 532), and 2016 (response rate = 47%, = 469).

Promoting Optimal Development: Identifying Infants and Young Children With Developmental Disorders Through Developmental Surveillance and Screening.

Early identification and intervention for developmental disorders are critical to the well-being of children and are the responsibility of pediatric professionals as an integral function of the medical home. This report models a universal system of developmental surveillance and screening for the early identification of conditions that affect children's early and long-term development and achievement, followed by ongoing care. These conditions include autism, deafness/hard-of-hearing, intellectual and motor disabilities, behavioral conditions, and those seen in other medical conditions.

Young Children with Attention-Deficit/Hyperactivity Disorder and/or Disruptive Behavior Disorders Are More Frequently Prescribed Alpha Agonists Than Stimulants.

To examine medication prescribing patterns for preschool-aged children with diagnoses of attention-deficit/hyperactivity disorder (ADHD) and/or disruptive behavior disorder (DBD). Secondary objectives included determining if prescription patterns varied by gender, insurance type, or comorbid diagnosis of autism spectrum disorder (ASD). A retrospective, cross-sectional chart review was completed for children ages 2-5 years who were treated at an academic medical center between 2013 and 2016 with a diagnosis of ADHD and/or DBD.

Preventing elopement in children with autism spectrum disorder.

Reports of missing children with autism spectrum disorder (ASD) are common in the media, and elopement can lead to dire consequences. This study quantified the use of preventive measures that target elopement, plus identified child/family characteristics associated with elopement and the use of preventive measures. This cross-sectional study included 394 caregivers of children ages 2-17 years with ASD followed in an academic medical center's Developmental-Behavioral Pediatrics clinic.

The Interprofessional/Family-Centered-Care Observation Rubric (I-FOR): Results of a Multicenter Study of a New Measure of Educational Outcomes.

Introduction The ability to provide family-centered care (FCC) and the ability to work in interprofessional care teams (IPC) are essential educational outcomes in graduate training programs. Lack of standardized measures leave programs to rely on idiosyncratic methods to monitor outcomes. We developed a faculty observation tool as part of an effort to create a national quality improvement database.

Ostracism in pediatric populations: review of theory and research.

Ostracism, ignoring and excluding a target individual, has recently emerged as one of the more common and damaging forms of social exchange. This article reviews the theoretical and empirical foundations of ostracism and its impact on the targeted individual, especially threats to the fundamental psychological needs of belonging, self-esteem, meaningful existence, and sense of control. Ostracism in children and adolescents is under-researched compared to bullying in general, in both the general youth population and in populations of children and youth with special health care needs (CYSHCN).

The Effects of Early Neglect on Cognitive, Language, and Behavioral Functioning in Childhood.

Objectives: Few studies have explored the impact of different types of neglect on children's development. Measures of cognition, language, behavior, and parenting stress were used to explore differences between children experiencing various forms of neglect, as well as to compare children with and without a history of early neglect.

Methods: Children, ages 3 to 10 years with a history of familial neglect (USN), were compared to children with a history of institutional rearing (IA) and children without a history of neglect using the Differential Abilities Scale, Test of Early Language Development, Child Behavior Checklist, and Parenting Stress Index.

Enhancing the algorithm for developmental-behavioral surveillance and screening in children 0 to 5 years.

Objective: To determine if the 2006 American Academy of Pediatrics developmental surveillance and screening algorithm is adequate or if revisions are needed.

Methods: A comprehensive literature search was conducted to investigate a clinician's ability to perform developmental-behavioral surveillance in children 0 to 5 years.

Results: Even when a broad-band developmental screen is typical, pediatricians should refer when they confidently suspect a delay but be far more suspicious about children who seem asymptomatic.

Anxiety disorders in children and adolescents.

Anxiety disorders are among the most common and functionally impairing mental health disorders to occur in childhood and adolescence. Primary care providers can expect to treat youth who have anxiety disorders frequently, and this article aims to provide the tools necessary to evaluate and manage patients who present with anxiety symptoms during childhood or adolescence. This article discusses the epidemiology of anxiety disorders, including the increased risk of future anxiety disorders and other mental health problems that are associated with having an anxiety disorder in childhood and adolescence.

Implementing developmental screening and referrals: lessons learned from a national project.

Objectives: To assess the degree to which a national sample of pediatric practices could implement American Academy of Pediatrics (AAP) recommendations for developmental screening and referrals, and to identify factors that contributed to the successes and shortcomings of these efforts.

Background: In 2006, the AAP released a policy statement on developmental surveillance and screening that included an algorithm to aid practices in implementation. Simultaneously, the AAP launched a 9-month pilot project in which 17 diverse practices sought to implement the policy statement's recommendations.

Bullying and ostracism experiences in children with special health care needs.

Objective: Bullying experiences are becoming increasingly common in children and can have devastating consequences. Ostracism threatens a child's need for self-esteem, sense of belonging, sense of control, and meaningful existence. Recent literature suggests that children with special health care needs may be at risk for these negative events and consequences.

Parental depressive symptoms: relationship to child development, parenting, health, and results on parent-reported screening tools.

Objective: To determine whether parents with depressive symptoms can accurately complete parent-reported developmental screens, and to explore effects of parental depressive symptoms on perceptions of children's health and parenting behaviors.

Study Design: A total of 382 parent-child (ages 0 to 2 years) dyads from pediatric sites across 17 U.S.

Exposure to potentially traumatic life events in children with special needs.

A series of studies of potentially-traumatic life-events (PTLE) in children and youth with special needs (CSN) was conducted after parents of 102 CSN from interdisciplinary pediatric clinics listed PTLE at significantly higher rates on the Pediatric Emotional Distress Scale (PEDS) compared to parents 58 students with no diagnoses. Subsequent studies replicated this disparity in 213 5-15 year-olds sampled through school-distributed parent PTLE checklists instead of PEDS. Results from school samples suggested significantly more PTLE in CSN, t (211) = -3.

Services for children and adolescents with autism spectrum disorders: payment issues.

Primary care physicians have an important role in assuring that children with autism are identified as early as possible and have a medical home providing appropriate care and care coordination. Understanding efficient methods of care and modifying practice habits to minimize services not currently supported by procedural codes will permit the primary clinician to be paid for this medical care. Current medical procedure codes can be legitimately used to bill for care related to developmental and behavioral health needs and consistent use of these codes will help address payment barriers.

Paternal correlates of cognitive and behavioral functioning in children with myelomeningocele.

This study examined paternal correlates of the cognitive and behavioral functioning of children with myelomeningocele, when controlling for maternal and biological/child correlates as possible sources of variance. Participants were 48 parent dyads of children with myelomeningocele (21 males, 27 females) between the ages of 4 and 12 years (mean 8y, 2mo, SD 2y 3mo). Lesion levels of participants ranged from the thoracic to sacral (thoracic-L3: n=15; L4-L5: n=15; sacral or lipomeningocele: n=18), of whom 38 had been shunted for hydrocephalus.

Can a broadband developmental-behavioral screening test identify children likely to have autism spectrum disorder?

Because services for children with autism spectrum disorder (ASD) are scarce, when children fail a broadband screening measure, providers need to carefully discern which children need ASD evaluations and which do not. This research considers how well a broadband screening test sorts those with and without probable ASD. The subjects were 427 children between 18 and 59 months of age with elevated risk scores on broadband screening, ie, Parents' Evaluation of Developmental Status (PEDS), a 10-item measure eliciting parents' concerns.

Toileting concerns, parenting stress, and behavior problems in children with special health care needs.

This study examined the relationship between toileting concerns, behavior problems, and parenting stress in parents of children with special health care needs (CSHCN). Participants included parents of 99 males and 71 females aged 4 to 12 years with neural tube defects (NTD), developmental-behavioral disabilities (DBD), or history of perinatal intraventricular hemorrhage (IVH). Parents completed the Achenbach Child Behavior Checklist (CBCL) and the Parenting Stress Index-Short Form (PSI-SF).

Social skills and behavior problems in children with disabilities with and without siblings.

This study examined social skills and behavior of children with disabilities (CWD) and the impact of siblings on these behaviors. Eighty-five CWD diagnosed with Attention-Deficit Hyperactivity Disorder only (ADHD-o), Learning Disability or Learning Problems (LD/LP), ADHD and LD combined (ADHD/LD) or Spina Bifida (SB) and their siblings were evaluated using standardized social skills and behavior rating scales. The ADHD-o group had significantly lower social skills and more behavior problems than the other groups.