Are We on the Right Track? Examining the Role of Developmental Behavioral Pediatrics

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I recently reflected on whether developmental behavioral pediatrics (DBP) is on the right track. Along with most section members of my generation, I first became involved with clinical care, teaching, and research activities as a general pediatrician (not a subspecialist) and saw and continue to view development and behavior (DB) as the foundation of pediatrics. This generalist perspective may puzzle those trained subsequently in DBP fellowships, but the generation that defined the field did so because it was concerned that many pediatricians were not adequately prepared to understand DB aspects of the care they were expected to provide, regardless of setting or venue. I am part of a generation that saw DB as so fundamental to all clinical pediatrics that it was hard to segregate it as a subspecialty. Today, fewer share this perspective, because fellowship training typically occurs before a clinician has a chance to practice general pediatrics and this historical perspective is not emphasized. DBP has strong roots going back to the 1920s, but in 1985 Stan Friedman defined it as “Those aspects of pediatrics generally ignored by most pediatric training programs.”1 He believed we needed a subspecialty not to provide specialized care, but to become central teachers in departments of pediatrics to convey a body of knowledge about normal and atypical DB of children and adolescents to trainees in residency training programs and to do research to add to the knowledge-base. John Duby’s recent tribute to 3 former Aldrich recipients pointed to great strides in DB training and research. We are now an established subspecialty with fellowship training and an organization, and all pediatric residents are required to take at least … Address correspondence to Ruth E. K. Stein, MD, 1300 Morris Park Ave, Room 6B27 Van Etten, Bronx, NY 104661. E-mail: ruth.stein{at}einstein.yu.edu