title: Beyond ADHD: How Well Are We Doing?
abstract: OBJECTIVE
  There has been increasing emphasis on the role of the pediatrician with respect to behavioral, learning, and mental health (MH) issues, and developmental behavioral rotations are now required in pediatric residency programs. We sought to examine whether this newer emphasis on MH is reflected in pediatricians' reports of their current practices.
  
  
  METHODS
  Data from 2 periodic surveys conducted in 2004 and 2013 by the American Academy of Pediatrics were examined to see whether there were differences in self-reported behaviors of usually inquiring/screening, treating/managing/comanaging, or referring patients for attention-deficit/hyperactivity disorder (ADHD), anxiety, depression, behavioral problems, or learning problems. We examined patterns for all practicing members and for those who practiced general pediatrics exclusively.
  
  
  RESULTS
  There were few changes over the decade in the percentage who inquired or screened among all clinicians; among those exclusively practicing general pediatrics, the percentage who inquired or screened increased about 10% for ADHD and depression. ADHD remained the only condition for which the majority of respondents treated/managed/comanaged (57%). While there was some increase in the percentages who treated other conditions, the other conditions were usually treated by <30% of respondents. A similar pattern of results was observed in analyses adjusted for physician, practice, and patient characteristics.
  
  
  CONCLUSIONS
  Despite the changing nature of pediatric practice and increased efforts to emphasize the importance of behavior, learning, and MH, the pediatric community appears to be making little progress toward providing for the long-term behavioral, learning, and MH needs of children and adolescents in its care.
authors.affiliation: Albert Einstein College of Medicine/Children's Hospital at Montefiore, New York, NY. Electronic address: ruth.stein@einstein.yu.edu.
authors.forename: Ruth E K
authors.initials: RE
authors.lastname: Stein
authors.affiliation: Statistical Research Consultants LLC, Schaumburg, Ill.
authors.forename: Amy
authors.initials: A
authors.lastname: Storfer-Isser
authors.affiliation: Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY; Nathan Kline Institute of Psychiatric Research, Orangeburg, NY.
authors.forename: Bonnie D
authors.initials: BD
authors.lastname: Kerker
authors.affiliation: Case Western Reserve University School of Medicine, Cleveland, Ohio.
authors.forename: Andrew
authors.initials: A
authors.lastname: Garner
authors.affiliation: University of California at Los Angeles, Los Angeles, Calif.
authors.forename: Moira
authors.initials: M
authors.lastname: Szilagyi
authors.affiliation: Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY.
authors.forename: Kimberly E
authors.initials: KE
authors.lastname: Hoagwood
authors.affiliation: American Academy of Pediatrics, Elk Grove Village, Ill.
authors.forename: Karen G
authors.initials: KG
authors.lastname: O'Connor
authors.affiliation: Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY.
authors.forename: Sarah
authors.initials: S
authors.lastname: McCue Horwitz
mesh_terms: D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000628:therapy; D001008:Anxiety Disorders / Q000175:diagnosis / Q000628:therapy*; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000628:therapy*; D003863:Depression / Q000175:diagnosis / Q000628:therapy; D003866:Depressive Disorder / Q000175:diagnosis / Q000628:therapy*; D019468:Disease Management; D005260:Female; D006801:Humans; D007859:Learning Disabilities / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010372:Pediatrics; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D000066553:Problem Behavior; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
keywords: ADHD; anxiety; behavior problems; depression; developmental behavioral pediatrics; learning problems; mental health; screening