February 5, 1999

Leaders of APA and the American Academy of Child and Adolescent Psychiatry recently dropped their objections to approving behavioral and developmental pediatrics as a certified subspecialty. The reversal came after the application was significantly revised to minimize the subspecialty's overlap with child and adolescent psychiatry.

James Thompson, M.D., an APA deputy medical director and head of the Office of Education, told Psychiatric News, "APA is pleased that through much hard work by the American Board of Psychiatry and Neurology Inc. (ABPN) and the American Board of Pediatrics (ABP), a satisfactory agreement has been reached on this issue. We believe that the revised draft, with its focus on normal development, will enhance the training of pediatricians as they work with children. At the same time, it emphasizes that child psychiatrists are the physicians best qualified to treat mental disorders in children."

John Sargent, M.D., chair of AACAP's Workgroup on Training and Education, commented to Psychiatric News, "The revised application is vastly improved because it is grounded within pediatrics and focused on working with normal children and families. Now a team of professionals oriented to a multidisciplinary approach to working with children will teach residents. This makes sense for children and families and recognizes the contribution and expertise of child and adolescent psychiatrists and child neurologists."

Sargent continued, "We objected to the previous version because the subspecialty was unfocused, and there was no expectation of collaboration with child and adolescent psychiatrists and child neurologists."

ABPN, which certifies child and adolescent psychiatrists, had sought out reactions by APA's and AACAP's leaders after the board objected to the application last winter submitted by the ABP to the American Board of Medical Specialties (ABMS), which reviews member requests for subspecialty certification. ABMS is the umbrella organization for the 24 approved medical specialty boards in the United States.

APA's Thompson wrote ABPN Executive Vice President Stephen Scheiber, M.D., in July, "APA continues to strongly oppose this proposal in any form. Such a specialty board would be duplicative of an already existing board and would be very confusing to the field and to the public. We also believe that it would poorly prepare physicians to work with children who have psychiatric disorders."

Scheiber told Psychiatric News that ABPN appreciated APA's support of its position that the behavioral pediatricians must be a distinct subspecialty board. "We approved the application in November after the joint ABPN/ABP task force significantly shifted the subspecialty's emphasis to normal development and behavior and away from pathological disorders."

The ABMS Assembly will vote on the 70-page subspecialty application next month. Scheiber said he expects it to be approved given the lack of opposition from organized psychiatry.