Although most pediatricians spend the majority of their time seeing well children or children with relatively minor medical problems, pediatrie residents spend most of their time in subspecialty training.1 And, because most of the training that pediatricians receive in the behavioral sciences is conducted in tertiary care settings, supervision in the management of common behavior problems is rarely provided.
The types of behavior problems that are seen in young children from intact families - the problems that pediatricians face daily in their practices - are rarely seen in tertiary care settings. The problems that parents report with the greatest frequency are uncomplicated bed-wetting, minor sleep disturbances, faddy eating, and typical oppositional behavior.2 Yet, when you look at the abstracts from the annual pediatrie meetings or the table of contents from the refereed pediatrie journals, little attention is given to these problems.3
Further, in studies that have looked at the amount of time that pediatricians spend on anticipatory guidance, the results are almost shocking. One widely quoted study reported that the average pediatrician spends less than 1 1Ji minutes on anticipatory guidance during well-child visits.4
This issue of Pediatrie Anna/s addresses some of the common behavior problems that ambulatory care pediatricians see every day: bed-wetting, sleep problems, toileting problems, attention-deficit disorder, and oppositional behaviors. The authors are practicing clinicians in pediatrie settings; they treat the problems that they write about every day. Hopefully, readers will find these articles interesting and the recommendations applicable in their practices.
1. The future of pediatrie education. In: Tust Forre Report on Pidiatric Education. Denver, GiIo: Hirshfeld Press; 1978.
2. Richman N, Stevenson JE, Graham PJ. Prevalence of behavior problems in 3-year-old children: an epidemiological study in a London borough. J Child Psychol Psychiatry. 1975; 16:277-287.
3. Christophersen ER. Injury control. Am Psychai. 1989;44=237-241.
4. Reisinger KJ, Bites JA. Anticipatory guidance in pediatrie practice. Pediatrics. 1980;66:8a9-892.