The Steven J. Parker Memorial Developmental-Behavioral Pediatric Conference: Clinical Problems in Primary Care

Emotional and behavioral problems among children and adolescents continue to be highly prevalent and their significance for well-being is well documented but the vast majority of children…are still unidentified and untreated (Academic Pediatrics, Volume 10, Number 4, July – August 2010 252-259). Early identification of developmental disorders is critical to the well-being of children and their families. It is an integral function of the primary care medical home and an appropriate responsibility of all pediatric health care professionals. Delayed or disordered development can be caused by specific medical conditions and may indicate an increased risk of other medical complications. Delayed or disordered development may also indicate an increased risk of behavior disorders or associated developmental disorders. Early identification should lead to further evaluation, diagnosis, and treatment. Early intervention is available for a wide range of developmental disorders; their prompt identification can spur specific and appropriate therapeutic interventions. Identification of a developmental disorder and its underlying etiology may also affect a range of treatment planning, from medical treatment of the child to family planning for his or her parents. In order to identify a delay, pediatric clinicians need to be aware of what problems exist and how they manifest. Of nearly 7.4 million children in the United States diagnosed with emotional, behavioral, or developmental conditions, a disproportionate number do not get the mental health services they need because they are under insured, according to a new report released by the Health Resources and Services Administration (HRSA). The study also finds that boys, adolescents, and children from low-income families are affected by conditions such as depression or Attention Deficit Disorder at higher rates than other children, but that adequate health services for these children remain an unmet need. The report, “The Mental and Emotional Well-Being of Children: A Portrait of States and the Nation 2007,” identified seven emotional, behavioral, or developmental conditions: depression, anxiety, Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder, conduct disorders, autism spectrum disorders, developmental delay and Tourette Syndrome. Children with these conditions can benefit from a variety of therapies including counseling and medication. This conference will address many of these gaps. In addition, in this conference we will focus on two theme specific modules. The first will be a session around issues of development in the developing world and in the U.S.: different world or same issues? The second in collaboration with the Department of Child Psychiatry at Boston Medical Center, will focus on the changes in diagnostics with the new DSM-V.