title: Does Length of Developmental Behavioral Pediatrics Training Matter?
abstract: Since 1997 pediatric residencies have been required to provide a 4-week block rotation in developmental and behavioral pediatrics (DBP), but it is not known whether this has altered the care and management of children by practicing pediatricians. The objective of this study was to compare the self-reported practice patterns of pediatricians who were trained with 4 or more weeks of DBP with the practice patterns of those who were trained for <4 weeks.
  
  
  
  We used self-reported practices from the American Academy of Pediatrics Periodic Survey 85. Pediatricians were asked whether they never, sometimes, or usually inquired about and screened for, and whether they treated/managed/comanaged attention deficit hyperactivity disorder, depression, anxiety, behavior problems and learning problems. They were also asked about a series of barriers to care. Analyses were weighted to account for low response rates.
  
  
  
  Those with more DBP training were significantly more likely to treat/manage/co-manage depression, anxiety, behavior problems and learning problems, but were still doing so less than one third of the time. There were no differences in the care of patients with attention deficit hyperactivity disorder or in screening or inquiring about mental health conditions. Those with more training were more likely to perceive somewhat fewer barriers and to report more specific familiarity with some Diagnostic and Statistical Manual of Mental Disorders criteria and some treatment modalities.
  
  
  
  Longer length of training is associated with more treatment, but significant deficits in self-reported practice remain, leaving much room for additional improvement in the training of clinicians in DBP.
authors.affiliation: Albert Einstein College of Medicine/Children's Hospital at Montefiore, Bronx, 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: New York Presbyterian, Cornell University College of Medicine, New York, NY.
authors.forename: Cori M
authors.initials: CM
authors.lastname: Green
authors.affiliation: Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY.
authors.forename: Sarah McCue
authors.initials: SM
authors.lastname: Horwitz
mesh_terms: D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000628:therapy; D001008:Anxiety Disorders / Q000628:therapy; D001289:Attention Deficit Disorder with Hyperactivity / Q000628:therapy; D003479:Curriculum; D003863:Depression / Q000175:diagnosis / Q000628:therapy; D003866:Depressive Disorder / Q000628:therapy; D004503:Education, Medical, Graduate / Q000379:methods*; D005260:Female; D006801:Humans; D007859:Learning Disabilities / Q000628:therapy; D008297:Male; D008403:Mass Screening; D001523:Mental Disorders / Q000175:diagnosis / Q000628:therapy*; D000072143:Pediatricians; D010372:Pediatrics / Q000193:education*; D010818:Practice Patterns, Physicians'; D000066553:Problem Behavior; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: behavior problems; developmental behavioral pediatrics; learning problems; mental health; pediatric education