Identifying and Addressing Developmental–Behavioral Problems: A Practical Guide for Medical and Nonmedical Professionals, Trainees, Researchers, and Advocates

Abstract

This book by national experts lives up to its title. It is practical, well organized, and well referenced. Primary care is emphasized in pediatric prevention, detection, and intervention for developmental–behavioral problems in private and public health settings. Care coordination and evidence-based methods for early detection and screening are reviewed. Useful appendices cover topics ranging from preventive health visit forms to judging training effectiveness to teaching developmental milestones. Particularly useful is the initial navigation guide locating specific topics in the book. Web pages for chapter subjects and links to professional and parenting websites abound, with helpful downloadable materials. Chapters open with a list of highlights and a relevant glossary. “Red flag” tables are succinct and instructive. Background is given showing cost savings from quality early intervention versus the huge cost of underdetection of developmental problems. Evidence is presented on the ineffectiveness of informal approaches for developmental screening, setting the foundation for scientific yet practical measurement approaches. Several quick broad-band screening tools (e.g., Ages and Stages Questionnaire-3, the PEDS: Developmental Milestones), autism-specific screeners such as the Modified Checklist for Autism in Toddlers (MCHAT), and other accepted tools are reviewed. Interpreting results, making needed referrals and follow-up plans are well explained. Federal and state laws including the Individuals with Disabilities Education Act (IDEA) and Early and Periodic Screening, Diagnosis, and Testing (EPSDT) are related to local impact. Key subtitles such as “Here’s what providers need to know and do” document practical steps. How Part C eligibility for early intervention varies across states is discussed, with needed referral steps and agency contact websites for programs such as Birth to Three. Although acknowledging the reality of 15minute well visits, there is a resounding shout-out for how much can be done in just 3 of those minutes to address developmental issues. Family focus is embedded throughout the book, but family needs are particularly explored in midchapters. How to prepare parents for the early detection process is discussed, including how to clarify billing and any denied claims. Sample cover letters model optimal parent literacy level. Collaboration between stakeholders is emphasized for best child outcomes. Developmental promotion pearls are offered. Thought-provoking case presentations bring the material to life. Models are given for clear, supportive statements to give difficult news while encouraging parental follow-through. Issues of unique populations such as older children are not forgotten. Screening tools discussed for older children include mental health screening, use of diagnostic attention-deficit hyperactivity disorder scales, academic measures such as the Safety Word Inventory and Literacy Screener (SWILS), and academic test interpretation for group achievement tests. Common scenarios are analyzed, such as the student with poor grades but adequate achievement scores along with how to refer the struggling student and collaborate with schools. A template is given for a Records Release Form. Strategies for early detection of language problems in primary care and language development in bilingual and dual language learners are explored. Red flag indicators and psychosocial risk factors for delayed language are summarized. Language promotion strategies, tips on making speech referrals, and what to expect after referral are vetted. The discussion of children who are adopted or in foster care is fascinating, as this section is written by professionals who share their own personal experiences growing up with these issues. This book has many target audiences and uses, not the least of which is training. Life-long learning in developmental– behavioral pediatrics for residents, fellows, medical and nursing students, and professionals already in practice is emphasized. Case examples address assessing trainees’ knowledge and application of developmental–behavioral principles. Excellent instructional resources on typical and atypical development are provided, with rich lists of texts and web-based resources. Cross-training professionals already in practice and training developmental specialists, researchers, and policymakers in a multidisciplinary manner are championed, with useful train-thetrainer tips. International models for prevention, early detection, intervention, and professional training are provided that give real-life examples on how to build systems in the final chapters. The research section gives a sound, clear presentation on test construction, psychometrics, and quality improvement. The role of the clinician as advocate is thoughtfully explored, along with strategies for policy advocacy at the federal, state, and local level, closing with optimistic suggestions and conclusions. This well-planned, comprehensive developmental–behavioral textbook is a must-have tool for pediatric health care professionals. It is an exquisite teaching tool for trainees and active working professionals and for clinicians and researchers.