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.
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.
a basic understanding of the techniques for developmental screening and
assessment for global developmental delays, speech and language delays,
and learning and attention problems.
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.
the common presentation, differential diagnosis and management of
children with pervasive developmental disorders and autism, including
an understanding of their social and educational needs.
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.
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.
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
- Learn and begin to become familiar with talking to parents about their child's development and progress in school.
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.
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.
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.
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.