AAP guidelines for pediatricians to support children with learning difficulties

Stress influences student's performance in all academic and non-academic pursuits. Nowadays, pediatricians are confronted with a diverse population of children who are struggling with behavioral and cognitive impairment. To present a clinical approach to tackle these children the American Academy of Pediatrics (AAP) has released guidelines for pediatricians on how to support children who are struggling academically. The guidelines were published in the Pediatrics, official journal of AAP.

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The guidelines complement existing American Academy of Pediatrics (AAP) clinical reports, practice guidelines, policy statements, tool kits, books, and case presentations that provide guidance regarding the early childhood age group as well as specific issues such as learning disabilities, mental health concerns, youth violence prevention, and foster care.

The recommendations were published in the Journal Pediatrics and have the following key points:

1. 
   

   Pediatricians should take an active role in the prevention, early identification, diagnosis, and treatment of academic progress problems. To this end, pediatricians should be knowledgeable of relevant AAP resources that allow them to effectively manage the care of school-aged children who are not progressing academically.

   
   


2. 
   

   Care coordination for children who are not progressing academically should take place in the context of the child’s medical home. Team-based care must include the pediatrician, specialists, and other health and human services professionals and families, regardless of the location of, or source of payment for, these services.

   
   


3. 
   

   Payment for all the activities, including non–face-to-face visits and coordination required to provide high-quality care to children who are not progressing academically, should be considered by payers.

   
   


4. 
   

   Pediatricians need to understand the rights that all children in the United States have to receive a free and appropriate public education, including those with learning disabilities, developmental disabilities, and chronic health conditions. Understanding these rights allows pediatricians to most effectively support families as they advocate for evaluations and interventions in the public school.

   
   


5. 
   

   Pediatricians should be familiar with the AAP clinical report on IDEA so that they are familiar with the law, the processes, and the challenges of the IDEA and Section 504 of the Rehabilitation Act of 1973.

   
   


6. 
   

   Considerations when choosing an approach to evaluation need to include the depth of evaluation necessary, the complexity of the intervention that will be required, the resource costs to families for the various options, and the level of coverage by an insurance plan(s) for the recommended evaluations.

   
   


7. 
   

   Pediatricians can most effectively serve their patients by establishing relationships with colleagues who can conduct further diagnostic evaluations when a school-aged child is not progressing academically, including subspecialists (such as developmental-behavioral pediatricians, neurologists, physiatrists, and child and adolescent psychiatrists), psychologists, neuropsychologists, allied health professionals (such as occupational, physical, and speech therapists), and school nurses.

   
   


8. 
   

   Pediatricians can develop an understanding of the different goals of evaluations to guide families to the most appropriate resources. Pediatricians should understand that the purpose of school psychology evaluations is to determine eligibility for education supports, and the purpose of evaluations by psychologists and neuropsychologists is to determine diagnoses and interventions. In schools, interventions are determined by the goals and objectives written in IEPs or 504 plans.

   
   


9. 
   

   Pediatricians may take an active role in the initiation, development, and implementation of IEPs and 504 plans when applicable.

   
   

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To read the full guideline, click on the link

https://pediatrics.aappublications.org/content/early/2019/09/20/peds.2019-2520