Supporting Children and Families

Toni Whitaker, MD, is a Professor of Pediatrics and the Division Chief of Developmental Pediatrics at the University of Tennessee Health Science Center (UTHSC) and Le Bonheur Children’s Hospital in Memphis, Tenn. She directs the UTHSC Leadership Education in Neurodevelopmental Disabilities (LEND) program funded by the Maternal and Child Health Bureau and serves as consultant and Ambassador to Tennessee for CDC’s Learn the Signs. Act Early. program.

How did you begin your career in early childhood?

My interest in early childhood development and education led me beyond my undergraduate degree in psychology to medical school, a pediatric internship and residency program, followed by specialty fellowship training in developmental pediatrics. Developmental pediatricians evaluate and treat children with a variety of developmental and behavioral conditions such as developmental delay (and risk for delay), autism spectrum disorder, attention-deficit/hyperactivity disorder, and learning disabilities, among others. We are trained to consider related health conditions to these disabilities and often work with other medical specialists for children with complex medical conditions. Developmental pediatricians may practice in a variety of settings but I, like many in my field, am in an academic medical setting where I devote effort to multiple missions including direct clinical work with children and families, academic training for preprofessional students, continuing education to practicing professionals, research to enhance knowledge around developmental and behavioral issues, and service and outreach to our communities.

Developmental pediatricians often work alongside other professionals in early childhood including other medical specialists as well as clinicians in related fields such a psychology, speech-language pathology, occupational therapy, audiology, etc. Further, we need to have understanding of and experience in interacting with educational professionals since many of the children and families that we serve will access early intervention, special education, and regular education settings. Our interdisciplinary and interprofessional teamwork and bidirectional exchange of information allows us to help families navigate sometimes complex medical and educational systems in order to get their children the services and supports they need.

What efforts have you been involved in to improve the quality of early childhood programs and services?

While my day-to-day work is most often in direct clinical service and/or teaching to students and advanced/post-doctoral trainees, I have had the privilege to serve a variety of audiences with training and resources related to developmental pediatrics. For approximately the last decade I have worked as an ambassador to the state of Tennessee for the Centers for Disease Control and Prevention‘s (CDC’s) “Learn the Signs. Act Early.” program that aims to improve early identification of developmental delays and disabilities in order to facilitate appropriate and timely interventions for children. In this role, I have worked with others in my state to promote education among clinical professionals, staff in state and local agencies, and community members. The “Learn the Signs. Act Early.” materials are free, evidence-informed health communication tools, offering easy-to-use strategies to get information into the hands of those who connect with children and families. These resources are often used by families to monitor and discuss their child’s developmental progress with the primary care doctor or clinic, though can be used by a variety of early childhood professionals.  I was part of the author group to review and update development milestones within the Act Early milestone checklists that are intended to help promote conversations between parents and healthcare and other early childhood professionals. Such resources can help enhance other monitoring and screening activities for child development that are in place within healthcare and early childhood settings.

What are some of the challenges you have experienced in your work and what strategies have you tried to overcome them?

Developmental delays and disabilities are very common and are often not identified as early as we would like. Estimates from the CDC show that as many as 1 in 6 children has a significant developmental delay or disability and 1 and 36 is estimated to have an autism spectrum disorder. However, despite the high prevalence rates of developmental disorders, there are relatively fewer professionals than are needed in the United States to fully evaluate and serve children and families. Professionals with specialized training have a responsibility to help build our collective workforce to serve children in need.

I have worked with other stakeholders and partners to develop strategies that lead to earlier identification and referral for intervention. In the state of Tennessee, I lead a training program that provides continuing education to medical providers in the primary medical home to support good practices in developmental surveillance and screening. As a clinical educator myself, a large part of my role as an academician is to train future generations of professionals to carry on the work that we do with children and families today. My own academic efforts are geared not only to pediatric medical residents and students but to graduate-level interdisciplinary trainees in a federally funded training program (Maternal and Child Health Bureau Leadership Education in Neurodevelopmental Disabilities). This multi-pronged approach is common in our field and helps us to model interdisciplinary work for our trainees.

What suggestions do you have for others interested in improving early childhood services and programs?

I have found great benefit personally and professionally in learning more about what other professionals do that relates to or complements my own interests and work in early childhood. We can help families navigate complex systems more effectively and facilitate our trainees’ mastery of skills when we lead by example.

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