Knowledge of Child Development and Special Education Systems Amongst Israeli Pediatricians

Objective: Childhood neurodevelopmental difficulties are very common occurring in about 20% of the pre- school population. Yet, both teaching and clinical exposure in the field child neuro-development are not routinely emphasized during the pediatric residency training in Israel. Despite this limited training and regardless of their occupational position post-residency, general pediatricians are very often consulted with regard to a variety of childhood developmental difficulties and delays and about the special education and/or developmental interventions available to them. We aimed to assess the basic knowledge in the field of childhood neurodevelopment and developmental difficulties among Israeli Pediatricians.

Methods: A 84-itemed survey developed especially for this study was answered anonymously by a randomly selected national sample of pediatric residents and senior pediatricians. Basic demographic and occupational details were collected, and level of knowledge in six main subject-matters was assessed: developmental milestones, global developmental delay, autism spectrum disorder, attention deficit hyperactivity disorder, referral to a child development institute, special education systems and medical conditions associated with developmental delays.

Results: A total of 346 respondents (92% response rate), (median age of 38 years) (interquartile range 35-48 years) participated. The group included 144 (42%) residents and 202 (58%) senior pediatricians. Of the knowledge items, respondents answered an average of 43% correctly. The best scores (81% correct answers) were in subject matters concerning medical conditions associated with developmental delays, and the worst scores (22% correct answers) were found regarding the different special education systems available in the country. Knowledge was significantly better in senior pediatricians compared to residents (p =.002) and amongst individuals who are parents (p =.005). There were no significant differences between genders, medical school attendance, the hospital in which residency was performed, the current occupational setting or acquisition of a sub-specialty. The majority of the study group felt their training in child development was insufficient and that they do not have sufficient access to resources and guidelines about child development and special education systems.

Conclusions: While this study did not compare the state of knowledge in neurodevelopment to the other domains of pediatrics, it showed there is significant knowledge gap on the topic of child development and special education systems amongst Israeli pediatricians, especially pediatric residents. Child development topics are underrepresented during pediatric basic training although they are highly prevalent in both in hospital and community practices. The training of pediatric residents in child development should not be limited to on-the-job learning. The current curricula of pediatric residency in Israel needs to be re-evaluated, and should include a formalized and designated time-frame of child development training across all pediatric residencies.