Pediatric neuro-developmental and behavioral disorders. Practitioners’ perspectives

Objective: Developmental and behavioral (DB)disorders are commonly encountered in the generalpediatric and neurology practices. There is a strongdemand for trained developmental pediatricians and childpsychiatrists in our region. In this study, we aimed tostudy practitioner’s experiences in dealing with thesedisorders and their referral practices.Methods: Attendees of an international pediatricsymposium on neuro-developmental and behavioraldisorders were included. The symposium was conductedby the Department of Neurosciences, King FaisalSpecialist Hospital and Research Center in Jeddah from4-6th March, 2003. A structured 25-item questionnairewas designed to examine their demographics, training,practice and referral patterns.Results: A total of 167 attendees registered for thesymposium and 131 (78%) questionnaires were returned.Participant’s ages were 23-69 years (mean 36, SD 8.5),with 67% being females. Many participants werepracticing general pediatrics (43.5%) and the majority(92%) frequently saw and followed children with DBDABSTRACTMohammed M. Jan, MBChB, FRCP(C).149disorders. However, only 24% felt highly confident intheir management. As well, only 35% and 31% ofphysicians received structured developmental andpsychiatry rotations, during their training. Those whoreceived a structured developmental rotation felt morecomfortable in making the correct diagnosis (odds ratio(OR) 4, 95% confidence interval (CI) 1.2-14, p=0.01) andin providing appropriate treatment (OR 3.8, 95% CI1.4-11, p=0.006). Many participants (32%) had no directaccess to a developmental pediatrician or childpsychiatrist for referrals.Conclusion: Developmental and behavioral disordersare common in daily pediatric practice. Mostpractitioners did not receive a structured rotationcovering these disorders during their training and werenot highly confident in managing affected children.Given the limited number of developmental pediatriciansand child psychiatrists, we highly recommend appropriatedevelopmental and psychiatric training for practitioners.