Graduation Year

2008

Document Type

Dissertation

Degree

Ph.D.

Degree Granting Department

Psychological and Social Foundations

Major Professor

Kathy Bradley-Klug, Ph.D.

Committee Member

Rose Iovannone, Ph.D.

Committee Member

Harold Keller, Ph.D.

Committee Member

Kathleen Armstrong, Ph.D.

Committee Member

Carol Lilly, M.D.

Keywords

AAP guidelines, School psychologists, Educators, Full-service schools, Qualitative

Abstract

General pediatricians are typically the first professionals to detect the early developmental concerns of young children during their infant and toddler stages. When concerns are identified by the general pediatrician, best practice encourages the referral of young children for further assessment and/or intervention. Due to these factors, this study focused on the methods general pediatricians use in their efforts to implement the American Academy of Pediatrics (AAP) guidelines for the developmental surveillance and screening of young children. Furthermore, this study focused on the barriers faced by general pediatricians and the solutions they have developed to overcome these barriers in their efforts to assist young children with developmental delays and disabilities.

Twenty-eight pediatricians who also were members of the Region V Florida Chapter of the AAP provided responses to survey data inquiring about the implementation of AAP guidelines within their settings. Six of the survey respondents were general pediatricians who each participated in a semi-structured interview to gain further insight into their implementation of the AAP guidelines. Additionally, existing barriers were examined to determine the strategies general pediatricians developed to overcome them. The results showed that each of the six general pediatricians reported their engagement in some, if not all recommended AAP guidelines. The general pediatricians shared specific examples of how this was done, which provided valuable data for other general pediatricians who desire to learn effective strategies for implementing AAP guidelines.

The interview responses addressed several themes, including training and continuing education, learning about and using developmental screeners, determining the cause of delays and disabilities, referring children with delays and disabilities, using a culturally-sensitive/family centered approach, and increasing parent awareness. General pediatricians also reported how they have overcome the barriers (e.g., limited time and staff members) to following AAP guidelines, as well as barriers that continue to exist (e.g., insufficient reimbursement for preventive care, difficulties serving children from low-income families, etc.). Although this study focused on how general pediatricians have overcome obstacles, multidisciplinary collaboration was emphasized as an integral factor needed to achieve the earliest identification and intervention implementation for young children with developmental concerns.

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