Paediatricians' Perspectives Surrounding Identification and Management of Early Childhood Disorders in the United States

BACKGROUND: Since 2001, the American Academy of Pediatrics has released and twice revised guidelines tasking paediatricians with screening children for developmental disorders, but diagnoses are often delayed. Paediatricians in the United States are also responsible for referring patients with identified concerns for services and for managing their long-term care. OBJECTIVES: This review aims to chronologically synthesize available literature about paediatricians' perspectives surrounding their roles in identifying and managing early childhood disorders and to identify how future interventions can best address these perspectives. METHODS: Early childhood disorders (ECDs) were defined as developmental delays and autism spectrum disorder. A literature search was performed on PubMed and Google Scholar. Surveys, interviews, focus groups and analyses of paediatricians' perspectives on their roles in identifying and managing children with ECDs were included if they were performed in the United States and published in a peer-reviewed journal in or after 2001. Literature was reviewed and analysed by sorting key findings into categories of 'knowledge', 'attitudes' and 'confidence', then organizing chronologically within each category. RESULTS: Of the 122 publications identified, 19 were selected and reviewed, revealing some overlying themes. First, paediatricians desire more training on ECDs, especially in assisting with navigation of intervention programs. Second, negative attitudes towards roles in identifying and managing ECDs have remained relatively consistent since 2001. Third, paediatricians' confidence declines from identification to long-term management of ECDs. CONCLUSIONS: This review chronologically synthesizes paediatricians' knowledge, attitudes and confidence surrounding their roles in identifying children with ECDs, referring them to other professionals and managing their long-term care. Paediatricians are not solely responsible for these tasks, as other medical professionals, families, therapists and educators work together to care for these children. This review provides recommendations, such as enhancing training programs and utilizing care coordinators, to address perspectives that may result in suboptimal patient care.