Developmental specialists have a keen eye for subtleties in the pediatric examination. With infants, they first rule out any concurrent medical causes for a given delay and then perform a careful assessment so that appropriate referrals for speech, occupational, or physical therapy can be made. Infants who are at risk for delays should also be referred to developmentalists, including those born prematurely, those who had congenital heart disease or meningitis, or those who experienced any other event that may have temporarily impaired oxygen flow to the brain.

Older children with learning issues in school can also benefit from seeing a developmentalist. Although the general pediatrician should feel comfortable diagnosing and treating attention-deficit hyperactivity disorder, some children may have receptive or expressive deficits at the root of their problem that, if diagnosed, could lead to more effective strategies for therapy. Currently, a fellowship in developmental pediatrics lasts 3 years. In the near future, this fellowship will become part of a 6-year residency leading to triple board certification in pediatrics, neurology, and development.

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