GOALS & OBJECTIVES
Major goals of this program are developmental-behavioral training of: 1) academic subspecialty pediatricians; 2) pediatric residents; and 3) pediatric practitioners. Also, we will train medical students and other health professionals. The program will be a model, a resource in the state and region, and a contributor to the national scene through its research leadership, educational activities, and advocacy. Goal 1: To prepare leaders in academic behavioral pediatrics who have excellent skills as clinicians, researchers, and teachers and to provide them with the necessary training for academic advancement and child health advocacy. Objective 1: At the end of three years the behavioral fellow will demonstrate the following: (A) clinical skills necessary for recognition and treatment of both common and complex behavioral and developmental problems; acquire knowledge of the importance of psychological and social factors in mediating illness and the individual's and families' response to illness, (B) capability to conduct and evaluate research, (C) skills as an excellent teacher,(D) skills necessary to assume an active faculty role, execute administrative responsibilities, and be successful in academic appointment and promotion, (E) skills necessary to function as an active advocate for the advancement of children's issues on local, state, and national levels. Goal 2: To train pediatric residents to understand the normal range of behavior and development, recognize and explore behavioral and developmental deviations and manage a range of common problems of children and adolescents; to refine the trainees' skills in eliciting psychosocial information from families. Objective 2: At the end of residency the trainee will demonstrate the following: (A) knowledge of the full range of behavioral and developmental issues necessary for a pediatric practice, (B) appreciation of the relevance of psychological and social aspects of well child care, acute illness, and chronic illness, (C) skills to use a behavioral and developmental approach in dealing with children and families. Goal 3: To enhance skills of practitioners and teachers of primary care pediatrics through innovative Collaborative Office Rounds (COR) and to provide continuing education to and liaison with pediatric practitioners and child health care providers from a range of disciplines. Objective 3: On a continuing basis practicing pediatric providers, including physicians, nurse practitioners, nurses and social workers will demonstrate knowledge of key aspects of child behavior and development. Goal 4: To introduce medical students to fundamentals of behavioral pediatrics. Objective 4: At the end of their pediatric clerkship medical students will recognize fundamental issues in child behavior and development as they affect health care delivery to children and adolescents.

METHODOLOGY
The program takes place in the Behavioral Unit of the Department of Pediatrics of the Albert Einstein College of Medicine/Montefiore Medical Center (AECOM/MMC) in Bronx, New York. This department operates large pediatric inpatient, outpatient, and emergency services for children in two municipal and two voluntary hospitals. These services provide care to ethnically diverse patient populations including many minorities (African American and Latino children). Structured course work for fellows in research as well as courses in development and behavior are available to trainees. Trainees include at least three fellows in Developmental-Behavioral Pediatrics and 74 residents in pediatrics, medical students, practicing pediatricians, pediatric nurses and nurse practitioners, social workers and other allied health professionals. The fellowship in Developmental-Behavioral Pediatrics includes: 1) supervised clinical experiences with all age groups in a variety of community based training settings, 2) structured course work, and 3) applied research training involving research mentorship and performance of a substantial project. The curriculum for pediatric residents is supervised by a multidisciplinary, multiethnic faculty. There is a successful COR group. Our educational program focuses on developmental-behavioral aspects of primary care pediatrics and emphasizes care of children with special health care needs in a variety of settings.

COORDINATION
The program coordinates service, research, and advocacy work with other Title V programs locally, regionally, and nationally.

EVALUATION
All trainees have objectives available for review and we monitor their progress though the training process. Fellows are evaluated on performance of clinical work, quality and productivity of research projects, efficacy in the teaching and advocacy roles, and structured course work. We monitor attainment of academic leadership positions by trainees and will assess their success in obtaining subspecialty certification by the American Board of Pediatrics. Residents are evaluated on ability to understand behavioral and developmental issues in all rotations, clinical performance and written evaluations, and knowledge of behavioral and developmental issues. We monitor their performance on pediatric board certifying examinations and career choices. Medical students are assessed by ability to demonstrate basic knowledge of child behavior and development. COR group is evaluated by participation and progression in the level of complexity of cases discussed. During the 1997 2002 project period, we trained six full time M.D. fellows funded by this grant and four other pediatricians as long term trainees. We have provided short term (1-6 months) periods of training to 155 residents taking a mandatory block rotation, seven nursing students and one attending. Approximately 50 medical students received behavioral training, including three who subsequently did a behavioral elective. We also have conducted a very successful COR model and provided numerous lectures to community practitioners. Former fellows are pursuing academic careers and other developmental-behavioral roles. Faculty members and fellows have given workshops or research presentations at national meetings and have published a substantial number of articles in peer reviewed journals as well as other publications. Studies are in progress on a wide range of behavioral and developmental issues.

ANNOTATION
The Leadership Education Program in Developmental-Behavioral Pediatrics is designed to train fellows for academic leadership roles in the field, to prepare future and current practitioners for the care of children in a way that incorporates a sensitivity to and knowledge of behavioral and developmental issues, and to provide continued education to practitioners and teachers of primary care pediatrics. We will achieve these objectives by providing extensive clinical, research, and teaching experience for fellows, clinical training for house officers and medical students, and COR group and continuing education for community practitioners.

KEYWORDS
Advocacy, Behavioral Pediatrics, Child Development, Children with Special Health Needs, Comprehensive Primary Care, Continuing Education, Developmental Disabilities, Family Centered Health Education, Health Professionals, Home Visiting Programs, Leadership Training, Nurses, Nutrition, Parent Education, Research, School Health Programs, Social Work.