An Ethical Conflict Between Parents and Clinician in a Child with a Language Delay.

A developmental-behavioral pediatrician evaluated a 2-year-old child for developmental delays. He determined that the child had mild expressive language delays; the child had an intelligible vocabulary of 20 words and at least 20 other words that he said unclearly. He said a few contracted 2-word phrases, such as "gimme" and "its ok.

Teasing out specific language impairment from an autism spectrum disorder.

Marcus is a handsome, sweet, 7½-year-old boy with a significant history of delayed development, specifically in speech and language skills, as well as difficulties with social interactions that have led other specialists to be concerned about a diagnosis of an autism spectrum disorder.He has been seen in our primary care practice since birth. He was born full-term after vaginal delivery weighing 6 pounds, 6 ounces.

Should the diagnosis of autism be made only on the basis of a standardized test?

This commentary argues that a standardized tool such as Autism Diagnostic Observation Schedule (ADOS) is not always required to make the diagnosis of autism, which can be made by obtaining a thorough history and performing an astute clinical examination as William Osler, founder of John Hopkins School of Medicine, taught or Dr. Leo Kanner practiced.

An ethical conflict between parents and clinician in a child with a language delay.

A developmental-behavioral pediatrician evaluated a 2-year-old child for developmental delays. He determined that the child had mild expressive language delays; the child had an intelligible vocabulary of 20 words and at least 20 other words that he said unclearly. He said a few contracted 2-word phrases, such as "gimme" and "its ok.

Communicating with parents of children with autism about vaccines and complementary and alternative approaches.

Despite incontrovertible evidence that vaccines do not cause autism, some parents continue to refuse them and many parents of children with autism seek hope in unproven and potentially harmful complementary and alternative (CAM) approaches. This commentary explores the reasons for such behaviors and proposes that pediatricians may support parents in their pursuit of hope in unproven treatments as long as these are not potentially harmful to the child or prohibitively expensive. While respecting parental autonomy and hope the pediatricians should share with parents their concerns about lack of scientific evidence about CAM and potential for harm by some approaches.

When disclosing a serious diagnosis to a minor conflicts with family values.

An 11-year old Asian-Indian boy was recently discovered to have acute myelogenous leukemia. The pediatric hematologist-oncologist arranged a meeting to inform the parents about the diagnosis, prognosis and treatment. The physician planned to include the child in this process.

Impact of culture on healthcare seeking behavior of Asian Indians.

Healthcare seeking behavior is a dynamic process that evolves through the stages of self evaluation of symptoms, self treatment, seeking professional advice and acting on professional advice. (Weaver, 1970) This article explores the influence of culture at each of these stages in the context of Asian Indian culture. Although Asian-Indians constitute only 1.

When disclosing a serious diagnosis to a minor conflicts with family values.

An 11-year old Asian-Indian boy was recently discovered to have acute myelogenous leukemia. The pediatric hematologist-oncologist arranged a meeting to inform the parents about the diagnosis, prognosis and treatment. The physician planned to include the child in this process.

Pediatrician practices regarding referral to early intervention services: is an established diagnosis important?

Objective: Early intervention (EI) programs provide services to children with developmental conditions, regardless of whether such children have an underlying medical diagnosis. We aim to (1) Determine the proportion of general pediatricians who believe an established diagnosis is important when considering EI referral; and (2) Determine whether this perception is associated with lower reported likelihood of referral.

Methods: Mailed survey to random sample of pediatricians.

Pediatricians' reported practices regarding developmental screening: do guidelines work? Do they help?

Background: In 2001, the American Academy of Pediatrics (AAP) adopted a policy that all infants and young children should be screened for developmental delays at regular intervals. The policy statement promoted the use of valid reliable instruments. It is unknown, however, what proportion of pediatricians follow this recommendation and whether such a practice is associated with improved identification of children with developmental difficulties.

Care coordination services in pediatric practices.

Objective: To examine the frequency with which pediatricians provide care coordination services to children, particularly those with special health care needs, in their practices and the barriers to providing these services.

Methods: An 8-page questionnaire was mailed to 1632 randomly selected US members of the American Academy of Pediatrics.

Results: The response rate was 56.