PEDIATRICS Vol. 64 No. 4 October 1979, pp. 506-514
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Primary Care Approaches to Developmental Disabilities

Jack P. Shonkoff MD1, Paul H. Dworkin MD1, Alan Leviton MD1, and Melvin D. Levine MD1

1 Departments of Medicine and Neurology, Children's Hospital Medical Center, Boston

Ninety-seven board certified pediatricians who spend at least 75% of their professional working hours involved in the delivery of primary care in New England were interviewed to explore their attitudes and current clinical approaches to developmental disabilities.

The majority of the pediatricians relied exclusively on clinical judgment and general observations for assessing developmental problems in their offices. Responsibility for preschool screening for potential learning problems and the assessment of school failure were considered appropriate pediatric concerns. Reported customary approaches to a variety of developmental problems were not affected by the size of the practice nor by the socioeconomic status of the patient population. Patterns of referral for consultation appeared to be more dependent on the nature of the suspected disorder than on the characteristics of the physicians or their practices.

The need for more rigorous training in the developmental aspects of child health has been emphasized. In order to meet this challenge, more precise techniques for pediatric developmental assessment and more conclusive evalutions of specific interventions will have to be produced.

Submitted on August 25, 1978
Accepted on February 20, 1979




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