HOW TO OBTAIN CME CREDITS BY READING THIS ISSUE
This CME activity is primarily targeted to patient-caring physicians specializing in pediatrics. Physicians can receive AMA PRA Category 1 Credits™ by reading the CME articles in Pediatric Annals and successfully completing the quiz at the end of the articles. Complete instructions are given subsequently. Educational objectives are found at the beginning of each CME article.
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Vindico Medical Education and Pediatric Annals. Vindico Medical Education is accredited by the ACCME to provide continuing medical education for physicians.
Vindico Medical Education designates this educational activity for a maximum of 3 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
FULL DISCLOSURE POLICY
In accordance with the Accreditation Council for Continuing Medical Education's Standards for Commercial Support, all CME providers are required to disclose to the activity authence the relevant financial relationships of the planners, teachers, and authors involved in the development of CME content An individual has a relevant financial relationship if he or she has a financial relationship in any amount occurring i ? the last 1 2 months with a commercial interest whose products or services are discussed in the CME activity content over which the individual has control. Relationship information appears at the beginning of each CME-accredited article in this issue.
UNLABELED AND INVESTIGATIONAL USAGE
The audience is advised that this continuing medical education activity may contain references to unlabeled uses of FDA-approved products or to products not approved by the FDA for use in the United States. The faculty members have been made aware of their obligation to disclose such usage.
As medical professionals with the most frequent contact with children, pediatricians are in the best position to positively impact a child's life. Realizing this, the American Academy of Pediatrics (AAP) has called for the clinician's office to serve as the medical home for all children, especially those with chronic care needs. Although appealing, this concept is not as simple to accomplish as one would assume. With increasing pressure to provide service to more patients with diminishing reimbursement for each encounter, it is difficult to assure adequate time for each patient to screen for behavioral and developmental problems. Indeed, despite the availability of well-validated standardized screening tools and the call of the AAP to routinely screen all 9-. 18- and 36-monthold children for developmental delays, most offices still struggle to accomplish this task. Adding to this challenge is deciding when and where to refer when delays are detected. Funding for such therapy is not always forthcoming, and public programs can be complex to navigate.
As partners in the care of children with developmental delays, occupational, physical, and speech therapists can lend great assistance in assessing delays and planning interventions. The pediatrician can then serve as an ongoing monitor to assure all the needs of the child are being met as well as noting if new delays have surfaced that need attention. In this way the practitioner can be a member of the care team while maintaining their role as coordinator of the medical home.
This issue of Pediatric Annals provides four excellent reviews spanning topics from public programs for developmentalIy delayed children or children at risk for delays to discussions of different therapy modalities for affected children. Additionally, two reviews of alternative and complementary medicine interventions for attention-deficit hyperactivity disorder and autism spectrum disorder demonstrate views that are prevalent in the public domain that are likely to be brought up in office visits for these children. After reviewing this issue the participant will not only be better prepared to answer the AAP's call to develop the office based medical home, but will also be better prepared to serve as a resource for educating the community on the needs of developmentally compromised children.
1. The American Academy of Pediatrics suggests pediatricians conduct developmental surveillance using standardized developmental screening instruments at every well child visit.
2. Clinical assessments of developmental progress detect less than 30% of children with developmentaldisabilities and are considered generally inaccurate.
3. Speech and language delays are common childhood problems affecting 3% to 10% of all children.
4. Children who present with stuttering and have a family history significant for stuttering are at no higher risk for clinically significant stuttering than the general population
5. Often, feeding difficulties are the first sign of developmental problems.
l.B 2.A 3. A 4. B 5.A