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An Exploration of Developmental Pediatrics

by Kylie Bachmann (’24)

Q: What is your name and where do you work?

A: Susan Wiley. I work in the Division of Developmental and Behavioral Pediatrics at Cincinnati Children’s Hospital Medical Center.

Q: What is developmental pediatrics?

A: Developmental-behavioral pediatrics is a sub-specialty within pediatrics which focuses on children with developmental disabilities, such as intellectual disability, autism spectrum disorders, and attention deficit hyperactivity disorder.

Q: Why did you choose this career path?

A: I didn’t know this field existed until I had my rotation in developmental pediatrics in pediatric residency. Because I had worked at a camp for adults with disabilities and volunteered for Special Olympics, it brought my past interest of working with people with disabilities into my medical field focus.

Q: What is your favorite thing about your career?

A: I love getting to see children make progress, no matter at what age. When a child with an intellectual disability or autism meets a milestone, I know they have worked hard to achieve it.

Q: If you had to convince someone to become a developmental pediatrician, what would you tell them?

A: This is an incredibly rewarding field and filled with people with a similar passion. The people I work with and the families and children I get to see are amazing.

Q: What is your LEAST favorite thing about developmental pediatrics?

A: It is hard to convey a diagnosis to a family but I know in doing so, we are helping the child get onto a path of support and improvement.

Q: What does the day-to-day of your career look like for you?

A: Some of my clinical care is done through working in teams with other providers such as psychologists, speech-language pathologists, occupational therapists, and physical therapists. We have a very interdisciplinary care model. I see a combination of new patients and follow patients over time.

Q: What kind of schooling and how many years did it take to become a developmental pediatrician?

A: The fellowship for developmental and behavioral pediatrics is a 3 year fellowship, which is usually done following a 3 year pediatric residency or a 4 year med-peds residency.

Q: What is your schedule like? Are you on call? Is it flexible?

A: The majority of our work is in the out-patient setting. We do take phone call as we manage medications and are available to answer questions about a child who may be having escalating behaviors. The schedule can be flexible because it is out-patient.

Q: What type of skills does this career require? (ex. attention to detail, critical thinking, working well under pressure, communication)

A: I tend to describe our field as a very holistic and chronic care model within pediatrics. With that in mind, it is helpful to remember to have the long-view in mind with patient progress. We also often have to use a lot of problem solving and observation to try to sort out what is going on in children who can’t always communicate what is wrong.

Q: What would you tell a medical student considering developmental pediatrics?

A: If you enjoy working with children with disabilities, this is a great option for a career. It is incredibly rewarding and while it is a sub-specialty, you do get to have a long-term approach to care which allows you to get to know your patients and families well.

Q: Would you consider developmental pediatrics a lesser known career? If so, why do you think this is?

A: This is a field that does seem to be under-recognized. Many people are not aware of the field until they are in pediatric residency and have the developmental pediatric rotation. Developmental-behavioral programs across the country are quite varied and this also impacts a resident’s experience with the field.

It is also important to note that there is also a field called neurodevelopmental disabilities. This is a similar field that is linked to neurology rather than pediatrics. Those who enter neurodevelopmental disabilities are board certified in adult neurology, pediatric neurology, and neurodevelopmental disabilities. It is a similar length of time in training as this program starts in residency.

Q: Of all the research you have done and all the articles you have published, which has been the most fulfilling for you? Which are you most proud of?

A: I work a lot with children who are deaf/hard of hearing. When I started in the field, most professionals in the field of hearing loss were not comfortable knowing how to support children who also have a developmental disability. I have focused a lot of my work on this population of children in order to help others see that with the right supports, children can make meaningful improvements even if they are not the same as a child who has average or above average cognitive abilities. One of the earliest papers I published was with an audiologist who interviewed 20 families of children with developmental disabilities who received a cochlear implant. They were able to describe why receiving an implant was important for their child and how this positively impacted their quality of life. I think this paper helped push others to consider children with disabilities to receive an implant and now 20 years later, many centers are more comfortable with this population of children.

Q: Is there anything else you would like to add?

A: I hope pre-med and medical students might become interested in our field. We have a 4th year elective rotation if you want to have a brief exposure to the field.

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