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DEVELOPMENTAL-BEHAVIORAL

Pediatrics

DEVELOPMENTAL-BEHAVIORAL

Pediatrics

Heidi M. Feldman

Ballinger-Swindells Professor of Developmental and Behavioral Pediatrics

Chief, Division of Developmental-Behavioral Pediatrics

Stanford University School of Medicine

Stanford California

Service Chief, Developmental-Behavioral Pediatrics, Stanford Childrens Health Palo Alto, California

Ellen Roy Elias

Director, Special Care Clinic

Children’s Hospital Colorado

Professor of Pediatrics and Genetics

University of Colorado School of Medicine Aurora, Colorado

Nathan J. Blum

W.T. Grant Professor of Pediatrics

Perelman School of Medicine

University of Pennsylvania

Chief, Division of Developmental and Behavioral Pediatrics

Children’s Hospital of Philadelphia Philadelphia, Pennsylvania

Manuel E. Jimenez

Associate Professor of Pediatrics and Family Medicine and Community Health

Rutgers Robert Wood Johnson Medical School

Attending Developmental and Behavioral Pediatrician

Children’s Specialized Hospital New Brunswick, New Jersey

Terry Stancin

Chief of Psychology

Director, Child & Adolescent Psychiatry & Psychology

The MetroHealth System

Professor, Departments of Psychiatry

Pediatrics & Psychological Sciences

Case Western Reserve University Cleveland, OH

Elsevier

1600 John F. Kennedy Blvd. Ste 1800 Philadelphia, PA 19103-2899

Developmental-Behavioral Pediatrics, FIFTH EDITION

Copyright © 2023 by Elsevier Inc. All rights reserved

Previous editions copyrighted 1983, 1992, 1999, 2009

No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions

This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein).

Notice

Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds or experiments described herein. Because of rapid advances in the medical sciences, in particular, independent verification of diagnoses and drug dosages should be made. To the fullest extent of the law, no responsibility is assumed by Elsevier, authors, editors or contributors for any injury and/ or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein.

ISBN: 9780323809726

ISBN: 978-0-323-80972-6

Content Strategist: Sarah Barth

Content Development Specialist: Rishi Arora

Publishing Services Manager: Shereen Jameel

Project Manager: Nadhiya Sekar

Design Direction: Brain Salisbury

Printed in India

May V. Albee, BS

Clinical Research Coordinator Division of Oncology Children’s Hospital of Philadelphia Philadelphia, Pennsylvania

Kathleen Angkustsiri, MD

Associate Professor of Clinical Pediatrics

Developmental-Behavioral Pediatrician MIND Institute

University of California–Davis Davis, California

Arash Anoshiravani, MD, MPH Division of Adolescent Medicine

Department of Pediatrics

Stanford University Palo Alto, California

David Alan Ansel, MD

Clinical Associate Professor of Pediatrics

Division of Developmental-Behavioral Pediatrics

Stanford University School of Medicine

Lucille Packard Children’s Hospital Palo Alto, California

Tanni L. Anthony, PhD

Director of Access, Learning, and Literacy

Colorado Department of Education Denver, Colorado

Melissa Armstrong-Brine, PhD MetroHealth Medical Center Center Case Western Reserve University Cleveland, Ohio

Jenna Arruda, MD, MPH Pediatric Integrative Medicine The Sutcliffe Clinic Los Altos, California

Pediatric Hospitalist Central Maine Medical Center Lewiston, Maine

Joan Rosenbaum Asarnow, PhD Professor, Psychiatry and Biobehavioral Sciences

Semel Institute for Neuroscience and Human Behavior

David Geffen School of Medicine

University of California Los Angeles Los Angeles, California

Marilyn Augustyn, MD Professor of Pediatrics

CONTRIBUTORS

Boston University School of Medicine Director of Developmental-Behavioral Pediatrics BMC Boston, Massachusetts

Peter Baker II, MD

Associate Professor of Pediatrics and Clinical Genetics & Metabolism

Department of Pediatrics

University of Colorado Children’s Hospital Colorado Aurora, Colorado

Linda G. Bandini, PhD

Healthy Weight Research Network

E.K. Shriver Center

UMass Chan Medical School

Boston, Massachusetts

William J. Barbaresi, MD

Chief, Division of Developmental Medicine

Boston Children’s Hospital Division of Developmental Medicine

Boston Children’s Hospital & Harvard Medical School

T. Berry Brazelton Professor of Pediatrics Harvard Medical School

Boston, Massachusetts

W. Steven Barnett, PhD Graduate School of Education

The State University of New Jersey

Rutgers University New Brunswick, New Jersey

Brenda Bassingthwaite, PhD, BCBA

Associate Professor

Munroe-Meyer Institute University of Nebraska Medical Center Omaha, Nebraska

Brittany S. Bassitt, MD General Pediatrician

Kaiser Permanent Northwest Hillsboro, Oregon

Courtney E. Batt, MD

Assistant Professor of Pediatrics

Section of Adolescent Medicine

University of Colorado School of Medicine Children’s Hospital of Colorado Aurora, Colorado

Rebecca A. Baum, MD

Clinical Professor of Pediatrics

University of North Carolina School of Medicine

Developmental Behavioral Pediatrician

UNC Health

Chapel Hill, North Carolina

Fiona M. Baumer, MD

Assistant Professor of Neurology and of Pediatrics

Stanford University School of Medicine Palo Alto, California

Ronald E. Becker, MD

Assistant Professor of Pediatrics

Harvard Medical School

Assistant in Pediatrics

Boston Children’s Hospital Boston, Massachusetts

Anna Malia Beckwith, MD

Assistant Professor of Pediatrics

Rutgers Robert Wood Johnson Medical School

Section Chief of Developmental Behavioral Pediatrics

Children’s Specialized Hospital New Brunswick, New Jersey

Nathaniel S. Beers, MD, MPA

Children’s National Hospital

HSC Health Care System

Washington, District of Columbia

David C. Bellinger, PhD, MSc

Professor of Neurology

Harvard Medical School

Boston Children’s Hospital Boston, Massachusetts

Amanda E. Bennett, MD, MPH

The Children’s Hospital of Philadelphia Division of Developmental and Behavioral Pediatrics

Philadelphia, Pennsylvania

Kelly Blankenship, DO

Associate Chief Medical Officer for Behavioral Health

Dayton Children’s Hospital Dayton, Ohio

Nathan J. Blum, MD

W.T. Grant Professor of Pediatrics

Perelman School of Medicine

University of Pennsylvania

Chief, Division of Developmental and Behavioral Pediatrics

Children’s Hospital of Philadelphia

Philadelphia, Pennsylvania

Kristen Boog, MA

School of Psychological and Behavioral Sciences

Southern Illinois University Carbondale, Illinois

Renée Boynton-Jarrett, MD, ScD Department of Pediatrics

Boston University School of Medicine Vital Village Community Engagement Network Boston, Massachusetts

Nicholas J.K. Breitborde, PhD, ABPP Department of Psychiatry and Behavioral Health

The Ohio State University Columbus, Ohio

Zoe Brennan-Krohn Staff Attorney

Disability Rights Program of the American Civil Liberties Union San Francisco, California

Annelise Brochier, MPH Research Project Manager Boston Medical Center Department of Pediatrics Boston, Massachusetts

Shalonda Brooks, PhD Nationwide Children’s Hospital Ohio State University Child Development Center Westerville, Ohio

Mariah Brown, BA Pediatric Endocrinology Children’s Hospital Colorado University of Colorado School of Medicine Aurora, Colorado

Michelle R. Brown, PhD Clinical Professor of Psychiatry Department of Psychiatry and Behavioral Sciences

Division of Child and Adolescent Psychiatry Stanford Children’s Health

Stanford University School of Medicine Stanford, California

Sophie Brunt, M Ed Doctoral Student

Department of Human Services School of Education and Human Development University of Virginia Charlottesville, Virginia

Kimberly Burkhart, PhD Clinical Psychologist

Associate Professor of Pediatrics and Psychiatry

Case Western Reserve University School of Medicine

Rainbow Babies and Children’s Hospital Division of Developmental-Behavioral Pediatrics and Psychology Cleveland, Ohio

Nicole R. Bush, PhD

University of California (UCSF) Department of Pediatrics

Division of Developmental Medicine

San Francisco, California

Eric M. Butter, PhD

Nationwide Children’s Hospital Department of Pediatric Psychology and Neuropsychology

Ohio State University Columbus, Ohio

Eliza Buyers, MD

Assistant Professor

Department of Obstetrics and Gynecology

University of Colorado

Anschutz Campus

Pediatric and Adolescent Gynecology

Children’s Hospital Colorado Aurora, Colorado

Caitlin F. Canfield, PhD

Division of Developmental and Behavioral Pediatrics Department of Pediatrics

NYU Grossman School of Medicine

New York, New York

Laura Arnstein Carpenter, PhD

Medical University of South Carolina Charleston, South Carolina

Kaitlyn Cavanaugh, MS, OTR/L, CLC

Occupational Therapist & Certified Lactation Counselor

Children’s Hospital Colorado Highlands Ranch, Colorado

Philip B. Cawkwell, MD

Child and Adolescent Psychiatrist

Bay Area Clinical Associates

Stanford University Palo Alto, California

Diane Chen, PhD

Potocsnak Family Division of Adolescent and Young Adult Medicine

Pritzker Department of Psychiatry and Behavioral Health

Ann & Robert H. Lurie Children’s Hospital of Chicago

Department of Psychiatry and Behavioral Sciences

Department of Pediatrics

Northwestern University Feinberg School of Medicine

Chicago, Illinois

Gayle Chesley, PhD

Children’s Hospital of Philadelphia

Perelman School of Medicine

University of Pennsylvania Philadelphia, Pennsylvania

Marie A. Clark, MD, MPH

Assistant Professor of Pediatrics

Case Western Reserve University School of Medicine

Rainbow Babies and Children’s Hospital

Division of Developmental-Behavioral Pediatrics and Psychology Cleveland, Ohio

Elizabeth Coan, PsyD

Psychologist

Developmental Pediatrics

Denver Fragile X Clinic

Children’s Hospital Colorado

University of Colorado School of Medicine

Aurora, Colorado

Shereen J. Cohen, PhD

Postdoctoral Fellow

MIND Institute

University of California–Davis Davis, California

Cara Coleman, JD, MPH

Director of Public Policy and Advocacy

Family Voices

Lexington, Massachusetts

Sean T. Corbett, MD

Associate Professor

Department of Urology

University of Virginia School of Medicine

Charlottesville, Virginia

DePorres Cormier II, MD

Division of Developmental Pediatrics

Department of Pediatrics

Saint Louis University School of Medicine

SSM Cardinal Glennon Children’s Hospital

Knights of Columbus Developmental Center

St. Louis, Missouri

Claire A. Coyne, PhD

Potocsnak Family Division of Adolescent and Young Adult Medicine

Pritzker Department of Psychiatry and Behavioral Health

Ann & Robert H. Lurie Children’s Hospital of Chicago

Department of Psychiatry and Behavioral Sciences

Northwestern University Feinberg School of Medicine

Chicago, Illinois

Catherine Crouse, MM, MT-BC, NICU-MT, NMT

Master of Music in Music Therapy

Music Therapist-Board Certified Neonatal Intensive Care Music Therapist

Neurologic Music Therapist

Lucile Packard Children’s Hospital Palo Alto, California

Carol Curtin, PhD

Healthy Weight Research Network

E.K. Shriver Center

UMass Chan Medical School Worcester, Massachusetts

Beth Ellen Davis, MD, MPH

Professor of Pediatrics

Division of Neurodevelopmental and Behavioral Pediatrics

University of Virginia Charlottesville, Virginia

Katie Davis, MSN, RN, PHNA-BC Population Health Innovation Institute Institute for H.O.P.E.

The MetroHealth System Cleveland, Ohio

Shanlee Davis, MD

Pediatric Endocrinology University of Colorado School of Medicine Aurora, Colorado

Thomas P. Demaria, PhD

Consultant and Advisor

National Center for School Crisis and Bereavement

Children’s Hospital Los Angeles Los Angeles, California

Allison G. Dempsey, PhD Department of Psychiatry University of Colorado School of Medicine Aurora, Colorado

Katie A. Devine, PhD, MPH

Rutgers Cancer Institute of New Jersey New Brunswick, New Jersey

Mary Beth DeWitt, PhD

Chief, Division of Child Psychology

Dayton Children’s Hospital Dayton, Ohio

Liliane Diab, MD

Assistant Professor

Department of Pediatrics, Section of Nutrition

University of Colorado School of Medicine

Clinical Director

Clinical Nutrition: Growth and Parenting Lifestyle Medicine Clinics Aurora, Colorado

Irene Cihon Dietz, MD Division of Comprehensive Care

Pediatrics

MetroHealth Medical Center

Case Western Reserve University School of Medicine Cleveland, Ohio

Elizabeth Dubow, MD

Assistant Professor, Pediatrics-Neurology Children’s Hospital Colorado University of Colorado Aurora, Colorado

Sarah E. Dubner, MD Instructor

Division of Developmental-Behavioral Pediatrics

Stanford University School of Medicine Stanford, California

John C. Duby, MD, CPE

Wright State University Boonshoft School of Medicine

Dayton Children’s Hospital Dayton, Ohio

Jessica Duis, MD, MS

Assistant Professor of Pediatrics and Genetics Director, Chromosome 15 clinics

Children’s Hospital Colorado University of Colorado Anschutz Medical Campus Aurora, Colorado

Mei Elansary, MD, MPhil

Assistant Professor of Pediatrics

Boston University School of Medicine Attending Physician BMC Boston, Massachusetts

Ellen Roy Elias, MD Director, Special Care Clinic Children’s Hospital Colorado Professor of Pediatrics and Genetics University of Colorado School of Medicine Aurora, Colorado

Janice Enriquez, PhD Associate Clinical Professor of Pediatrics

MIND Institute

UC Davis Health Davis, California

Robert W. Enzenauer, MD, MPH/MSPH Professor of Ophthalmology University of Colorado School of Medicine Aurora, Colorado

Shannon Erisman, PhD

Assistant Professor of Psychiatry and Human Behavior Clinician Educator Alpert Medical School at Brown University Clinical Director Postpartum Day Hospital

Women & Infants Hospital Providence, Rhode Island

Krista Eschbach, MD

Assistant Professor, Pediatrics-Neurology Children’s Hospital Colorado University of Colorado Aurora, Colorado

Jordan Ezell Klein, PhD

Medical University of South Carolina Charleston, South Carolina

Karla K. Fehr, PhD

School of Psychological and Behavioral Sciences

Southern Illinois University Carbondale, Illinois

Heidi M. Feldman, MD, PhD

Ballinger-Swindells Professor of Developmental and Behavioral Pediatrics

Chief, Division of Developmental-Behavioral Pediatrics

Stanford University School of Medicine

Stanford California

Service Chief, Developmental-Behavioral Pediatrics

Stanford Childrens Health

Palo Alto, California

Lauren B. Fishbein, PhD

Department of Child and Adolescent Psychiatry and Behavioral Sciences

The Children’s Hospital of Philadelphia Philadelphia, Pennsylvania

Jason M. Fogler, PhD

Senior Staff Psychologist Co-Director: ADHD Program

Training Director: Leadership Education in Neurodevelopmental & related Disabilities (LEND)

Division of Developmental Medicine, Boston Children’s Hospital

Assistant Professor of Pediatrics & Psychology, Harvard Medical School Boston, Massachusetts

Deborah A. Frank, MD

Founder Grow Clinic for Children Boston Medical Center

Founder and Principal Investigator

Children’s Health Watch

Professor of Child Health and Well-Being

Boston University School of Medicine Boston, Massachusetts

Sandra L. Friedman, MD, MPH Professor of Pediatrics

University of Colorado School of Medicine

Section Head, Developmental Pediatrics

Children’s Hospital Colorado Aurora, Colorado

Sarah L. Friedman, PhD

Research Professor

Department of Psychological and Brain Sciences

The George Washington University Washington, District of Columbia

Mary A. Fristad, PhD, ABPP

Division of Child & Family Psychiatry

Big Lots Behavioral Health Services

Nationwide Children’s Hospital Columbus, Ohio

Nadine Gaab, PhD

Associate Professor of Education

Harvard Graduate School of Education and Associate Professor of Pediatrics

Harvard Medical School

Boston, Massachusetts

Rachel Lee Gilgoff, MD

Senior Clinical and Science Advisor

ACEs Aware Initiative

Office of the California Surgeon General Aurrera Health Group Sacramento, California

R. Emily Gonzalez, PhD

Department of Pediatrics

University of Virginia School of Medicine Charlottesville, Virginia

Julie Good, MD

Clinical Associate Professor

Pediatric Pain Management and Pediatric Palliative Care

Department of Anesthesiology, Perioperative and Pain Medicine (by courtesy, Pediatrics)

Stanford Children’s Health

Stanford University School of Medicine Center for Academic Medicine Stanford, California

Susan Hayden Gray, MD

Associate Professor of Pediatrics

Medical Director of UVA Teen and Young Adult Health Center University of Virginia Charlottesville, Virginia

A. Dawn Greathouse, PhD, BCBA

Pediatric Neurodevelopmental Psychologist

Child Development Center

Nationwide Children’s Hospital

Assistant Professor

The Ohio State University Columbus, Ohio

Randi Hagerman, MD

Developmental Pediatrics

University of California–Davis MIND Institute

Sacramento, California

Eleanore M. Hall, PsyD

Department of Psychiatry

University of Colorado School of Medicine Aurora, Colorado

Howard Hall, PhD, PsyD, BCB Professor of Pediatrics, Psychiatry, and Psychological Sciences

Rainbow Babies & Children’s Hospital

University Hospitals Cleveland Medical Center

Division of Developmental/Behavioral Pediatrics & Psychology Cleveland, Ohio

Bonnie Halpern-Felsher, PhD Professor of Pediatrics, Epdemiology and Population Health, and Psychiatry and Behavioral Sciences

Division of Adolescent Medicine

Department of Pediatrics

Stanford University Palo Alto, California

Sarah A. Hamilton, MD

Department of Psychiatry and Behavioral Health

The Ohio State University Columbus, Ohio

Robin L. Hansen, MD Professor of Pediatrics Emerita MIND Institute

University of California Davis School of Medicine Davis, California

Sandra G. Hassink, MD, MSc

Healthy Weight Research Network Emeritus Associate Professor of Pediatrics

Nemours Children’s Hospital Wilmington, Delaware

Marissa Hauptman, MD, MPH Associate Director

Pediatric Environmental Health Center and Region 1 New England Pediatric Environmental Health Specialty Unit (PEHSU)

Boston Children’s Hospital Boston, Massachusetts

Assistant Professor, Harvard Medical School Boston, Massachusetts

Katheleen Hawes, PhD, PMH-CNS, BC Assistant Professor of Pediatrics, Clinician Educator

Alpert Medical School at Brown University Women & Infants Hospital Providence, Rhode Island

Rebecca A. Hazen, PhD

Division of Developmental and Behavioral Pediatrics & Psychology

Rainbow Babies and Children’s Hospital University Hospitals

Cleveland Medical Center

Department of Pediatrics

Case Western Reserve University Cleveland, Ohio

Albert Hergenroeder, MD

Professor of Pediatrics

Pediatrics-Adolescent Medicine and Sports Medicine

Chief, Adolescent Medicine and Sports Medicine

Baylor College of Medicine

Texas Children’s Hospital Houston, Texas

Jenniffer Herrera, MD

Assistant Professor of Pediatrics

Division of Neurodevelopmental and Behavioral Pediatrics

University of Virginia Charlottesville, Virginia

Francis Hickey, MD

Children’s Hospital Colorado Aurora, Colorado

Pamela High, MD

Professor of Pediatrics, Clinician Educator

Alpert Medical School at Brown University

Director, Developmental Behavioral Pediatrics

Hasbro Children’s Hospital

Providence, Rhode Island

Matthew C. Hocking, PhD

Pediatric Psychologist

Division of Oncology

Children’s Hospital of Philadelphia

Department of Psychiatry

Perelman School of Medicine

University of Pennsylvania Philadelphia, Pennsylvania

Cody A. Hostutler, PhD

Clinical Assistant Professor of Pediatrics

The Ohio State University

Pediatric Psychologist

Nationwide Children’s Hospital Columbus, Ohio

Susan Howell, MS, CGC

Genetic Counselor

Developmental Pediatrics

Denver Fragile X Clinic

Children’s Hospital Colorado

University of Colorado School of Medicine

Aurora, Colorado

Lynne C. Huffman, MD

Professor of Pediatrics

Division of Developmental-Behavioral Pediatrics

Stanford University School of Medicine

Stanford, California

Abby Hughes-Scalise, PhD

Clinical Psychology PsyD Program Augsburg University Minneapolis, Minnesota

Susan L. Hyman, MD

Healthy Weight Research Network University of Rochester Medical Center Rochester, New York

Kida Ingram, PhD Psychologist Development Medicine Center Instructor Harvard Medical School Boston, Massachusetts

Sandhyaa Iyengar, MD MPH Practice-Based Scholar

The Center for Violence Prevention

Children’s Hospital of Philadelphia

The Perelman School of Medicine

The University of Pennsylvania Philadelphia, Pennsylvania

Carissa R. Jackel, MD

Assistant Professor of Clinical Pediatrics Perelman School of Medicine University of Pennsylvania Associate Fellowship Program Director Children’s Hospital of Philadelphia Philadelphia, Pennsylvania

Bayan Jalalizadeh, MD

Child, Adolescent, and Adult Psychiatrist

Children’s Health Council Palo Alto, California

Manuel E. Jimenez, MD, MS

Associate Professor of Pediatrics and Family Medicine and Community Health

Rutgers Robert Wood Johnson Medical School

Attending Developmental and Behavioral Pediatrician

Children’s Specialized Hospital New Brunswick, New Jersey

Megan M. Julian, PhD Department of Psychiatry University of Michigan Ann Arbor, Michigan

Colleen Kahn, MA-MFT-AT, MA-ATR-BC

Marriage and Family Therapy and Art Therapy Board Certified Art Therapist

Lucile Packard Children’s Hospital Palo Alto, California

Robert D. Keder, MD

Connecticut Children’s Medical Center University of Connecticut School of Medicine Farmington, Connecticut

Brooks Keeshin, MD University of Utah Salt Lake City, Utah

M. Kathleen Kelly, PhD, PT

Associate Professor University of Pittsburgh School of Health & Rehabilitation Sciences Pittsburgh, Pennsylvania

Karen Kelminson, MD Children’s Hospital Colorado Aurora, Colorado

Mary A. Khetani, ScD, OTR/L

Departments of Occupational Therapy and Disability and Human Development University of Illinois Chicago, Illinois

Bridget Kiley, MSc, LMCH

Arlington Youth Counseling Center Cambridge, Massachusetts

Judy Lu Kim, MD

Assistant Professor Section of Transition Medicine Department of Medicine Department of Family and Community Medicine Baylor College of Medicine Houston, Texas

Patricia A. Kinser, PhD, WHNP-BC, RN Professor Virginia Commonwealth University School of Nursing Richmond, Virginia

Michael W. Kirkwood, PhD, ABPP-CN Director

Rehabilitation Psychology & Neuropsychology Department of Rehabilitation Children’s Hospital Colorado Professor, Department of Physical Medicine & Rehabilitation

University of Colorado School of Medicine Aurora, Colorado

John R. Knight, Jr., MD

Founder and Director Emeritus Center for Adolescent Substance Use & Addiction Research (CeASAR) Department of Pediatrics

Boston Children’s Hospital Boston, Massachusetts

Associate Professor Pediatrics (Ret.)

Harvard Medical School Boston, Massachusetts

Holly Knotowicz, MS, CCC-SLP

Speech Language Pathologist Picky Eaters Anonymous, LLC Portland, Maine

Aaina Kochhar, MD

Assistant Professor Section of Genetics & Metabolism Department of Pediatrics University of Colorado Anschutz Medical Campus Aurora, Colorado

Anson J. Koshy, MD, MBE

Associate Professor

McGovern Center for Humanities and Ethics McGovern Medical School Houston, Texas

Mary C. Kral, PhD Professor of Pediatrics

Medical University of South Carolina Charleston, South Carolina

Nancy F. Krebs, MD, MS Professor of Pediatrics Head Section of Nutrition

Associate Vice Chairman, Academic Affairs, Department of Pediatrics

University of Colorado School of Medicine Aurora, Colorado

Casey E. Krueger, PhD

Clinical Assistant Professor (Affiliated) Division of Developmental-Behavioral Pediatrics Department of Pediatrics

Stanford University School of Medicine

Palo Alto, California

Jeremy Kruger, MD Department of Psychiatry and Behavioral Sciences

University of Washington Seattle, Washington

Sara Kupzyk, PhD, LP, BCBA-D

Assistant Professor University of Nebraska at Omaha Omaha, Nebraska

Gary Kwok, PhD

Rutgers Cancer Institute of New Jersey New Brunswick, New Jersey

Philip J. Landrigan, MD, MSc Director

Program for Global Public Health and the Common Good Boston College Chestnut Hill, Massachusetts

Austin Larson, MD

Assistant Professor of Pediatrics and Clinical Genetics & Metabolism

Department of Pediatrics, Section of Clinical Genetics and Metabolism

University of Colorado Children’s Hospital Colorado Aurora, Colorado

Adrienne Lazaro, MS

Department of Pediatrics

Division of Adolescent Medicine

Stanford University Palo Alto, California

Michele Ledesma, MD

Assistant Professor of Pediatrics

New York Medical College

Developmental & Behavioral Pediatrics

Boston Children’s Health Physicians

Maria Fareri Children’s Hospital Valhalla, New York

Stephen S. Leff, PhD

Co-Director

The Center for Violence Prevention Children’s Hospital of Philadelphia

The Perelman School of Medicine

The University of Pennsylvania Philadelphia, Pennsylvania

John E. Leikauf, MD

Clinical Assistant Professor

Child and Adolescent Psychiatry and Child Development

Psychiatry and Behavioral Sciences

Stanford University Palo Alto, California

Mary L. O’Connor Leppert, MB BCH

Kennedy Krieger Institute

Johns Hopkins University School of Medicine Baltimore, Maryland

Bethany Leraas, MA

School of Psychological and Behavioral Sciences

Southern Illinois University Carbondale, Illinois

Irene M. Loe, MD

Division of Developmental-Behavioral Pediatrics

Department of Pediatrics

Stanford University School of Medicine Stanford, California

Julie C. Lumeng, MD

Department of Pediatrics

University of Michigan

Ann Arbor, Michigan

Michelle M. Macias, MD

Division of Developmental-Behavioral Pediatrics

Department of Pediatrics

Medical University of South Carolina Charleston, South Carolina

Dawn M. Magnusson, PT, PhD

Department of Physical Medicine and Rehabilitation

University of Colorado Anschutz Medical Campus Aurora, Colorado

Fatima Malik, MD

Clinical Assistant Professor

Department of Pediatrics

University Hospitals Connor Whole Health Rainbow Babies and Children’s Hospital Cleveland, Ohio

Kathryn Mancini, PhD

MetroHealth Medical Center

Department of Psychiatry

Case Western Reserve University School of Medicine Cleveland, Ohio

Kilby Mann, MD

Department of Physical Medicine and Rehabilitation

University of Colorado Children’s Hospital Colorado Aurora, Colorado

Melissa Marquardt, PhD

Licensed Psychologist Independent Practice Oregon Health Sciences University Portland, Oregon

Raman Marwaha, MD

Child/Adolescent Psychiatrist MetroHealth System Director

MetroHealth Psychiatry Residency Program Assistant Professor of Psychiatry

Case Western Reserve University School of Medicine Cleveland, Ohio

Micah Mazurek, PhD Professor

Department of Human Services

School of Education and Human Development University of Virginia Charlottesville, Virginia

Susan H. McDaniel, PhD

Dr. Laurie Sands Distinguished Professor of Families & Health

Departments of Psychiatry & Family Medicine

University of Rochester School of Medicine & Dentistry

Rochester, New York

Eric McDonald, MD

Child and Adolescent Psychiatry

The Permanente Medical Group

Santa Clara, California

Laura Joan McGuinn, MD

Professor of Pediatrics

Thomas Lowder Chair in DevelopmentalBehavioral Pediatrics

Division of Developmental-Behavioral Pediatrics

Department of Pediatrics

The University of Alabama School of Medicine Birmingham, Alabama

Naomi J.L. Meeks, MD

Assistant Professor

Section of Genetics & Metabolism

Department of Pediatrics

University of Colorado Anschutz Medical Campus Aurora, Colorado

Robyn Mehlenbeck, PhD, ABPP

George Mason University Center for Psychological Services

Fairfax, Virginia

Alan L. Mendelsohn, MD

Professor of Pediatrics and Population Health Division of Developmental and Behavioral Pediatrics

Department of Pediatrics

NYU Grossman School of Medicine

New York, New York

Cheryl Messick, PhD

Department of Communication Science and Disorders

School of Health and Rehabilitation Sciences

University of Pittsburgh Pittsburgh, Pennsylvania

Jonathan W. Mink, MD, PhD

Endowed Professor in Pediatric Neurology Professor of Neurology, Neuroscience, and Pediatrics

University of Rochester School of Medicine & Dentistry

Rochester, New York

Laura J. Mintz, MD, PhD

Assistant Professor

CWRU School of Medicine

MetroHealth Medical Center

Cleveland, Ohio

Susan Mizner

Director

Disability Rights Program of the American Civil Liberties Union

San Francisco, California

Sonia A. Monteiro, MD Department of Pediatrics

Section of Developmental Pediatrics

Baylor College of Medicine

Meyer Center for Developmental Pediatrics & Autism

Texas Children’s Hospital Houston, Texas

Deborah Mood, PhD Department of Pediatrics University of Colorado Denver Aurora, Colorado

Jessica Moore, PhD

Assistant Professor Departments of Pediatrics and Psychiatry University of Rochester School of Medicine & Dentistry Rochester, New York

Sara W. Moyer, RN, BS Virginia Commonwealth University School of Nursing Richmond, Virginia

Claudia M. Mueller, MD, PhD

Associate Professor Department of Surgery Stanford University Stanford, California

Christina Mulé, PhD, NCSP

Assistant Professor

Division of Developmental and Behavioral Pediatrics

Department of Pediatrics, University of Rochester School of Medicine & Dentistry

Assistant Professor, Division of Developmental and Behavioral Pediatrics

Department of Pediatrics Tufts University School of Medicine Boston, Massachusetts

Tiffany Munzer, MD Department of Pediatrics University of Michigan Ann Arbor, Michigan

Nancy Murphy, MD Department of Pediatrics School of Medicine

University of Utah Salt Lake City, Utah

Caitlin B. Murray, PhD Department of Anesthesiology and Pain Medicine

University of Washington School of Medicine & Seattle Children’s Hospital Seattle, Washington

Marsheena Murray, PhD, ABPP

MetroHealth Medical Center Cleveland, Ohio

Brittany R. Myers, PhD Pediatric Psychologist

MetroHealth System

Assistant Professor of Psychiatry

Case Western Reserve University School of Medicine Cleveland, Ohio

Cy Nadler, PhD Director of Autism Services

Division of Developmental and Behavioral Health

Children’s Mercy Kansas City

Associate Professor of Pediatrics

University of Missouri-Kansas City School of Medicine

Kansas City, Missouri

Robert Needlman, MD

MetroHealth Medical Center Department of Pediatrics

Case Western Reserve University School of Medicine Cleveland, Ohio

Jeffrey Okamoto, MD

John A. Burns School of Medicine

University of Hawaii–Manoa

Kapiolani Medical Center for Women and Children Honolulu, Hawaii

Joyce Oleszek, MD

Department of Physical Medicine and Rehabilitation

University of Colorado Children’s Hospital Colorado Aurora, Colorado

Sara O’Rourke, MOT, OTR/L, BCP

Outpatient Occupational Therapy Program Manager

Nationwide Children’s Hospital Columbus, Ohio

Judith A. Owens, MD, MPH

Professor of Neurology

Harvard Medical School

Co-Director of Sleep Medicine

Boston Children’s Hospital Waltham, Massachusetts

Padmini Palat, MD, MPH

Associate Professor

University of Colorado

Department of Pediatrics

Section of Neurology

Children’s Hospital Colorado Aurora, Colorado

Tonya M. Palermo, PhD

Department of Anesthesiology and Pain Medicine

University of Washington School of Medicine

Seattle Children’s Research Institute

Seattle, Washington

Craig J. Parris, MS, APRN, PMHNP-BC, FNP-C

Department of Psychiatry and Behavioral Health

The Ohio State University Columbus, Ohio

Jessica Patel, PhD

Clinical Assistant Professor (Affiliated)

Division of Developmental-Behavioral Pediatrics

Department of Pediatrics

Stanford University School of Medicine

Palo Alto, California

Silvia Pereira-Smith, MD

Division of Developmental-Behavioral Pediatrics

Department of Pediatrics

Medical University of South Carolina Charleston, South Carolina

Hannah Perrin, MD University of California (UCSF) Department of Pediatrics

Division of Developmental Medicine

San Francisco, California

Megan Honor Pesch, MD, MS Division of Developmental and Behavioral Pediatrics

Department of Pediatrics

University of Michigan Medical School

Ann Arbor, Michigan

Jaime W. Peterson, MD, MPH

Department of Pediatrics

Oregon Health and Science University

Portland, Oregon

Randall Phelps, MD, PhD

Developmental and Behavioral Pediatrician

Associate Professor of Pediatrics

Child Development and Rehabilitation Center

Institute on Development and Disability

Oregon Health and Science University

Eugene, Oregon

Laura Pickler, MD, MPH

Associate Professor University of Colorado Aurora, Colorado

Aaron Powell, MD Pediatric Physiatrist Department of Rehabilitation Children’s Hospital Colorado Assistant Professor

Department of Physical Medicine and Rehabilitation University of Colorado School of Medicine Aurora, Colorado

Lisa Prock, MD, MPH Director Developmental Medicine Center

Boston Children’s Hospital Boston Assistant Professor

Harvard Medical School Boston, Massachusetts

Michael A. Puente, MD

Assistant Professor of Ophthalmology

University of Colorado School of Medicine Aurora, Colorado

Marianne Pugatch, PhD, LICSW Postdoctoral Fellow

Clifford Attkisson Clinical Services Research Training Program (T-32) Division of Adolescent and Young Adult Medicine

Department of Pediatrics

Benioff Children’s Hospital University of California, San Francisco Department of Psychiatry and Behavioral Sciences

Weill Institute for Neurosciences University of California San Francisco, California

Jamie T. Rabot, MD Child Development and Rehabilitation Center Institute on Development and Disability

Oregon Health and Science University Eugene, Oregon

Lisa Ramirez, PhD, ABPP Department of Child and Adolescent Psychiatry and Psychology, The MetroHealth System Department of Psychiatry

Case Western Reserve University School of Medicine Cleveland, Ohio

Leonard A. Rappaport, MD, MS Emeritus Chief Division of Developmental Medicine

Boston Children’s Hospital

Mary Deming Scott Professor of Pediatrics

Harvard Medical School

Boston, Massachusetts

Jennifer M. Rathbun, MD, MA

Clinical Assistant in Psychiatry

Supervisor, Child & Adolescent Psychiatry Training Program

Massachusetts General Hospital

Clinical Instructor in Psychiatry

Harvard Medical School

Boston, Massachusetts

Karen Ratliff-Schaub, MD, MBOE Children’s Hospital, Prisma Health System

Clinical Associate Professor of Pediatrics

University of South Carolina College of Medicine, Greenville Greenville, South Carolina

Shelly Reggiani, EdD

North Clackamas School District Equity and Instructional Services

Clackamas, Oregon

Lewis and Clark College

Graduate School of Education & Counseling Portland, Oregon

Marie Reilly, MD

Developmental Behavioral Pediatrician

Developmental Medicine Center

Boston Children’s Hospital Boston, Massachusetts

Dillon Reitmeyer, MSW

Rutgers School of Social Work

New Brunswick, New Jersey

Bibiana Restrepo, MD

Associate Clinical Professor of Pediatrics

MIND Institute

UC Davis Health Davis, California

Luis A. Rivas Vazquez, BS

Research Assistant II Department of Pediatrics (Division of General Pediatrics)

Oregon Health & Science University Portland, Oregon

Paul M. Robins, PhD

Children’s Hospital of Philadelphia Perelman School of Medicine

University of Pennsylvania Philadelphia, Pennsylvania

Erin Roby, PhD

Division of Developmental and Behavioral Pediatrics

Department of Pediatrics

NYU Grossman School of Medicine

New York, New York

Nancy J. Roizen, MD

Professor of Pediatrics

Case Western Reserve University School of Medicine

Rainbow Babies and Children’s Hospital

Division of Developmental-Behavioral Pediatrics and Psychology Cleveland, Ohio

Rosmary Ros-DeMarize, PhD

Division of Developmental-Behavioral Pediatrics

Department of Pediatrics

Medical University of South Carolina Charleston, South Carolina

Erica Fornaris Rouch, PhD

Assistant Professor Department of Human Services

School of Education and Human Development University of Virginia Charlottesville, Virginia

Suzanne Cushwa Rusnak, MEd, MSSA, LSW

Mindfulness Coordinator

Connor Whole Health

University Hospitals Independent Mindfulness Teacher, Coach Consultant Cleveland, Ohio

Afiya Sajwani, BA

Potocsnak Family Division of Adolescent and Young Adult Medicine

Ann & Robert H. Lurie Children’s Hospital of Chicago Chicago, Illinois

Amy L. Salisbury, PhD, RN, PMH-CNS, BC

Professor and Associate Dean for Research, Scholarship, and Innovation

Clinical Nurse Specialist, Child & Family Psychiatry

Virginia Commonwealth University, School of Nursing Richmond, Virginia

Benjamin W. Sanders, MD, MSPH, MS

Department of Pediatrics (Division of General Pediatrics)

Oregon Health & Science University

Portland, Oregon

Ishani Sandesara, MD

Division of Hospitalist, Pediatrics Hospice, and Palliative Medicine

Internal Medicine and Pediatrics

University of Michigan School of Medicine

Ann Arbor, Michigan

Kourtney Santucci, MD

Assistant Professor Department of Pediatrics

University of Colorado School of Medicine Aurora, Colorado

Ellin K. Scholnick, Ph.D

Professor Emerita

University of Maryland College Park, Maryland

David J. Schonfeld, MD

Director

National Center for School Crisis and Bereavement

Children’s Hospital Los Angeles

Professor of Clinical Pediatrics

Keck School of Medicine

University of Southern California Los Angeles, California

Alison Schonwald, MD

Department of Pediatrics

Cambridge Health Alliance

Associate Professor

Harvard Medical School

Cofounder

Touchstone Neurodevelopmental Center Woburn, Massachusetts

Justin Charles Schwartz, MD

Developmental-Behavioral Pediatrician

Associate Professor of Pediatrics

Division of Developmental-Behavioral Pediatrics

Department of Pediatrics

The University of Alabama School of Medicine Birmingham, Alabama

Brittany L. Schwarz, MD

Johns Hopkins University School of Medicine

Kennedy Krieger Institute

Bloomberg Children’s Center Baltimore, Maryland

Tina Scott-Mordhorst, MD

Clinical Professor

University of Nebraska Medical Center Omaha, Nebraska

Kylie M.L. Seeley, MD, MPH

Stanford School of Medicine

Palo Alto, California

Emily K. Shabason, MD

Attending Physician

Division of Developmental and Behavioral Pediatrics

Children’s Hospital of Philadelphia Philadelphia, Pennsylvania

Laura A. Shaffer, PhD, ABPP

Department of Pediatrics

University of Virginia School of Medicine Charlottesville, Virginia

Jeffrey D. Shahidullah, PhD

Assistant Professor of Psychiatry and Behavioral Sciences

Dell Medical School

University of Texas–Austin

Pediatric Psychologist

Developmental and Behavioral Pediatrics

Dell Children’s Medical Center Austin, Texas

Emily Shelkowitz, MD

Fellow in Clinical Genetics & Metabolism

Department of Pediatrics

Section of Clinical Genetics and Metabolism

Children’s Hospital Colorado University of Colorado Aurora, Colorado

Jaclyn A. Shepard, PsyD

Associate Professor University of Virginia School of Medicine

Behavioral Medicine Center

Department of Psychiatry & Neurobehavioral Sciences Charlottesville, Virginia

Kevin M. Simon, MD

Attending Psychiatrist, Department of Psychiatry & Behavioral Science

Adolescent Substance Use & Addiction Program (ASAP)

Developmental Medicine Center, Boston

Children’s Hospital Brookline, Massachusetts Instructor in Psychiatry Harvard Medical School Boston, Massachusetts

Kristen Slaymaker, DO

Developmental Pediatrics

Children’s Hospital Colorado University of Colorado School of Medicine Aurora, Colorado

Peter J. Smith, MD, MA

Associate Professor of Pediatrics

Section of Developmental and Behavioral Pediatrics

University of Chicago Chicago, Illinois

Barbara Sourkes, PhD

Professor

Department of Pediatrics

Stanford University School of Medicine

John A. Kriewall and Elizabeth A. Haehl Director, Palliative Care Program

Lucile Packard Children’s Hospital Stanford

Palo Alto, California

Leslie Speer, PhD, BCBA, NCSP

MetroHealth Medical Center

Center Case Western Reserve University Cleveland, Ohio

Emily M. Spelbrink, MD, PhD

Stanford University School of Medicine

Palo Alto, California

Adiaha Spinks-Franklin, MD, MPH

Division of Developmental Pediatrics

Department of Pediatrics

Baylor College of Medicine Houston, Texas

Deborah M. Spitalnik, PhD

The Boggs Center on Developmental Disabilities

Professor of Pediatrics and Family Medicine and Community Health

Rutgers Robert Wood Johnson Medical School

New Brunswick, New Jersey

Margaret Stager, MD Professor CWRU School of Medicine

MetroHealth Medical Center Cleveland, Ohio

Terry Stancin, PhD, ABPP Chief of Psychology Director, Child & Adolescent Psychiatry & Psychology

The MetroHealth System

Professor, Departments of Psychiatry Pediatrics, & Psychological Sciences Case Western Reserve University Cleveland, Ohio

Meg Stanger, MS, PT, PCS

Manager of Occupational Therapy and Physical Therapy

UPMC Children’s Hospital of Pittsburgh Pittsburgh, Pennsylvania

Walter H. Stearns, MD

Department of Psychiatry and Behavioral Health

The Ohio State University Columbus, Ohio

Terri Stillwell, MD, MPH

Division of Pediatric Infectious Diseases

Department of Pediatrics

University of Michigan Medical School

Ann Arbor, Michigan

Stephanie K. Takamatsu, PhD

Department of Psychiatry

University of Colorado School of Medicine Aurora, Colorado

Nicole Tartaglia, MD

Developmental Pediatrics

Denver Fragile X Clinic

Children’s Hospital Colorado University of Colorado School of Medicine Aurora, Colorado

Talia Thompson, PhD

Developmental Pediatrics

Children’s Hospital Colorado University of Colorado School of Medicine Aurora, Colorado

Sarah J. Tlustos, PhD, ABPP-CN Pediatric Neuropsychologist Department of Rehabilitation

Children’s Hospital Colorado Assistant Professor Department of Physical Medicine and Rehabilitation

University of Colorado School of Medicine Aurora, Colorado

Eric Tridas, MD

Medical Director (retired) of the Tridas Center for Child Development Tampa, Florida

Paige J. Trojanowski, PhD

George Mason University Center for Psychological Services Fairfax, Virginia

Elizabeth Troy, MD

Assistant Professor

University of Colorado Department of Pediatrics

Section of Neurology

Children’s Hospital Colorado Aurora, Colorado

Megan E. Tudor, PhD

Assistant Clinical Professor of Pediatrics

Licensed Clinical Psychologist

MIND Institute

University of California–Davis Davis, California

Doris Valenzuela-Araujo, MD

Department of Pediatrics

Oregon Health and Science University

Portland, Oregon

Amanda Van Scoyoc

Community Faculty Member

Yale Child Study Center

New Haven, Connecticut

Douglas L. Vanderbilt, MD

Professor of Clinical Pediatrics (Educational Scholar)

Keck School of Medicine of University of Southern California

Children’s Hospital of Los Angeles Los Angeles, California

Jessica VanOrmer Simpson, PhD

MetroHealth Medical Center

Case Western Reserve University Cleveland, Ohio

Robert G. Voigt, MD

Department of Pediatrics

Section of Developmental Pediatrics

Baylor College of Medicine

Meyer Center for Developmental Pediatrics & Autism

Texas Children’s Hospital Houston, Texas

Christine Waanders, PhD

Practice-Based Scholar

The Center for Violence Prevention

Children’s Hospital of Philadelphia Philadelphia, Pennsylvania

Kate E. Wallis, MD, MPH

Division of Developmental-Behavioral Pediatrics

Children’s Hospital of Philadelphia

Department of Pediatrics

Perelman School of Medicine at the University of Pennsylvania Philadelphia, Pennsylvania

Laura Weissman, MD

Assistant Professor in Pediatrics

Harvard Medical School

Attending Physician

Division of Developmental Medicine

Boston Children’s Hospital

Boston, Massachusetts

Carol Weitzman, MD

Co-Director

Autism Spectrum Center

Boston Children’s Hospital

Boston, Massachusetts

Kristen Wigby, MD

Genetics, Rady Children’s Hospital

San Diego, California

Breanna M. Winder-Patel, PhD

Assistant Clinical Professor of Pediatrics

Licensed Clinical Psychologist

MIND Institute

University of California–Davis Davis, California

Larry Wissow, MD

Department of Psychiatry and Behavioral Sciences

University of Washington Seattle, Washington

Kara K. Wright, MD, MPH

Associate Clinical Professor

Volunteer, Department of Pediatrics

University of California–San Francisco

Pediatrician/Consultant

Tenderloin Community School

Bay Area Women’s and Children’s Center

San Francisco, California

Michele Yang, MD

Associate Professor, Department of Pediatrics and Neurology

University of Colorado Denver

Children’s Hospital Colorado

Aurora, Colorado

Angela Yarnell Bonino, PhD, CCC-A University of Colorado Boulder Department of Speech, Language, and Hearing Sciences

Boulder, Colorado

Mary Yarus, M Ed, LDT, CALT

Dyslexia Specialist

Region 4 Education Service Center

Houston, Texas

Ann Ming Yeh, MD

Clinical Associate Professor

Department of Pediatrics

Division of of Gastroenterology, Hepatology, and Nutrition

School of Medicine, Stanford University

Palo Alto, California

Musa Yilanli, MD

Division of Child & Family Psychiatry

Big Lots Behavioral Health Services

Nationwide Children’s Hospital Columbus, Ohio

Samuel H. Zinner, MD Professor of Pediatrics

University of Washington School of Medicine

Developmental-Behavioral Pediatrician

Seattle Children’s Hospital Seattle, Washington

Marcia Zorrilla, DrPH, MPH Division of Adolescent Medicine Department of Pediatrics Stanford University Palo Alto, California

Barry Zuckerman, MD Professor and Chair Emeritus of Pediatrics Boston University School of Medicine Boston, Massachusetts

Katharine E. Zuckerman, MD, MPH Department of Pediatrics (Division of General Pediatrics) Oregon Health & Science University Portland, Oregon

Lucas Zullo, PhD University of California–Los Angeles Los Angeles, California

Welcome to the fifth edition of Developmental-Behavioral Pediatrics. As editors, we have attempted to ensure that the new version maintains the high standards of the previous four editions. We are humbled as we recognize that, for the first time, none of the editors of this textbook served as editors for the first edition of Developmental-Behavioral Pediatrics, published in 1983. We recognize and thank all the previous editors and authors whose fine contributions to earlier versions helped to create and define the field of developmentalbehavioral pediatrics.

In the almost 40 years since the first edition of this textbook was published, developmental-behavioral pediatrics has evolved with enhanced theories, important scientific discoveries, increasing prevalence of developmental and behavioral conditions, new interventions, and our improved understanding of important influences on outcomes. We sought to reflect these profound changes with a new organization and new chapters in the book. The book begins with a new section on the theoretical foundations of developmental-behavioral pediatrics care and research. The section on life stages has a new chapter on important considerations for the transition to adulthood for all adolescents. The sections on environmental and on biologic influences have been expanded and updated to include more information on parenting, adverse childhood experiences, genetics, and brain injury and to address racism and bias in healthcare settings. The coverage of developmental, behavioral, and emotional conditions and the developmental and behavioral outcomes of physical health conditions has been expanded to include new chapters on suicide and self-harm, stress disorders, movement disorders, brain tumors, and sexuality in children with developmental disabilities. We open each chapter with a pithy vignette, designed to excite the reader’s interest and to humanize the conditions and issues we address.

Throughout the book, we have highlighted the interprofessional care required to optimize outcomes for children with developmental and behavioral conditions and their families. An interprofessional focus is reflected in our editor group that now includes Terry Stancin PhD, a leading psychologist in the field of developmental-behavioral pediatrics, complementing the two returning editors, Heidi Feldman MD, PhD and Ellen Elias MD, and the other two new editors, Nathan Blum MD and Manuel Jimenez MD, MS. Where appropriate, the chapters are authored by individuals from more than one professional discipline. With an interprofessional focus, we also greatly expanded the section on assessment and measurement to include chapters on evaluation of children who are minimally verbal, evaluation of emotions and behaviors, neuropsychological assessment, and assessment of adaptive functioning. Another new chapter discusses approaches to integrating data across different assessments and managing uncertainty. Similar expansion has occurred in the management section with new chapters on counseling and readiness

to change, a common factors approach to counseling, applied behavior analysis, rehabilitation services, community-based interventions, and endocrine and gynecological care for youth with severe disabilities. As in the previous edition, we end with a section on systems issues, and in the final chapter we, the editors, reflect on implications of the right to belong and the right to be different for interprofessional care for children with developmental and behavioral conditions.

Given the emphasis on interprofessional care throughout the book, we hope that this volume will meet the needs of a varied and interprofessional readership. For the specialist in developmental-behavioral pediatrics providing clinical care or in-training, it should provide a reliable resource for the best information available in this broad and complex field. For clinicians in primary care, psychology, psychiatry, education, nursing, rehabilitation therapies, social work, and other professions, the book offers comprehensive coverage of the wide spectrum of developmental, behavioral, emotional, physical, and psychosocial challenges clinicians assess and manage when they care for children, youth, young adults, and their families. For researchers, the book provides a summary of the current state of knowledge and identifies gaps where our knowledge needs to be expanded and improved.

This book came together with the contributions of many. We thank the outstanding returning and new authors whose contributions allowed us to achieve our ambitious goals for this book. Our publisher has provided tremendous enthusiasm, guidance, and support, critical to completing this project. In addition, we gratefully acknowledge the multitude of ways in which the US Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal Child Health Bureau (MCHB) has supported the field of developmental and behavioral pediatrics and interprofessional education. Children and families, faculty, and trainees in multiple disciplines, many authors and readers of the book, and the editors have benefited from HRSA-supported programs, including the Leadership Education in Developmental-Behavioral Pediatrics training program, the Leadership Education in Neurodevelopmental and Related Disabilities (LEND) training program, and a variety of research networks focused on the care of children with autism and on the practice of developmental and behavioral pediatrics. Finally, we thank the children and families we care for, our colleagues, and our own families. All of you inspire us every day.

The previous editions of the book have all ended the Preface with poems or quotes from famous authors. In recognition of the importance of history and tradition, and previous editors of the book, we humbly continue that tradition. We appreciate the sentiments of this poem, though we might have chosen different pronouns for this current era.

CHILDREN LEARN WHAT THEY LIVE

If a child lives with criticism, He learns to condemn.

If a child lives with hostility, He learns to fight.

If a child lives with ridicule, He learns to be shy.

If a child lives with shame, He learns to feel guilty.

If a child lives with tolerance, He learns to be patient.

If a child lives with encouragement, He learns confidence.

If a child lives with praise, He learns to appreciate.

If a child lives with fairness, He learns justice.

If a child lives with security, He learns to have faith.

If a child lives with approval, He learns to like himself.

If a child lives with acceptance and friendship, He learns to find love in the world

SECTION 1 Foundations of DevelopmentalBehavioral Pediatrics

1 An Introduction to the Field of DevelopmentalBehavioral Pediatrics, 1

Douglas L. Vanderbilt and Heidi M. Feldman

2 The Biopsychosocial Model: Understanding Multiple, Interactive Influences on Child Development and Behavior, 11

Megan M. Julian and Julie C. Lumeng

3 Theories of Human Development, 19

Sarah L. Friedman and Ellin K. Scholnick

4 Theories of Learning and Behavior Change, 28

Cy Nadler and A. Dawn Greathouse

SECTION 2 Life Stages

5 The Maternal-Fetal Dyad: Challenges and Adaptations, 37

Amy L. Salisbury, Sara W. Moyer, Shannon Erisman, Patricia A. Kinser, Katheleen Hawes, and Pamela High

6 Infancy, 49

Marilyn Augustyn, Mei Elansary, and Barry Zuckerman

7 Toddlerhood and the Preschool Years, 59

Rosmary Ros-DeMarize, Silvia Pereira-Smith, and Michelle M. Macias

8 Middle Childhood, 72

David Alan Ansel

9 Adolescence, 91

Bonnie Halpern-Felsher, Marcia Zorrilla, Adrienne Lazaro, and Arash Anoshiravani

10 Transition to Adulthood, 108

Kimberly Burkhart, Marie A. Clark, Courtney E. Batt, and Nancy J. Roizen

11 End-of-Life, Death, and Bereavement, 116

Michelle R. Brown, Julie Good, and Barbara Sourkes

SECTION 3 Social and Environmental Contexts of Children

12 Understanding Child Development and Behavior in the Context of Family Systems, 121

Jessica Moore, Christina Mulé, and Susan H. McDaniel

13 Parenting and Parenting Behavior, 133

Caitlin F. Canfield, Erin Roby, Kimberly Burkhart, Renée BoyntonJarrett, and Alan L. Mendelsohn

14 Foster Care and Adoption: Implications for Developmental and Behavioral Pediatrics, 143

Kida Ingram and Lisa Prock

15 Trauma, Resilience, and Child Development, 153

Marsheena Murray and Robert D. Keder

16 Childcare, 163

W. Steven Barnett and Anna Malia Beckwith

17 Peers, 167

Gary Kwok and Katie A. Devine

18 Schools as a Milieu, 171

Anson J. Koshy and Mary Yarus

19 Neighborhoods and Personal Networks, 178

Sarah E. Dubner and Lynne C. Huffman

20 Celebrating Sociocultural Diversity in the Exam Room and Addressing Racism and Bias, 189

Irene M. Loe, Adiaha Spinks-Franklin, and Kate E. Wallis

21 The Influence of Digital Media on Children and Families, 201

Tiffany Munzer

22 Natural and Human Disasters, 210

David J. Schonfeld and Thomas P. Demaria

SECTION 4 Biological Factors, Medical Conditions, and Exposures Affecting Development and Behavior

23 Biological Mechanisms of Human Development and Behavior, 221

Ellen Roy Elias

24 Genetic Disorders and Their Associated Mechanisms, 226

Jessica Duis and Ellen Roy Elias

25 Chromosome Disorders and Inheritance Patterns, 241

Aaina Kochhar and Naomi J.L. Meeks

26 Sex Chromosome Aneuploidy, 249

Kristen Wigby, Talia Thompson, Mariah Brown, Nicole Tartaglia, and Shanlee Davis

27 Down Syndrome, 262

Francis Hickey and Karen Kelminson

28 Fragile X Syndrome and FMR1 Variants, 270

Susan Howell, Elizabeth Coan, Kristen Slaymaker, Randi Hagerman, and Nicole Tartaglia

29 Nervous System, 280

Elizabeth Troy and Padmini Palat

30 Neuromuscular Disorders, 297

Michele Yang

31 Seizures and Epilepsy, 304

Elizabeth Dubow and Krista Eschbach

32 Diffuse Acquired Brain Injury, 315

Sarah J. Tlustos, Aaron Powell, and Michael W. Kirkwood

33 Congenital Infections, 324

Megan Honor Pesch and Terri Stillwell

34 Consequences of Preterm Birth, 333

Brittany L. Schwarz and Mary L. O’Connor Leppert

35 Nutritional Disorders, 344

Liliane Diab and Nancy F. Krebs

36 Inborn Errors of Metabolism, 357

Emily Shelkowitz, Austin Larson, and Peter Baker II

37 Prenatal Exposure of Alcohol, Tobacco, and Drugs, 390

Carol Weitzman and Michele Ledesma

38 The Impact of Environmental Chemicals on the Developing Brain, 398

Marissa Hauptman and Philip J. Landrigan

SECTION 5 Developmental Disorders

39 Cerebral Palsy and Other Motor Disorders, 407

Kilby Mann, Joyce Oleszek, and Nancy Murphy

40 Intellectual Disability, 420

Sandra L. Friedman and Ellen Roy Elias

41 Autism Spectrum Disorder, 431

Bibiana Restrepo, Janice Enriquez, and Robin L. Hansen

42 Developmental Considerations in Deafness, 445

Deborah Mood and Angela Yarnell Bonino

43 Blindness and Visual Impairment, 455

Michael A. Puente, Tanni L. Anthony, and Robert W. Enzenauer

44 Language and Speech Disorders, 466

Heidi M. Feldman and Cheryl Messick

45 Sensory Processing Disorders, 477

Karen Ratliff-Schaub and Sara O’Rourke

SECTION 6 Variation in Behavior, Learning, Emotion, and Mental Health

46 Attention-Deficit/Hyperactivity Disorder (ADHD), 483

William J. Barbaresi and Jason M. Fogler

47 Learning Disabilities, 497

Nadine Gaab, Marie Reilly, and Eric Tridas

48 Talent and Giftedness, 510

Mary C. Kral

49 Mood Disorders in Children and Adolescents, 516

Musa Yilanli and Mary A. Fristad

50 Suicide Prevention Care in the Pediatric Setting: A Trauma-Informed Approach, 529

Lucas Zullo, Brooks Keeshin, and Joan Asarnow

51 Anxiety Disorders in Children and Adolescents, 537

Rebecca A. Hazen and Marie A. Clark

52 Psychotic-Spectrum Disorders in Children and Adolescents, 549

Sarah A. Hamilton, Craig J. Parris, Nicholas J.K. Breitborde, and Walter H. Stearns

53 Substance Use Disorders and Other Risk-Taking Behaviors in Youth, 559

Kevin M. Simon, Marianne Pugatch, and John R. Knight

54 Dual Diagnosis of Mental Health and Developmental Disorders in Developmental-Behavioral Pediatrics, 576

Shalonda Brooks and Eric M. Butter

55 Aggression and Disruptive Behavior Disorders, 584

Stephen S. Leff, Christine Waanders, and Sandhyaa Iyengar

56 Acute Stress Disorder and Posttraumatic Stress Disorder in Youth, 594

Jason M. Fogler, Amanda Van Scoyoc, Melissa Marquardt, and Randall Phelps

57 Adjustment and Adjustment Disorders in Developmental-Behavioral Pediatrics, 609

Kathryn Mancini and Robert Needlman

SECTION 7 Developmental and Behavioral Considerations Related to Medical Care

58 Impact of Hospitalization and Acute Medical Care on Children and Families, 615

Gayle Chesley and Paul M. Robins

59 Children with Chronic Illness and Medical Complexity, 621

Kourtney Santucci and Ellen Roy Elias

60 Survivors of Childhood Brain Tumors: Developmental and Behavioral Considerations, 630

Emily K. Shabason, May V. Albee, and Matthew C. Hocking

61 Neurodevelopment in Children With Congenital Heart Disease, 636

David C. Bellinger and Leonard A. Rappaport

62 Medications With Developmental and Behavioral Side Effects, 643

Sonia A. Monteiro and Robert G. Voigt

63 Palliative Care for Children With Medical Complexity, 649

Irene Cihon Dietz and Ishani Sandesara

64 Chronic Pain, 660

Caitlin B. Murray and Tonya M. Palermo

SECTION 8 Variations in Functional Domains

65 Feeding and Swallowing Disorders, 671

Laura Pickler, Kaitlyn Cavanaugh, and Holly Knotowicz

66 Growth Faltering, 677

Jennifer M. Rathbun, Annelise Brochier, and Deborah A. Frank

67 Childhood Obesity, 685

Carol Curtin, Sandra G. Hassink, Susan L. Hyman and Linda G. Bandini

68 Urinary Incontinence and Nocturnal Enuresis, 692

Jaclyn A. Shepard and Sean T. Corbett

69 Toileting and Encopresis, 701

Laura Weissman

70 Sleep and Sleep Disorders In Children, 711

Ronald E. Becker and Judith A. Owens

71 Movement Disorders, 722

Samuel H. Zinner and Jonathan W. Mink

72 Habit Disorders in Children and Adolescents, 735

Carissa R. Jackel and Nathan J. Blum

73 Sexuality and Its Variations, 744

Laura J. Mintz and Margaret Stager

74 Sexuality in Children and Youth With Disabilities, 748

Beth Ellen Davis, Susan Hayden Gray, and Jenniffer Herrera

75 Gender and Its Variation in Youth, 757

Claire A. Coyne, Afiya Sajwani, and Diane Chen

SECTION 9 Assessment and Measurement in Developmental-Behavioral Pediatrics

76 Fundamentals of Developmental, Behavioral, and Psychological Assessment, 765

Melissa Armstrong-Brine, Jessica VanOrmer Simpson, and Terry Stancin

77 The Interview in Developmental-Behavioral Pediatrics, 776

John C. Duby, Kelly Blankenship, and Mary Beth DeWitt

78 The Physical Exam: Laying on of Hands or Not, 785

Jamie T. Rabot, Randall Phelps, and Heidi M. Feldman

79 Evaluation of Children Who Are Nonverbal/Minimally Verbal, 793

Casey E. Krueger and Jessica Patel

80 Assessment of Temperament, 799

Hannah Perrin and Nicole R. Bush

81 Developmental Surveillance and Screening, 804

Benjamin W. Sanders, Brittany S. Bassitt, Luis A. Rivas Vazquez, and Katharine E. Zuckerman

82 Evaluation of Emotion and Behavior, 813

Laura A. Shaffer and R. Emily Gonzalez

83 Evaluation of School Readiness: Beyond ABCs, 824

Jaime W. Peterson, Doris Valenzuela-Araujo, Kylie M. L. Seeley, and Shelly Reggiani

84 Observational Assessment in DevelopmentalBehavioral Pediatrics, 831

Jordan Ezell Klein and Laura Arnstein Carpenter

85 Developmental, Cognitive, and Intelligence Testing, 838

Stephanie K. Takamatsu, Eleanore M. Hall, and Allison G. Dempsey

86 Educational Testing and Evaluation of Academic Performance, 847

Sara Kupzyk, Brenda Bassingthwaite, and Tina Scott-Mordhorst

87 Neuropsychology in Developmental-Behavioral Pediatrics Practice, 858

Melissa Armstrong-Brine and Leslie Speer

88 Evaluation of Adaptive Functioning, 865

Micah O. Mazurek, Sophie Brunt, and Erica Fornaris Rouch

89 Assessments of the Central Nervous System, 871

Fiona M. Baumer and Emily M. Spelbrink

90 Integration of Data Sources and Uncertainty, 880

Alison Schonwald and Bridget Kiley

SECTION 10 Interventions, Management, and Treatment of Developmental and Behavioral Conditions

91 Counseling and Readiness to Change, 887

Rebecca A. Baum and Cody A. Hostutler

92 Common Factors and Lifestyle Interventions, 894

Jeremy Kruger and Larry Wissow

93 Behavioral Parent Training and Consultation, 902

Cy Nadler and Nathan J. Blum

94 Applied Behavior Analysis for Autism Spectrum Disorder, 912

Amanda E. Bennett and Lauren B. Fishbein

95 Crisis Management in Developmental-Behavioral Pediatrics, 923

Brittany R. Myers and Raman Marwaha

96 Individual Therapy for Children and Adolescents: Play Therapy and Interpersonal Therapy as Developmentally Centered Relational Change Modalities, 931

Karla K. Fehr, Abby Hughes-Scalise, Bethany Leraas, and Kristen Boog

97 Family Systems Therapy and Its Importance in Developmental-Behavioral Pediatrics, 940

Robyn Mehlenbeck and Paige J. Trojanowski

98 Cognitive-Behavioral Therapy in DevelopmentalBehavioral Pediatrics, 947

Megan E. Tudor, Shereen J. Cohen, Breanna M. Winder-Patel, and Kathleen Angkustsiri

99 Psychopharmacology, 958

DePorres Cormier II and Alison Schonwald

100 Hypnosis, Biofeedback, and Meditation, 974

Howard Hall, Fatima Malik, and Suzanne Rusnak

101 Growth Mindset as a Brief Intervention: Research to Practice, 982

Irene M. Loe, Kara K. Wright, and Claudia M. Mueller

102 Treatment of Developmental, Behavioral, and Mental Health Conditions via Technology, 990

Philip B. Cawkwell, Bayan Jalalizadeh, Eric McDonald, and John E. Leikauf

103 Early Intervention, 996

Dawn M. Magnusson and Mary A. Khetani

104 Special Education Services, 1005

Nathaniel S. Beers and Cara Coleman

105 Transition to Adulthood for Young Adults With Intellectual and Developmental Disabilities, 1014

Judy Lu Kim and Albert Hergenroeder

106 Rehabilitation Services: Occupational Therapy and Physical Therapy, 1023

M. Kathleen Kelly and Meg Stanger

107 Speech-Language Pathology for DevelopmentalBehavioral Disorders, 1029

Cheryl Messick

108 Art and Music Therapy, 1035

Colleen Kahn and Catherine Crouse

109 Integrative Medicine for Disorders of Development and Behavior, 1041

Ann Ming Yeh, Rachel Lee Gilgoff, and Jenna Arruda

110 Community-Based Interventions, 1050

Lisa Ramirez and Katie Davis

111 Endocrine and Gynecologic Management of Children With Severe Disabilities, 1057

Shanlee Davis and Eliza Buyers

SECTION 11 Societal and Legal Contexts of Developmental-Behavioral Pediatrics

112 Social Inclusion, 1067

Deborah M. Spitalnik and Dillon Reitmeyer

113 Education Law: Implications for DevelopmentalBehavioral Pediatrics, 1073

Jeffrey Okamoto

114 Health Care Systems for Children With Disabilities, 1079

Justin Charles Schwartz and Laura Joan McGuinn

115 Interprofessional Team-Based Care, 1088

Jeffrey D. Shahidullah, Cody A. Hostutler, and Rebecca A. Baum

116 Ethical Considerations, 1096

Peter J. Smith

117 The Pitfalls of Guardianship (Conservatorship) and the Promise of Alternatives, 1100

Zoe Brennan-Krohn and Susan Mizner

SECTION 12 Conclusion

118 The Right to Belong, The Right to be Different, 1107

Heidi M. Feldman, Ellen Roy Elias, Nathan J. Blum, Manuel E. Jimenez, and Terry Stancin

Index, 1111

Color versions of the figure are available in the online version

SECTION 1 Foundations of Developmental-Behavioral Pediatrics

1

An Introduction to the Field of Developmental-Behavioral Pediatrics

For additional material related to the content of this chapter, please see Chapters 2, 3, 113, 117, and 120

VIGNETTE

A group of medical students from the Pediatric Interest Group approach you seeking career guidance. You probe their interests and goals. They desire that their career be built on a solid molecular and biomedical foundation yet tempered with an understanding of the social context and psychological contributors to health and illness. They want to keep open the possibility of working not only in clinical care, teaching, and research but also in systems-level policy and advocacy. They want to address important clinical and societal needs and prefer to do so in innovative, collaborative partnerships that empower families, primary care colleagues, and interdisciplinary teams. They find thinking both at macro- and microsystems levels to be exciting and understand that important outcomes of medical care include not only disease-free survival but maybe also optimal functional outcomes for individuals and populations. Finally, they want to follow children and families over time with a life-course lens. The students want to know what area of medicine you would recommend for them to consider for a rewarding career.

This chapter provides an orientation to developmentalbehavioral pediatrics (DBP), a young and yet maturing subspecialty of pediatrics. In this chapter we explore the origins of DBP; its emergence from historical, medical, and social imperatives; its current challenges; and opportunities for further growth.

RATIONALE FOR THE FIELD OF DBP

The field of DBP emerged from the need to increase the capacity of pediatrics to understand, evaluate, treat, and manage children with developmental disabilities, mental health disorders, and those at risk for these disorders based on the presence of medical conditions or adverse social and psychological environments. These children represent a large swath

of the population in the United States and across the globe. In the United States 26% of children are at moderate or high risk for developmental-behavioral (DB) problems. Among the 18% of US children with a special health care need, over half have one or more emotional or behavioral health difficulties. Internationally, almost 53 million children under age 5 years are estimated to have a developmental, behavioral, or emotional disorder (Global Research on Developmental Disabilities Collaborators, 2018). DBP is a distinctive subspecialty developed to help address these needs.

Definition of DBP

The field of DBP was defined in an application to the American Board of Pediatrics (ABP) for subspecialty certification that was approved in 1998. DBP was conceived as a pediatric subspecialty with goals of research, teaching, advocacy, and clinical work in the domains of human development and behavior. All aspects of development—cognitive, social, emotional, and physical development—were acknowledged and seen as linked to contexts of family, school, and larger communities. Although the scope of practice may overlap with child neurology, child psychiatry, and child psychology, DBP was distinct because it retained its foundation in pediatrics, maintaining interest in high-prevalence, lower-severity conditions and typical developmental trajectories as well as in children with low-prevalence, high-severity conditions. Importantly, DBP is an interdisciplinary field. The interdisciplinary perspective can be seen, for example, in the authorship of the chapters in this book; clinical practices that use interdisciplinary teams; and membership of the primary professional organization, the Society for Developmental & Behavioral Pediatrics (SDBP), that includes physicians, psychologists, nurses, and others.

Key Perspectives and Values

DBP conceptualizes development and behavior as arising from biopsychosocial-ecological transactions (see Chapter 2) along a life-course timeframe (see Chapter 3). The life-course frame emphasizes that prevention and early intervention may substantially affect the developmental trajectory. DBP

acknowledges that neurobiology shapes developmental outcomes, and the social context and developmental changes shape neurobiology (see Chapter 2).

DBP care is person centered and strengths based; it engages individuals in their own care, to the extent possible, recognizing their unique strengths as well as their needs. DBP clinical practice is family centered, utilizing shared decision making with families in the diagnostic and management phases. The contextual understanding recognizes the important role of culture (see Chapter 20) in the manifestations and understanding of illness and disability and in decisions about the acceptability of approaches to treatment. Cultural humility brings respect to different cultures and acknowledges socially embedded disparities in equity, diversity, and inclusion. DBP care necessitates close collaboration of the health care system with community resources and services. Many DBPs take on advocacy roles through engagement with practice associations, health systems, community-based organizations, or policymakers at local, state, and national levels. What is definitional about DBP is its unique perspective and not a set of organ systems, diagnoses, or practice settings (Schonfeld, 2008).

HISTORICAL GROUNDING FOR DBP PERSPECTIVE

The DBP subspecialty emerged from the confluence of five historical trends: (1) changing concepts about children, (2) the emergence of pediatrics, (3) evolving concepts about disability, (4) evolving concepts about mental health, and (5) the development of public policy and public systems of care.

Changing Concepts of Children in Society

The term child comes from the Latin infans, which means “the one who does not speak.” Throughout history and across

of Child Rearing

1. Infanticidal Prehistory to 4th century CE

2. Abandoning 4th century to 13th century

3. Ambivalent 13th century to 17th century

4. Intrusive 18th century

5. Socialization 19th century to mid-20th century

6. Helping Mid-20th century to present

7. Emotionally literate

cultures, childhood has been an evolving concept. Childhood was defined as the period from birth to age 7 years in the Roman world and birth to age 18 years in the modern era. Table 1.1 demonstrates that child rearing has shifted perspectives over time with the rationales for the practices in Table 1.2 based on changing constructs about childhood (Haring, Sorin, & Caltabiano, 2019).

Agrarian cultures typically emphasized utilitarian functions for children (i.e., their ability to work). Urbanization led to changes in the state of childhood. As women in cities went to work to support their families, the children required childcare, nutritional infant formulas, and education. Yet, community-wide resources for women and children were limited due to their lack of political power, limitations on property ownership, excessive taxation, political injustice, and corruption.

In the late 17th and early 18th centuries the Enlightenment marked a change in the concept of the child. Philosophers such as John Locke (1632–1704) and Jean-Jacques Rousseau (1712–1778) emphasized the impact of experience on the developing child. This conceptualization accentuated the need to provide children with nurturing environments, education, and growth-enhancing experiences.

In the last century the concept of child agency gradually has taken hold, allowing for legal strategies to promote child welfare. An early instantiation was found in 17th-century France, where children were granted “minor rights” to education, among other areas. In 1908 the New York City Health Department founded the Bureau of Child Hygiene to address child health, including prenatal care, infant mortality, school inspections, and child labor laws. The League of Nations adopted the Declaration of the Rights of the Child in 1924, the first international treaty giving specific rights to children and responsibilities to adults. The United Nations (UN) Fund for Urgency for the Children was created in 1947 to

Children worked to support the family; suffered child abuse, infanticide, and emotional abandonment.

Physical and sexual abuse of children continued; children revered people of authority to avoid being abandoned (to monasteries, service to nobility).

Laws were developed to protect children; schools were established. Child still “bad.” Shaming and blaming used as discipline. Love-hate relationships between parents and child.

Parents increased love and care to their children; punishment used for bad behavior.

Parents offered increasing respect to their children’s wishes, even though beating and shaming discipline methods continued to socialize children.

Parents began to help their children to achieve their own goals in adult life.

Early 21st century Parents raise children aware of their own emotional reactions, responsible for their own life and society.

Adapted from Haring, U., Sorin, R & Caltabiano, N J (2019). Reflecting on childhood and child agency in history Palgrave Communications, 5, 52 https://doi org/10 1057/s41599-019-0259-0

TABLE 1.1 Evolving Views

TABLE 1.2 Typology of Concept of Children

Concept Description

Innocent child, born pure

Child requires the care and protection of adults and has no agency.

Evil child due to original sin Child was inherently evil, and severe beatings could put a child on the right path to maturity.

Snowballing child

Out-of-control child

Child takes power from the adult in an uneven relationship where tired parents give in to the child’s demands.

Child has lost control, and the adult feels powerless to express agency.

Noble/savior child Child takes on responsibility to protect others, and adults might depend on child because of illness or substance abuse.

Miniature adult

Adult-in-training

Commodified child

Child as victim

Agentic child

Child as a small adult with no distinction between childhood and adulthood, so society uses child as laborer, soldier, or other occupation.

Child has “human becomings,” not as “human beings”; view is favored by developmental psychologists such as Piaget, Erikson, and Freud.

Child has no voice, is open to exploitation by adults.

Child is living in wartimes and crime, is powerless, and often not noticed as adults can only appeal to charities for help.

Child has support of loving adults to help guide and achieve goals; the child’s voice is respected and considered, so child acts collaboratively with adults.

Adapted from Haring, U., Sorin, R. & Caltabiano, N. J. (2019). Reflecting on childhood and child agency in history. Palgrave Communications, 5, 52. https://doi.org/10.1057/s41599-019-0259-0

promote humanitarianism and development aid and later became UNICEF (UN Children’s Fund). In 1959 the General Assembly of the UN adopted the Declaration of the Rights of the Child, which led to the International Charter of the Child Rights. All but one of the 195 UN members signed the document, and 192 ratified it. The United States signed but has not ratified it.

The Emergence of Pediatrics

During ancient history, health care for children had been the province of families and midwives. Physicians avoided the care of children because of prevailing social beliefs, limited medical training about children’s health, and the poor prognosis of many childhood diseases. Health care specifically for children emerged in the late 18th and 19th centuries. The first dispensary for children in London, England, was established in 1769. The first children’s hospital, L’hôpital des Enfants-Malades, was founded in Paris in 1802. The first children’s hospitals in the United States were established in 1855 in Philadelphia and New York City (American Academy of Pediatrics [AAP], 2001). Abraham Jacobi (1830–1919), often considered the father of American pediatrics (Strain, 2004), organized the first children’s clinic at the New York Medical College in 1860. He also organized the pediatric subsections for the American Medical Association (AMA) in 1880. He collaborated on public health efforts such as providing safe milk for poor infants in New York (Mahnke, 2000).

Evidence of the crystallization of the field of pediatrics was the launch of Archives of Pediatrics, the first US journal to be devoted exclusively to children, in 1884 and the first professional society, the American Pediatric Society, in 1888. Pediatricians recognized that treating childhood diseases

required public health as well as clinical interventions. In 1926 the Section on the Diseases of Children of the AMA voted in support of the reauthorization of the Sheppard-Towner Act, a modest federal maternal and child health program, on the same day that the AMA House of Delegates passed a resolution condemning the act. The conflict that followed ultimately led to the creation of the AAP in 1930 and subsequently the ABP. Public health advances promoted by pediatrics, such as sewage treatment, clean water, breastfeeding, and free medical care, all substantially reduced infant mortality and improved the health of children (Mahnke, 2000).

Pediatrics has thrived since the 20th century in medical schools and children’s hospitals. With the advent of vaccines and antibiotics, the clinical focus of pediatrics is shifting away from infectious diseases to the management of chronic illnesses, including developmental disabilities, recognition of poverty and environmental causes of disease, and addressing the psychosocial determinants of health (Brosco, 2011).

Evolving Conceptualization of Disability

From antiquity through the Middle Ages in Europe, disabilities were interpreted metaphysically as punishment for sin or the work of evil, as opposed to biomedically (Kanner, 1964).

A major shift began when a physician, Jean-Marc-Gaspard Itard (1775–1835), undertook the education of Victor, the Wild Boy of Aveyron, an abandoned and disabled child. He applied Enlightenment principles to educate the child but achieved only incremental success (Kanner, 1964). Itard’s student, Eduard Séguin (1812–1880), known as the father of special education, further popularized this concept of a comprehensive individualized educational program for children with disabilities. Maria Montessori (1870–1952), a child

psychiatrist and first woman physician in Italy, based her educational philosophy on Séguin’s contributions. Center-based habilitation programs emerged, but in the second half of the 19th century they devolved into primarily custodial institutions with poor living conditions—some even practicing sterilization and euthanasia (Kanner, 1964).

After World War II, families championed the cause of disabilities through the establishment of advocacy organizations (Kanner, 1964). Formed in 1950, the National Association of Parents and Friends of Mentally Retarded Children, now known as The Arc, advocated for equal rights, improved education and health care for people with disabilities, taught skills that are important for independence and employment to individuals with disabilities, and encouraged research in the area of disability (Segal, 1974). These efforts dovetailed with a changing legal landscape in public policy and education. A disability-oriented civil rights movement of the 1960s formulated a political agenda, focusing on overcoming the oppression, promoting independence and self-sufficiency, and advocating for social change. The social model of disability conceptualizes the cause of disability not as a health condition but as social, physical, and attitudinal barriers to participation in community life.

Evolving Concepts of Mental Health Disorders

Mental illness was at various times attributed to environmental causes such as loss of status or money, physiologic causes, astrologic alterations, possession by the devil, moral weakness, or divine punishment. Metaphysical treatments sought to correct the individual, such as inducing catharsis, submerging patients in ice baths, inducing vomiting, or bloodletting. Social exclusion and incarceration were other approaches that continue to this day as currently over 35% of prison inmates have a history of a mental health condition.

The Enlightenment dramatically altered the care of individuals with mental health disorders. Philippe Pinel (1745–1826), regarded as the father of modern psychiatry, promoted the method of moral management. The method included intense observation and conversation with individuals affected with mental disorders, supportive care such

as hypnosis and relaxation, treatment in home-like settings, and work programs (Weiner, 1992). Attractive asylums were built that promised humane and effective treatments (Weiner, 1992). The institutions became overcrowded and returned to the use of restraints and shock therapies. The institutionalized population remained very high and conditions deplorable until the National Mental Health Foundation exposed the abuses in such institutions as the Byberry Hospital in Philadelphia in the 1940s (Sareyan, 1994). In 1963 President John F. Kennedy proposed the development of comprehensive community mental health centers to reduce the number of individuals in custodial care and support the full spectrum of services from diagnosis through emergency care. Deinstitutionalization gained momentum; however, homelessness and crime are visible indications of the limitations of investment in these community-based programs.

The Development of Psychology

With changing concepts in mental health emerged the field of psychology. Table 1.3 includes several notable psychologists who pioneered psychometrics and developmental assessment. These assessments allowed clinicians to characterize individual differences in development and cognitive skill. Unfortunately, the work on intelligence served as a rationalization of the eugenics movement that claimed the superiority of the white race (Kanner, 1964). While the defeat of the Nazis in World War II discredited the eugenics movement, vestiges of this thinking sadly persist to the present.

Another area of psychology theorized about the origins of emotion. Sigmond Freud (1856–1939), the founder of psychoanalysis, proposed that unconscious conflicts, often thought to be related to psychosexual development, caused emotional disorders (see Chapter 3). Despite its empiric and conceptual limitations, this theory continues to hold a potent basis within psychology. Erik Erikson (1902–1994) later reconceptualized Freudian stages in psychosocial rather than psychosexual terms, which define the major tasks that children face at various points in development. This theory has heuristic value in current conceptualizations (see Chapter 3).

Pioneers in the Psychological Assessment

Individual Dates Contributions

Charles Darwin 1809–1882

Francis Galton 1822–1911

Alfred Binet

Theodore Simon 1857–1911 1873–1961

Lewis Terman 1877–1956

Arnold Gesell 1880–1961

• Introduced the study of human behavioral development in “A Biographical Sketch of an Infant,” a treatise on the development of movement, vision, emotions (anger, fear, and pleasure), reasoning, moral sense, and communication in his infant son.

• Described the variations of development in human intelligence.

• Designed a carefully constructed Binet-Simon test in 1905 for differentiating children with typical development vs. those needing special education.

• Standardized the Binet-Simon on a large sample of US children to create the Stanford-Binet test of intelligence.

• Described the typical developmental milestones in “An Atlas of Infant Behavior” and advocated for the field of developmental pediatrics.

TABLE 1.3

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