William L. Coleman

Neurodevelopmental study of writing disorders in middle childhood.

This study investigated patterns of neurodevelopmental dysfunction in children with writing disorders (WD). Records of children, ages 9 to 15 years, referred to a school problems clinic were examined. Using teacher questionnaire information, including ratings of writing legibility, mechanics, rate, linguistic sophistication, and spelling, 99 cases of WD were found. Sixty-three children without WD served as clinic controls. A cluster analysis revealed four discrete subtypes of WD and two non-WD control clusters. The four WD clusters were found to have different patterns of writing and reading characteristics. Neurodevelopmental tests discriminated among the clusters (F = 2.8, p < .0001), and an examination of neurodevelopmental performance characteristics among the clusters showed different patterns of strengths and weaknesses. An empirically derived subtyping of WD is proposed: WD with fine motor and linguistic deficits, WD with visualspatial deficits, WD with attention and memory deficits, and WD with sequencing deficits. This subtyping, if confirmed in a population study, may have important diagnostic and therapeutic implications. J Dev Behav Pediatr 13:17–23, 1992. Index terms: learning disorders, written language, dysgraphia, spelling, subtypes.

Brief Solution-Focused Strategies for Behavioral Pediatrics

In an era of shrinking resources and managed care, brief models of psychotherapy are receiving increasing attention. One of the newest and innovative of those, brief, solution-focused therapy, is particularly efficient, because it concentrates on the present and the future; builds on strengths; focuses on clear, realistic goals; uses tasks; and develops client cooperation and efficacy. Parents have long turned to pediatricians for help in addressing a variety of child-rearing and other family concerns. Behavioral pediatricians who are looking for time-effective ways to counsel families should consider the six solution-focused techniques described in this article and pursue training in this approach to family therapy, yet another example of family-focused pediatrics.

developmental and Behavioral Pediatric Practice Patterns and Implications for the Workforce: Results of the Future of Pediatric Education Ii Survey of Sections Project

&NA; A survey of developmental‐behavioral pediatricians was conducted to obtain data and insights on their current practice. As part of the Future of Pediatric Education (FOPE) II Survey of Sections Project, questionnaires were sent to individuals who were most likely to represent those pediatricians engaged in the subspecialty of developmental‐behavioral pediatrics. Four groups of physicians were compared within the survey: developmental‐behavioral fellowship group (n = 272), developmental disabilities fellowship group (n = 139), general academic pediatrics or other fellowship group (n = 57), and a nonfellowship group (n = 224). A majority of respondents indicated a need for an increased number of subspecialists in developmental‐behavioral pediatrics in their community during the next 3 to 5 years. There were significant differences in the survey results of a variety of practice issues between those who had and had not received formal fellowship training. The survey data illustrate a developmental‐behavioral pediatrician workforce that is becoming increasingly fellowship trained, receiving more referrals, and encountering constraints to seeing more patients in an era of declining reimbursement for services. To overcome these obstacles, stakeholders in child health, including health care payers, will need to be educated about the unique skills and clinical expertise of physicians in developmental‐behavioral pediatrics and neurodevelopmental disabilities. J Dev Behav Pediatr 24:180‐188, 2003. Index terms: workforce, developmental‐behavioral pediatrics, neurodevelopmental disabilities, practice.

The First Interview with a Family

The family interview is the essence of family-focused pediatric care. The first interview is especially critical because it provides the creation of a therapeutic alliance, an assessment of the family and its concerns, and the formation of goals and solutions. Knowing interviewing techniques will ensure a successful outcome for the family and the pediatrician.