Developmental Behavioral Peds

[DOchic]

Hi! I was wondering if anyone knows the track for becoming a developmental behavioral pediatrician? Do you do a Pediatric Residency and then subspecialize in it? Also, how long is it? Thanks in advance for any input ya'll can offer!

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[raptor5]

Need to do Peds first.
Fellowship is 3 years.
Check Freida for different programs.
FREIDA

 

[dsherida]

Yep, 3Peds, 3Behavioral/Dev. Peds. I hung out with a Behavioral/Dev Pediatrician in clinic last summer and it is a very cool and interesting specialty!

 

[Vox Animo]

can anyone provide more information on this field, or post a site? I had a little trouble finding the kind of information i want on google.

What is it like day to day?

 

[Homunculus]

What is it like day to day?

to me?



at the risk of p*ssing off some people-- they do a wonderful service, but it's nothing that a general pediatrician, given enough time and screening tests, couldn't do. if i had an hour with all my patients i could do a CAT/CLAMS, DENVER, and order a high res chromosome and fragile X probe, too.

the upside? ever hear of a middle of the night stat devo consult? that and the fact you are much more of a manager and a care coordinator than anything else. they are good at what they do, but i like to do more interventional stuff

--your friendly neighborhood should order a stat MRCP devo consult caveman

 

[Bernardo_11]

Hey there, thanks for your interest. I myself am a first yr fellow. To answer your question about the field, Homonculus is well... half right. In a sense, the field is still defining itself. I have met DB specialists who feel that the fellowships exists mainly to train academic specialists who will teach residents and medical students in Developmental/Behavioral problems most general pediatricians will face in practice. This is somewhat akin to academic fellowships in General Pediatrics.

I tend to think we do more than that. We assess developmental delays, just like many early intervention programs- but we take it a step beyond that in coming with a diagnosis and etiology of that delay (if it exists). In general peds most practitioners use a Denver, PEDS, ASQ's and other SCREENS to make referrals for possible developmental delay. The tools DB pedaitricians use, such as the Geselle or Bailey, are more intricate and thus are ASSESSMENTS in the various developmental domains.

Although a good general pediatrician can screen for an autistic child, we are abe to diagnose it. And I don't use CLAMS/CAT or other screening tools. I simply observe the children in their natural settings and base it off DSM-IV criteria.

There is also a large exposure to child psychiatry, and being able to do common psychopharmacology in some of your patients. With the shortage of chid mental health professionals, this can also be useful to know.

I agree with Homonculus that we often serve as a care coordinator. But while most general pediatricians are pretty good at coordinating the various specialists involved in the special needs child's medical care, DB pediatricians are able to coordinate proper interventional care that the special needs child gets from early intervention or special education.

As our technology is improving, children born with developmental disabilities are living much longer. So I think there will be a growing need for this specialty.

I had a wonderful time practicing as a general pediatrician back on Guam. Residents often ask me why I entered this specialty. I usually tell them I wanted to be a better general pediatrician. This specialty is a bridge between neurodevelopment and psychiatry, as well as giving you more exposure to genetics.

Hope this helps. PM me if you have any more questions.

Nardo,
DB Peds Fellow

 

[oldbearprofessor]

I think it is also worth noting that developmental pediatrics is a key specialty in terms of clinical outcomes-based research. A crucial question asked about almost any intervention in neonatology for example these days is "What will be its effect on long-term neurocognitive outcome?" This relates to everything from new respiratory care methods, steroid-use strategies, nutrition, pain relief and nursery ambient conditions, etc, etc. To get a good understanding of these issues requires close work with developmental pediatrics over a long-term basis. New tools are being developed to assess short and long-term responses and of course interaction between neonatologists, developmentalists and epidemiologists is crucial. Similar issues exist for pediatric cardiology, heme-onc and many pedi fields. So, those interested in clinical investigation have the opportunity to use these skills in designing and implementing research strategies on a wide-range of patient populations.

Regards

OBP

 

[Homunculus]

Hey there, thanks for your interest. I myself am a first yr fellow. To answer your question about the field, Homonculus is well... half right. In a sense, the field is still defining itself. I have met DB specialists who feel that the fellowships exists mainly to train academic specialists who will teach residents and medical students in Developmental/Behavioral problems most general pediatricians will face in practice. This is somewhat akin to academic fellowships in General Pediatrics.

I tend to think we do more than that. We assess developmental delays, just like many early intervention programs- but we take it a step beyond that in coming with a diagnosis and etiology of that delay (if it exists). In general peds most practitioners use a Denver, PEDS, ASQ's and other SCREENS to make referrals for possible developmental delay. The tools DB pedaitricians use, such as the Geselle or Bailey, are more intricate and thus are ASSESSMENTS in the various developmental domains.

Although a good general pediatrician can screen for an autistic child, we are abe to diagnose it. And I don't use CLAMS/CAT or other screening tools. I simply observe the children in their natural settings and base it off DSM-IV criteria.

There is also a large exposure to child psychiatry, and being able to do common psychopharmacology in some of your patients. With the shortage of chid mental health professionals, this can also be useful to know.

I agree with Homonculus that we often serve as a care coordinator. But while most general pediatricians are pretty good at coordinating the various specialists involved in the special needs child's medical care, DB pediatricians are able to coordinate proper interventional care that the special needs child gets from early intervention or special education.

As our technology is improving, children born with developmental disabilities are living much longer. So I think there will be a growing need for this specialty.

I had a wonderful time practicing as a general pediatrician back on Guam. Residents often ask me why I entered this specialty. I usually tell them I wanted to be a better general pediatrician. This specialty is a bridge between neurodevelopment and psychiatry, as well as giving you more exposure to genetics.

Hope this helps. PM me if you have any more questions.

Nardo,
DB Peds Fellow

there's the answer from the horse's mouth.

good post

--your friendly neighborhood take it from him not me caveman

 

[Vox Animo]

What types of research do these types of doctors conduct?

Is most of it just diagnosis methods, are is there research areas into the cause, treament or cure of certain developmental disabiliites?

 

[Bernardo_11]

What types of research do these types of doctors conduct?

Is most of it just diagnosis methods, are is there research areas into the cause, treament or cure of certain developmental disabiliites?

It is extremely varied. Some are researching diagnostic methods for certain conditions, other are studying developmental outcomes with certain interventions for developmental disabilites. Others have been more epidemiological, studying the causes and eating habits related to obesity. I went to a conference last year amongst the Maternal child Health funded DB peds programs and the presentations for research projects had a huge variety of topics. From ADHD and academic performance, from the amount of recess in schools, LDL/HDL levels in chidren with Downs syndrome, salivary cortisol levels in children with autism getting immunizations, breastfeeding and immigrant acculturation, amount of TV watching in children.... dude... you name it it can possibly be researched in some form or another with DB Peds.

Hope this helps,
Nardo
DB Peds Fellow

 

[Vox Animo]

What is a good website i can look at to get more information, or more info on research/programs ect. I've googled it a few times, but can't seem to find good info?

 

[Bernardo_11]

What is a good website i can look at to get more information, or more info on research/programs ect. I've googled it a few times, but can't seem to find good info?

Yeah, I know. A lot of the programs out there are pretty small, having 1-2 fellows at a given time. So having nice websites about their program is not a huge priority. But here's a few places you can try:

http://dbp.mchtraining.net

This site consists of those programs funded by the Maternal Child Health grant. Most of these programs are on the east coast.

http://www.ama-assn.org/ama/pub/category/2997.html

Do a search for Developmental/Behavioral Pediatrics fellowships (there are 31 accreddited programs now). Contact those program directors and ask if they have a brochure.

Hope this helps

Nardo,
DB Peds fellow

 

[canadagirl]

Thanks Bernardo_11 for all the info about developmental peds! A couple questions:

Is there a core textbook that I could read to learn more about what developmental peds is all about?

Do dev. peds. also take care of complex-needs kids (I don't know if that's the right term, I mean kids with multiple disabilities generally with cognitive issues as well, etc)? If not, what subspecialty primarily looks after these kids?

Also - are fellowships generally undertaken at the same institution where you do your residency, or do people often switch institutions?

Thanks!

 

[Bernardo_11]

Thanks Bernardo_11 for all the info about developmental peds! A couple questions:

Is there a core textbook that I could read to learn more about what developmental peds is all about?

Do dev. peds. also take care of complex-needs kids (I don't know if that's the right term, I mean kids with multiple disabilities generally with cognitive issues as well, etc)? If not, what subspecialty primarily looks after these kids?

Also - are fellowships generally undertaken at the same institution where you do your residency, or do people often switch institutions?

Thanks!

The top books to get for DB peds:

1) Encounters with Children: Pediatric Behavior and Development by Suzanne Dixon, Martin Stein, and Susan Dixon - this is basically a book designed for general pediatricians and gives them an idea of the child's developmental level in all domains depending on their age. It presents it based on what you'd expect during their clinical visits.

2) Developmental-Behavioral Pediatrics (Developmental-Behavioral Pediatrics (Levine)) by Melvin D. Levine, William B. Carey, and Allen C. Crocker- this is basically the big textbook for the field. Kinda like OUR Nelsons.

3) Disorders of Development and Learning, 3rd Edition by Mark L. Wolraich- a good book that presents the common pathologies we find in this field, such as cerebral palsy, ADHD, autism, dyslexia, spina bifida and a ton of others.

Hope this helps for now. This should give you plenty to read before you get into a fellowship yourself.

As far as the competition, it's not very competitive. If you have a sincere interest in it, I am sure you can get into any program, irregardless of the residency you attended.

Take care,
Nardo
DB Peds Fellow