Table Of ContentDevelopmental
Behavioral
Disorders
Selected Topics
VOLUME .3
CRITICAL ISSUES IN
DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS
SERIES EDITOR: MARVIN I. GOTTLIEB, M.D., Ph.D.
Hackensack Medical Center
Hackensack, New Jersey
and University of Medicine and Dentistry of New Jersey
New Jersey Medical School
Newark, New Jersey
DEVELOPMENTA L-BEHAVIORAL DISORDERS: Selected Topics
Volumes 1-3
Edited by Marvin 1. Gottlieb, M.D., Ph.D., and John E. Williams, M.D.
A Continuation Order Plan is available for this series. A continuation order will bring
delivery of each new volume immediately upon publication. Volumes are billed only upon ac
tual shipment. For further information please contact the publisher.
Developmental
Behavioral
Disorders
Selected Topics
VOLUME 3
EDITED BY
MARVIN I. GOTTLIEB, M.D., Ph.D.
Director, Institute for Child Development
Hackensack Medical Center
Hackensack, New Jersey
Prtifessor, Department of Pediatrics
University tif Medicine and Dentistry tif New Jersey
New Jersey Medical School
Newark, New Jersey
AND
JOHN E. WILLIAMS, M.D.
Chiif, Section of Developmental Pedialrics
Associate Director, Institute for Child Development
Hackensack Medical Center
Hackensack, New Jersey
Clinical Assistant Professor, Department rif Pediatrics
University tif Medicine and Dentistry tif New Jersey
New Jersey Medical School
Newark, New Jersey
SPRINGER SCIENCE+BUSINESS MEDIA, LLC
Library of Congress Cataloging in Publication Data
(Revised for val. 3)
Developmental-behavioral disorders.
(Critical issues in developmental and behavioral pediatrics)
Includes bibliographical references.
1. Developmental disabilities. 2. Child psychiatry. 3. Pediatrics-Psychological
aspects.1. Gottlieb, Marvin 1. I!. Williams,John E. Oohn Edward), 1951-
RJ135.D475 1988 618.92/89 88-171674
ISBN 978-1-4613-6652-2 ISBN 978-1-4615-3714-4 (eBaok)
DOI 10.1007/978-1-4615-3714-4
© 1991 Springer Science+Business Media New York
Originally published by Plenum Publishing Corporation in 1991
Softcover reprint of the hardcover 1s t edition 1991
All rights reserved
No part of this book may be reproduced, stored in a retrieval system, or transmitted
in any form or by any means, electronic, mechanical, photocopying, microfilming,
recording, or otherwise, without written permission from the Publisher
Contributors
GLEN P. AYLWARD, Ph.D. • Director, Division of Developmental
and Behavioral Pediatrics, Departments of Pediatrics and Psychiatry,
Southern Illinois University School of Medicine, Springfield, Illi
nois 62794-9230
GIULIO J. BARBERO, M.D. • Professor, Department of Child
Health, University of Missouri School of Medicine, Columbia, Mis
souri 65212
RITA BENEZRA-OBEITER, M.D. • Developmental Pediatrician,
Institute for Child Development, Hackensack Medical Center,
Hackensack, New Jersey 07601; and Assistant Professor of Clinical
Pediatrics, University of Medicine and Dentistry of New Jersey
New Jersey Medical School, Newark, New Jersey 07103
FREDERICK J. BOGIN, M.D. • Developmental Behavioral Pedi
atrics, The Hitchcock Clinic, Nashua, New Hampshire 03061-2028
FRANK R. BROWN III, Ph.D., M.D. • Director Vince Moseley Cen
ter for Handicapped Children, Medical University of South Caroli
na, Charleston, South Carolina 29425-3306
EDWARD R. CHRISTOPHERSEN, Ph.D. • Professor of Pediatrics,
Chief, Behavioral Pediatrics Section, The Children's Mercy Hospi
tal, Kansas City, Missouri 64108
GERALD ERENBERG, M.D. • Child Neurologist, Departments of
Neurology and Pediatrics, and Director, Learning Assessment
Clinic, Cleveland Clinic Foundation, Cleveland, Ohio 44195-5045
v
vi Contributors
MARIANNE E. FELICE, M.D. • Director, Adolescent Medicine, Vice
Chairman, Department of Pediatrics, University of Maryland
School of Medicine, Baltimore, Maryland 21201
GERALD S. GOLDEN, M.D. • Boling Center for Developmental Dis
abilities, Shainberg Professor of Pediatrics, Departments of Pedi
atrics and Neurology, University of Tennessee Center for Health
Sciences, Memphis, Tennessee 38lO5
PETER A. GORSKI, M.D. • Director, Division of Behavioral and De
velopmental Pediatrics, Department of Pediatrics, The Evanston
Hospital and Northwestern University Medical School, Evanston,
Illinois 60201
MARVIN I. GOTTLIEB, M.D., Ph.D. • Director, Institute for Child
Development, Hackensack Medical Center, Hackensack, New
Jersey 07601; and Professor of Pediatrics, Department of Pediatrics,
University of Medicine and Dentistry of New Jersey-New Jersey
Medical School, Newark, New Jersey 07lO3
SUSAN R. HARRIS, Ph.D., P.T. • School of Rehabilitation Medicine,
University of British Columbia, Vancouver, British Columbia V6T
2B5, Canada
RANDYE F. HURON, M.D. • Developmental Pediatrician, Institute
for Child Development, Hackensack Medical Center, Hackensack,
New Jersey 07601; and Assistant Professor of Clinical Pediatrics,
University of Medicine and Dentistry of New Jersey-New Jersey
Medical School, Newark, New Jersey 07lO3
PUNAM KASHYAP, M.D. • Section of Developmental Pediatrics, In
stitute for Child Development, Hackensack Medical Center,
Hackensack, New Jersey 07601
ERNEST F. KRUG III, M.D. • Medical Director, Center for Develop
mental Pediatrics, Greenville Hospital System, Greenville, South Ca
rolina 29605
KAREN OLNESS, M.D. • Professor of Pediatrics, Chief, Division of
General Academic Pediatrics, Case Western Reserve University
School of Medicine, and Developmental Pediatrics, Rainbow Babies
and Children Hospital, Cleveland, Ohio 44106
Contributors vii
POLLY PANITZ, M.D. • Division of Behavioral and Developmental
Pediatrics, Department of Pediatrics, The Evanston Hospital and
Northwestern University Medical School, Evanston, Illinois 60201
CAROLINE N. PRESTON, Ph.D. • Vince Moseley Center for Hand
icapped Children, Medical University of South Carolina,
Charleston, South Carolina 29425-3306
VIRGINIA RANDALL, M.D. • Colonel, U.S. Army Medical Corps,
U.S. Army Medical Department, Consultant to the Surgeon General
(Army), Falls Church, Virginia 22041-3258
N. PAUL ROSMAN, M.D. • Professor of Pediatrics and Neurology,
Departments of Pediatrics and Neurology, Tufts University School
of Medicine, and Chief, Division of Pediatric Neurology, Floating
Hospital for Infants and Children, New England Medical Center
Hospitals, Boston, Massachusetts 02111
DONALD I. SCHIFFMAN, M.D. • Director, Department of Pedi
atrics, Hackensack Medical Center, Hackensack, New Jersey 07601;
and Clinical Associate Professor of Pediatrics, Department of Pedi
atrics, University of Medicine and Dentistry of New Jersey-New
Jersey Medical School, Newark, New Jersey 07103
BARTON D. SCHMITT, M.D. • Director of Consultive Services, Pro
fessor of Pediatrics, Department of Pediatrics, The University of
Colorado School of Medicine, The Children's Hospital, Denver,
Colorado 80218
HAKON TORjESEN, B.A. • Executive Director, Center for Interna
tional Health, Case Western Reserve University, Cleveland, Ohio
44106
Preface
We are most pleased to present Volume 3 of Developmental-Behavioral
Disorders: Selected Topics, designed to serve as a companion for standard
reference textbooks that address cogent issues in developmental pedi
atrics. Periodic publications such as Selected Topics and theme-related
articles, as well as continuing education programs, attempt to supple
ment in a timely fashion the rapidly changing knowledge base in devel
opmental-behavioral pediatrics. These media are important as forums
for enhancing the quality of clinical practice, teaching skills, and re
search activities. The need is critical for periodically disseminating and
updating information about issues in developmental medicine, in as
much as this field of study continues to expand at a meteoric pace.
During the past several decades, developmental medicine has been
recognized as a defined subspecialty in pediatrics. The spectrum of
problems encompassed by this discipline is relatively broad and at times
clinically overwhelming. The ultimate goal of preventing delays, disor
ders, and/or dysfunctions from becoming chronic handicapping condi
tions has, by volume per se, created clinical dilemmas for pediatric health
care providers. There are numerous facets of providing efficient and
effective care, which in the field of developmental-behavioral pediatrics
are often exaggerated impediments to the delivery of services by pri
mary health care specialists, e.g., time, clinical skills, need for inter
disciplinary management, medical-legal responsibilities, financial reim
bursements. These issues, as well as clinical problems, are still very much
part of the information base to be disseminated to concerned pro
fessionals.
An additional uniqueness of the professionals involved in devel
opmental-behavioral pediatrics is the extensive lines of communica
tion that must be established with other medical specialists, including
the perinatologist, neonatologist, geneticist, otolaryngologist, pediatric
neurologist, pediatric surgeon and surgical subspecialist, child/adoles-
ix
x Preface
cent psychiatrist, and others with contributing skills. The professional
interface must include members of an interdisciplinary team other
than medical specialties, including: audiology, speech/language pa
thology, social work, psychology, occupational therapy, physical therapy,
early childhood specialist, learning disability consultant-and many
other health care disciplines. As the child with developmental dis
abilities ages, dialogue with the internist, the geriatrician, and other
adult-oriented professionals is mandatory. In essence, the professional
assuming primary responsibility for diagnosis and/or management of
the child with developmental disabilities must learn the many "lan
guages" of the interdisciplinary team who provide the information base
that must be amalgamated for meaningful comprehensive care. These
"languages" are often learned by reading articles and texts that have
contributions from members of various disciplines. Similarly the new
technologies that become available, to improve acumen in diagnosis
and/or management, are scrutinized in updated texts and research
articles. The field of developmental-behavioral pediatrics has had in
creasing "breakthroughs" in technologies such as brain mapping, aug
mentative communications, adaptive equipment, videofluoroscopy, and
computer strategies.
The concerned professional is consequently confronted with the
formidable educational challenge of "keeping up to date." As travel
funds for attending conferences become less available, educational me
dia such as reference books, Selected Topics, and journal articles become
increasingly important for the learning process.
To be included in Volume 4 of Selected Topics are issues covering a
range of developmental-behavioral problems, including:
• The adolescent with developmental disabilities
• Rett syndrome-updated
• Brain anomalies in the dyslexic
• Tourette syndrome: A complex neurodevelopmental disorder
• Biological basis for learning disabilities
• Subtyping attention deficits: Why and how?
• Williams syndrome and learning disabilities
• Spoiled kids-and other discipline problems
• Divorce, focus on the child: Developmental, psychosocial, and
legal considerations
The series will hopefully serve to meet some of the needs of "keep
ing up to date." As editors of this volume, we hope that in some small
way we can enhance professional education and ultimately take pride in
