Pediatric Developmental Clinic

This is a subspecialty clinic in the Bellevue Hospital Pediatric Clinic. The resident will find the attending, who will be the preceptor for the session, and the developmental fellow.

Residents will see patients independently and present the information to the attending. During this session, the residents will use, among other developmental tests, the Denver II Screening test , and the E=mc2 (screening for learning problems).

The resident should:

  • Gain an awareness of the many varied reasons that primary pediatricians refer children for further developmental evaluation.
  • Develop a basic understanding of the techniques for developmental screening and assessment for global developmental delays, speech and language delays, and learning and attention problems.
  • Become familiar with the indications for further assessment of children with developmental problems, such as referral to neurology, genetics, ENT, psychology, psychiatry, physiatry, special education; the roles that these subspecialty areas play.
  • Formulate an understanding of the complex medical, social, and educational needs of children with mental retardation or severe disabilities with behavioral disorders that require medication.
  • Be able to diagnose attention deficit hyperactivity disorder and plan for the management of the child, including with medication, behavioral intervention, educational intervention, and parent/child education, and understand the associated educational and social issues.
  • Understand the common presentation, differential diagnosis and management of children with pervasive developmental disorders and autism, including an understanding of their social and educational needs.
  • Become familiar with the technique of the neurodevelopmental evaluation, including the developmental and behavioral history, information about current functioning at home and in school, the neurologic examination, and specific developmental and cognitive assessment techniques.
  • Improve one's ability to use observation as a tool to detect behavioral abnormalities and developmental problems.
  • Gain skill in communicating with parents - skill in listening to parents, the ability to discuss difficult diagnoses and chronic conditions, the ability to express uncertainty as to prognosis in some cases.
  • Learn and understand the different level of developmental assessments that can be performed on children, depending on the child's presentation, the urgency of the information, and the time/staff constraints of the pediatrician.
  • Learn and begin to become familiar with talking to parents about their child's development and progress in school.
  • Learn, and begin to incorporate into their knowledge base, important milestones in development and academic progress, by performing these screening tests, and becoming familiar with the tasks they contain.
  • Become familiar with and comfortable in performing the Denver II and the E=mc2 in continuity clinic.

Role of the Resident

The resident is expected to:

  • Be present for all sessions indicated on their individual schedule.
  • Take the history and perform physical examination of at least one new patient for each session, present to the attending, provide a short differential of what the patient's main developmental or behavioral issue is, offer thoughts about management.
  • Observe the management technique of attending and/or fellow, including the assessment instrument used, physical or developmental findings, discussion/interaction with parent, utilization of outside resources, referral to outside or additional professionals, pharmacological management as needed.
  • See this patient in the next follow-up visit, provided the resident is still doing the rotation.
  • Do specific reading about one patient's developmental condition, and be able to discuss or give a short presentation about the condition, either during the clinic session, or at a designated time.