In Ottawa, the three developmental pediatricians are members of the Department of Pediatrics and see patients at the Children’s Hospital of Eastern Ontario (CHEO) and at the Ottawa Children’s Treatment Centre (OCTC). The OCTC is one of a network of Ontario children’s rehabilitation centres where children with developmental difficulties can be assessed and receive treatment in a multi-disciplinary setting.

The developmental pediatricians are involved in direct clinical work, education and research. Our goal is to provide comprehensive assessments and treatments at our own centre, while working with colleagues across the country to establish clinical and educational best practices in the field of developmental pediatrics.

Medical students, neonatal fellows and residents training in pediatrics, genetics and psychiatry spend time with our group. While training with us, they are exposed not just to our own clinical work and teaching, but also to that of psychologists, social workers, therapists, physiatrists and educators also working in the treatment centre.

Our scholarly interests relate to medical ethics, the use of psychotropic medication in children with autism and developmental delay, genetic testing in developmental pediatric practice, feeding in children with disabilities and medical education.

Resources

• Royal College of Physicians and Surgeons of Canada
• CaRMS
• PARO

The pediatricians in the Developmental Pediatrics program are involved in diagnosing and providing ongoing care for children with difficulties related to autism spectrum disorders, global developmental delay, intellectual disability and disorders of movement including cerebral palsy. Our role includes determining the extent, nature and etiology of the developmental difficulties as well as planning for educational, medical and therapy services. The children usually have complex medical, physical, cognitive, behavioural and psychosocial needs. Long-term care is common.

We participate in multi-disciplinary diagnostic and follow up clinics at CHEO and at the Ottawa Children’s Treatment Centre. At diagnostic clinics we may be joined by psychologists and social workers. When dealing with problems related to feeding and growth, we may also work with a dietician or occupational therapist. Outside of clinic times, we will also collaborate with educators, speech and language pathologists, physiotherapists and other physicians to help ensure comprehensive and coordinated care for the children and families.

Developmental pediatrics is primarily an outpatient service. We consult on inpatients upon request but full assessments are done once the children are well enough to attend an outpatient clinic.

Outpatient care

• OCTC developmental clinics: 800 patient visits per year
• CHEO Down Syndrome clinics: 24-28 clinics per year
• CHEO feeding team: 12 sessions per year
• Neonatal follow-up clinics: 12-15 clinics per year

Outreach

• Serve children from the Baffin area
• Telephone/teleconference sessions with school personnel, CAS, community therapy providers

Clinical problems and diseases evaluated and followed

• Autism spectrum disorders
• Global developmental delay/disability
• Cerebral palsy
• Down Syndrome
• Prematurity
• Acquired brain injury
• Mixed developmental disorders

Focus of developmental follow-up clinics

• Developmental monitoring
• Medical investigations related to development
• Behaviour and medication
• Feeding and growth
• Sleep
• Transitions

Laboratory and diagnostic programs

The diagnosis of autism and global developmental delay involves the use of specialized diagnostic tests. Trainees in the developmental program are educated in the use of a variety of developmental assessment tools, many of which they will be able to use in an office practice. They will become familiar with tests which are used by colleagues in psychology, audiology, physiotherapy and speech and language therapy. There is also a focus on the tests needed for genetic testing and feeding assessments in children with developmental and physical disabilities.

The Ottawa Children’s Treatment Centre staff is often involved in multicentre trials relating to children with physical and developmental disabilities. The largest project currently underway focuses on the study of hemiplegic cerebral palsy.

Division members are involved in the following areas of study:

• Neurology of autism spectrum disorders
• Feeding difficulties in the Down syndrome population
• Use of genetic microarray testing by developmental pediatricians
• Medical ethics

Medical students and residents are welcome to become involved in projects already underway at the Ottawa Children’s Treatment Centre or to propose new research projects that could be undertaken at the centre.

• Macklin, Elizabeth MA MD FRCP

• Nair, Asha MD, FRCPC

• Ponesse, Jonathan MD, FRCPC

Undergraduate training opportunities

First-year medical students can participate in ten-hour observerships. They spend three half days observing developmental diagnostic assessments and follow-up management clinics.

Third and fourth year medical students regularly participate in elective rotations with the developmental group which last approximately two weeks. Students participate in clinics and teaching sessions with the staff and residents. They are given the opportunity to take histories and participate in direct observational testing of the children. They observe therapists and educators working with children who have developmental and physical disabilities.

Postgraduate training program

All pediatric, pediatric neurology and genetics residents from the University of Ottawa Faculty of Medicine spend one month studying developmental pediatrics under the supervision of the developmental pediatricians. Senior pediatric residents often choose to return for further training in their final year. Residents from the psychiatry program spend up to six months on a developmental pediatric rotation. 

During a developmental pediatric rotation, residents will have the opportunity to learn to diagnose autism and global developmental delay and to identify and manage the various medical, behavioural and psychosocial problems that are associated with these conditions. They will have the experience of working with multi-disciplinary teams and of observing psychologists, social workers, educators, occupational and physical therapists, speech and language therapists and dieticians working with this population. They will have the unique opportunity of observing children with physical and developmental disabilities in their onsite classrooms. They will also have direct teaching sessions chosen based on their own learning needs, usually focusing on autism, cerebral palsy, Down syndrome, ADHD and developmental testing. 

Additional postgraduate training 

At this time there is no fellowship training program in Developmental Pediatrics in Ottawa.