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American Academy of Pediatrics
Developmental and
Behavioral Pediatrics
Robert G. Voigt, MD, FAAP
Michelle M. Macias, MD, FAAP
Scott M. Myers, MD, FAAP
Editors
D&BP COVER.indd 1 9/20/10 9:49 AM
American Academy of Pediatrics
Developmental and
Behavioral Pediatrics
Section on Developmental and Behavioral Pediatrics
American Academy of Pediatrics
Robert G. Voigt, MD, FAAP
Editor in Chief
Michelle M. Macias, MD, FAAP
Associate Editor
Scott M. Myers, MD, FAAP
Associate Editor
American Academy of Pediatrics Department of Marketing and Publications Staff
Maureen DeRosa, MPA
Director, Department of Marketing and Publications
Mark Grimes
Director, Division of Product Development
Eileen Glasstetter, MS
Manager, Division of Product Development
Sandi King, MS
Director, Division of Publishing and Production Services
Kate Larson
Manager, Editorial Services
Linda Diamond
Manager, Art Direction and Production
Theresa Wiener
Manager, Publications Production and Manufacturing
Kevin Tuley
Director, Division of Marketing and Sales
Linda Smessaert
Manager, Clinical and Professional Publications Marketing
Library of Congress Control Number: 2010906842
ISBN-13: 978-1-58110-274-1
MA0414
The recommendations in this publication do not indicate an exclusive course of treatment or serve
as a standard of care. Variations, taking into account individual circumstances, may be appropriate.
Every effort has been made to ensure that the drug selection and dosage set forth in this text are in
accordance with the current recommendations and practice at the time of the publication. It is the
responsibility of the health care provider to check the package insert of each drug for any change
in indications or dosage and for added warnings and precautions.
The mention of product names in this publication is for informational purposes only and does not
imply endorsement by the American Academy of Pediatrics.
Listing of resources does not imply an endorsement by the American Academy of Pediatrics (AAP).
The AAP is not responsible for the content of the resources mentioned in this publication. Web site
addresses are as current as possible, but may change at any time.
The coding content in Chapter 25 was accurate as of January 1, 2010. CPT copyright 2011 American
Medical Association (AMA). All rights reserved. The AMA assumes no liability for data contained
herein. CPT is a registered trademark of the AMA.
The publishers have made every effort to trace the copyright holders for borrowed material. If they
have inadvertently overlooked any, they will be pleased to make the necessary arrangements at the
first opportunity.
Copyright © 2011 American Academy of Pediatrics. All rights reserved. No part of this publication
may be reproduced, stored in a retrieval system, or transmitted in any form or by any means,
electronic, mechanical, photocopying, recording, or otherwise, without prior permission from
the publisher. Printed in the United States of America.
9-273/0910
1 2 3 4 5 6 7 8 9 10
Editor in Chief
Robert G. Voigt, MD, FAAP
Director, Leopold L. Meyer Center for Developmental Pediatrics
Texas Children’s Hospital
Head, Section of Developmental and Behavioral Pediatrics
Baylor College of Medicine
Houston, TX
Associate Editors
Michelle M. Macias, MD, FAAP
Professor of Pediatrics
Director, Division of Developmental-Behavioral Pediatrics
Medical University of South Carolina
Charleston, SC
Scott M. Myers, MD, FAAP
Neurodevelopmental Pediatrician
Geisinger Health System
Danville, PA
Clinical Assistant Professor of Pediatrics
Temple University School of Medicine
Philadelphia, PA
Section on Developmental and Behavioral Pediatrics (SODBP)
2010–2011
Executive Committee Members
Michelle M. Macias, MD, FAAP, Chairperson
Carolyn Bridgemohan, MD, FAAP
Jill J. Fussell, MD, FAAP
Edward Goldson, MD, FAAP
Laura J. McGuinn, MD, FAAP
Lynn Mowbray Wegner, MD, FAAP, Immediate Past Chairperson
Carol C. Weitzman, MD, FAAP
Liaisons
Kenneth W. Norwood Jr, MD, FAAP
Council on Children With Disabilities
Pamela C. High, MD, MS, FAAP
Society for Developmental and Behavioral Pediatrics
Contributing Editor
Michael I. Reiff, MD, FAAP
SODBP Newsletter Editor
Program Chairperson
Nathan J. Blum, MD, FAAP
Staff
Linda B. Paul, MPH
Contributing Authors
Glen P. Aylward, PhD, ABPP
Professor, Pediatrics and Psychiatry
Southern Illinois University School of Medicine
Division of Developmental-Behavioral Pediatrics/Psychology
Springfield, IL
14: Psychoeducational Testing
William J. Barbaresi, MD, FAAP
Director, Developmental Medicine Center
Children’s Hospital Boston
Associate Professor of Pediatrics
Harvard Medical School
Boston, MA
15: Learning Disabilities
17: Disruptive Behavior Disorders
Peter A. Blasco, MD, FAAP
Associate Professor of Pediatrics, Oregon Health and Sciences University
Director, Neurodevelopmental Residency Program, Oregon Health
and Sciences University
Director, Oregon LEND Training Program, Child Development
and Rehabilitation Center
Portland, OR
9: Motor Development
Nathan J. Blum, MD, FAAP
Director, Section of Behavioral Pediatrics
The Children’s Hospital of Philadelphia
Professor of Pediatrics
University of Pennsylvania School of Medicine
Philadelphia, PA
4: Basics of Child Behavior and Primary Care Management of
Common Behavioral Problems
Thomas D. Challman, MD, FAAP
Neurodevelopmental Pediatrics
Director, Pediatric Subspecialties
Geisinger Medical Center
Danville, PA
13: Autism Spectrum Disorders
21: Complementary and Alternative Medicine in Developmental and
Behavioral Pediatrics
viii Contributing Authors
David O. Childers Jr, MD, FAAP
Assistant Professor and Division Chief of Developmental Pediatrics
University of Florida College of Medicine, Jacksonville
Jacksonville, FL
5: Early Intervention
Carmen L. Dickerson, LCSW
Instructor of Pediatrics
Baylor College of Medicine
Social Work Services
The Meyer Center for Developmental Pediatrics at Texas Children’s Hospital
Houston, TX
23: Social and Community Services
John C. Duby, MD, FAAP
Professor of Pediatrics
Northeastern Ohio Universities Colleges of Medicine and Pharmacy
Director, Division of Developmental-Behavioral Pediatrics
Akron Children’s Hospital
Akron, OH
12: Social and Emotional Development
James Eugene Edwards, MD, MAEd
Associate Professor
Youth Division, Department of Psychiatry
Medical University of South Carolina
Charleston, SC
18: Anxiety and Mood Disorders
Jill J. Fussell, MD, FAAP
Associate Professor
University of Arkansas for Medical Sciences
Arkansas Children’s Hospital
Little Rock, AR
10: Cognitive Development
Patti Hackett, MEd
Medical Home Coordinator
Longwood Pediatrics LLP
Boston, MA
24: Transition to Adult Medical Care
Contributing Authors ix
Elizabeth B. Harstad, MD
Fellow, Developmental and Behavioral Pediatrics
Children’s Hospital Boston
Boston, MA
17: Disruptive Behavior Disorders
Desmond P. Kelly, MD, FAAP
Medical Director, Division of Developmental-Behavioral Pediatrics
Vice Chair for Academics
Children’s Hospital of the Greenville Hospital System University Medical Center
Greenville, SC
22: Sensory Impairments: Hearing and Vision
Angela C. LaRosa, MD, MSCR
Associate Professor of Pediatrics
Developmental and Behavioral Pediatrics
Medical University of South Carolina
Charleston, SC
5: Early Intervention
Mary L. O’Connor Leppert, MB, BCh, FAAP
Developmental Pediatrics
Kennedy Krieger Institute
Assistant Professor of Pediatrics
Johns Hopkins University School of Medicine
Baltimore, MD
7: Neurodevelopmental Assessment and Medical Evaluation
Paul H. Lipkin, MD, FAAP
Director, Center for Development and Learning
Kennedy Krieger Institute
Associate Professor of Pediatrics
Johns Hopkins University School of Medicine
Baltimore, MD
6: Developmental and Behavioral Surveillance and Screening Within the Medical
Home
x Contributing Authors
Michelle M. Macias, MD, FAAP
Professor of Pediatrics
Director, Division of Developmental-Behavioral Pediatrics
Medical University of South Carolina
Charleston, SC
1: Introduction—Child Development: The Basic Science of Pediatrics
11: Speech and Language Development and Disorders
Michael W. Mellon, PhD, ABPP
Associate Professor, Pediatric Psychologist
Division of Behavioral Medicine and Clinical Psychology
Cincinnati Children’s Hospital Medical Center
Cincinnati, OH
19: Evidence-based Psychological and Behavioral Interventions
Scott M. Myers, MD, FAAP
Neurodevelopmental Pediatrician
Geisinger Health System
Danville, PA
Clinical Assistant Professor of Pediatrics
Temple University School of Medicine
Philadelphia, PA
1: Introduction—Child Development: The Basic Science of Pediatrics
13: Autism Spectrum Disorders
21: Complementary and Alternative Medicine in Developmental and
Behavioral Pediatrics
Mary E. Pipan, MD, FAAP
Clinical Director, Trisomy 21 Program
Attending Physician, Developmental-Behavioral Pediatrics
The Children’s Hospital of Philadelphia
Philadelphia, PA
4: Basics of Child Behavior and Primary Care Management of Common Behavioral
Problems
Michael I. Reiff, MD, FAAP
Associate Professor of Pediatrics and Family Medicine
Director, Autism Spectrum and Neurodevelopmental Disorders Clinic
Director, Minnesota LEND Program
University of Minnesota
Minneapolis, MN
16: Attention-Deficit/Hyperactivity Disorder
Contributing Authors xi
Ann M. Reynolds, MD, FAAP
Associate Professor of Pediatrics
University of Colorado Denver
The Children’s Hospital
Aurora, CO
10: Cognitive Development
Melissa B. Schultz, MD
Fellow, Department of Pediatric and Adolescent Medicine
Division of Developmental and Behavioral Pediatrics
Mayo Clinic
Rochester, MN
9: Motor Development
Prachi Edlagan Shah, MD
Assistant Professor, Pediatrics
Division of Child Behavioral Health
University of Michigan Center for Human Growth and Development
University of Michigan
Ann Arbor, MI
3: Interviewing and Counseling Children and Families
Eve G. Spratt, MD, MSCR
Associate Professor of Pediatrics and Psychiatry
Director, Pediatric Psychiatry
Division of Developmental-Behavioral Pediatrics
Medical University of South Carolina
Charleston, SC
18: Anxiety and Mood Disorders
Martin T. Stein, MD, FAAP
Professor of Pediatrics
Division of Child Development and Community Health
University of California San Diego
Rady Children’s Hospital
San Diego, CA
16: Attention-Deficit/Hyperactivity Disorder
xii Contributing Authors
Stuart W. Teplin, MD, FAAP
Developmental-Behavioral Pediatrician
Emeritus Associate Professor, University of North Carolina at Chapel Hill
School of Medicine
Chapel Hill, NC
22: Sensory Impairments: Hearing and Vision
Kimberly A. Twyman, MD, FAAP
Assistant Professor of Pediatrics
Division of Developmental Pediatrics and Rehabilitation
Saint Louis University School of Medicine
Saint Louis, MO
11: Speech and Language Development and Disorders
Christopher K. Varley, MD, FAACAP
Professor
Department of Psychiatry and Behavioral Sciences, University of Washington
School of Medicine
Attending Physician, Seattle Children’s Hospital
Seattle, WA
20: Principles of Psychopharmacologic Management
Sherry Sellers Vinson, MD, MEd, FAAP
Assistant Professor of Pediatrics/Neurodevelopmental Disabilities Residency
Director
Baylor College of Medicine
Neurodevelopmental Disabilities Specialist
The Meyer Center for Developmental Pediatrics at Texas Children’s Hospital/
The Developmental High Risk Clinic at Ben Taub General Hospital
Houston, TX
23: Social and Community Services
Robert G. Voigt, MD, FAAP
Director, Leopold L. Meyer Center for Developmental Pediatrics
Texas Children’s Hospital
Head, Section of Developmental and Behavioral Pediatrics
Baylor College of Medicine
Houston, TX
1: Introduction—Child Development: The Basic Science of Pediatrics
8: Developmental and Behavioral Diagnoses: The Spectrum and Continuum
of Developmental-Behavioral Disorders
Contributing Authors xiii
Paul P. Wang, MD, FAAP
Vice President, Clinical Development
Seaside Therapeutics
Cambridge, MA
2: Nature, Nurture, and Their Interactions in Child Development and Behavior
Lynn Mowbray Wegner, MD, FAAP
Clinical Associate Professor
Chief, Division of Developmental/Behavioral Pediatrics
University of North Carolina School of Medicine
Chapel Hill, NC
25: Billing and Coding for Developmental and Behavioral Problems in
Outpatient Primary Care
Patience H. White, MD, MA, FAAP
Professor of Medicine and Pediatrics
George Washington University School of Medicine and Health Sciences
Vice President, Public Health
Arthritis Foundation
Washington, DC
24: Transition to Adult Medical Care
Reviewers
American Academy of Pediatrics Board of Directors Reviewer
Michael V. Severson, MD, FAAP
Committee and Section Reviewers
Stephen Barnett, MD, FAAP
Robert T. Burke, MD, MPH, FAAP
Edward S. Curry, MD, FAAP
Larry Desch, MD, FAAP
Cynthia Devore, MD, FAAP
Ellen R. Elias, MD, FAAP
Timothy A. Geleske, MD, FAAP
Robert S. Gerstle, MD, FAAP
Peter A. Gorski, MD, MPA, FAAP
Eugene R. Hershorin, MD, FAAP
Susan L. Hyman, MD, FAAP
Paula K. Jaudes, MD, FAAP
Jane M. Foy, MD, FAAP
Miriam A. Kalichman, MD, FAAP
Kathi J. Kemper, MD, MPH, FAAP
Matthew E. Knight, MD, FAAP
James J. Laughlin, MD, FAAP
Herschel R. Lessin, MD, FAAP
Susan E. Levy, MD, FAAP
Gregory S. Liptak, MD, MPH, FAAP
Douglas McNeal, MD, FAAP
Nancy A. Murphy, MD, FAAP
Kenneth W. Norwood Jr, MD, FAAP
Jeffrey K. Okamoto, MD, FAAP
Adelaide S. Robb, MD
Chadwick T. Rogers, MD, FAAP
David M. Rubin, MD, MSCE, FAAP
Howard M. Saal, MD, FAAP
Paul J. Sagerman, MD, MS, FAAP
Calvin C.J. Sia, MD, FAAP
Geoffrey R. Simon, MD, FAAP
Jack T. Swanson, MD, FAAP
Nancy L. Swigonski, MD, MPH, FAAP
Renee M. Turchi, MD, MPH, FAAP
Lani S.M.Wheeler, MD, FAAP
David W. Willis, MD, FAAP
Table of Contents
Chapter 1
Introduction—Child Development: The Basic Science of Pediatrics...............1
Robert G. Voigt, MD, FAAP
Michelle M. Macias, MD, FAAP
Scott M. Myers, MD, FAAP
Chapter 2
Nature, Nurture, and Their Interactions in Child Development
and Behavior..................................................................................................................5
Paul P. Wang, MD, FAAP
Chapter 3
Interviewing and Counseling Children and Families.......................................... 23
Prachi E. Shah, MD
Chapter 4
Basics of Child Behavior and Primary Care Management of
Common Behavioral Problems.................................................................................37
Mary E. Pipan, MD, FAAP
Nathan J. Blum, MD, FAAP
Chapter 5
Early Intervention........................................................................................................59
David O. Childers Jr, MD, FAAP
Angela C. LaRosa, MD, MSCR
Chapter 6
Developmental and Behavioral Surveillance and Screening
Within the Medical Home.......................................................................................... 69
Paul H. Lipkin, MD, FAAP
Chapter 7
Neurodevelopmental Assessment and Medical Evaluation................................93
Mary L. O’Connor Leppert, MB, BCh, FAAP
Chapter 8
Developmental and Behavioral Diagnoses: The Spectrum and
Continuum of Developmental-Behavioral Disorders..........................................121
Robert G. Voigt, MD, FAAP
Chapter 9
Motor Development.....................................................................................................147
Melissa B. Schultz, MD
Peter A. Blasco, MD, FAAP
xviii Table of Contents
Chapter 10
Cognitive Development..............................................................................................171
Jill J. Fussell, MD, FAAP
Ann M. Reynolds, MD, FAAP
Chapter 11
Speech and Language Development and Disorders..............................................201
Michelle M. Macias, MD, FAAP
Kimberly A. Twyman, MD, FAAP
Chapter 12
Social and Emotional Development.........................................................................221
John C. Duby, MD, FAAP
Chapter 13
Autism Spectrum Disorders.......................................................................................249
Scott M. Myers, MD, FAAP
Thomas D. Challman, MD, FAAP
Chapter 14
Psychoeducational Testing.........................................................................................293
Glen P. Aylward, PhD, ABPP
Chapter 15
Learning Disabilities....................................................................................................313
William J. Barbaresi, MD, FAAP
Chapter 16
Attention-Deficit/Hyperactivity Disorder..............................................................327
Michael I. Reiff, MD, FAAP
Martin T. Stein, MD, FAAP
Chapter 17
Disruptive Behavior Disorders..................................................................................349
Elizabeth B. Harstad, MD
William J. Barbaresi, MD, FAAP
Chapter 18
Anxiety and Mood Disorders.....................................................................................359
Eve G. Spratt, MD, MSCR
James E. Edwards, MD, MAEd
Chapter 19
Evidence-based Psychological and Behavioral Interventions............................399
Michael W. Mellon, PhD, ABPP
Table of Contents xix
Chapter 20
Principles of Psychopharmacologic Management................................................411
Christopher K. Varley, MD, FAACAP
Chapter 21
Complementary and Alternative Medicine in Developmental
and Behavioral Pediatrics...........................................................................................449
Thomas D. Challman, MD, FAAP
Scott M. Myers, MD, FAAP
Chapter 22
Sensory Impairments: Hearing and Vision............................................................467
Desmond P. Kelly, MD, FAAP
Stuart W. Teplin, MD, FAAP
Chapter 23
Social and Community Services................................................................................495
Carmen L. Dickerson, LCSW
Sherry Sellers Vinson, MD, MEd, FAAP
Chapter 24
Transition to Adult Medical Care.............................................................................513
Patience H. White, MD, MA, FAAP
Patti Hackett, MEd
Chapter 25
Billing and Coding for Developmental and Behavioral Problems
in Outpatient Primary Care.......................................................................................533
Lynn Mowbray Wegner, MD, FAAP
Appendices......................................................................................................................551
Index ...............................................................................................................................573
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