Developmental and behavioral pediatric practice patterns and implications for the workforce: results of the Future of Pediatric Education II Survey of Sections Project.

A survey of developmental-behavioral pediatricians was conducted to obtain data and insights on their current practice. As part of the Future of Pediatric Education (FOPE) II Survey of Sections Project, questionnaires were sent to individuals who were most likely to represent those pediatricians engaged in the subspecialty of developmental-behavioral pediatrics. Four groups of physicians were compared within the survey: developmental-behavioral fellowship group (n = 272), developmental disabilities fellowship group (n = 139), general academic pediatrics or other fellowship group (n = 57), and a nonfellowship group (n = 224). A majority of respondents indicated a need for an increased number of subspecialists in developmental-behavioral pediatrics in their community during the next 3 to 5 years. There were significant differences in the survey results of a variety of practice issues between those who had and had not received formal fellowship training. The survey data illustrate a developmental-behavioral pediatrician workforce that is becoming increasingly fellowship trained, receiving more referrals, and encountering constraints to seeing more patients in an era of declining reimbursement for services. To overcome these obstacles, stakeholders in child health, including health care payers, will need to be educated about the unique skills and clinical expertise of physicians in developmental-behavioral pediatrics and neurodevelopmental disabilities.

Social competence and friendship formation in adolescents with attention-deficit/hyperactivity disorder.

Friendship formation (making friends, keeping friends, and having successful interactions with peers and adults) constitutes a critical developmental-social milestone for adolescents. This process can be especially challenging for adolescents with attention-deficit/hyperactivity disorder, whose attentional problems may negatively affect their social skills (verbal and nonverbal language) and who fail to appreciate the complexity and nuances of adolescent communication. They often do not respond to feedback cues. They may be perceived as "immature," lacking empathy, and loners and losers, they may endure a "reputational bias," and they often experience coexisting challenges (eg, language problems, learning disabilities, or obesity). Successful and gratifying interactions, or the lack thereof, deeply and broadly affect adolescents: their self-esteem, self-image, confidence, school-learning, lifestyle, behavior, sexual activity, intimacy formation, mental-emotional well-being, and physical health. Successful achievement of this ever-evolving milestone has lifelong implications. This article describes various social-interactional skills, other components of social competence, and the dysfunctions that may cause social failure and suffering and describes how to evaluate and help manage problems in adolescents with attention-deficit/hyperactivity disorder.