CASE Jimmy, a 21⁄2-year-old boy, was seen for the first time by a new pediatrician after a recent family move. His mother made the appointment for a health supervision visit although she had concerns about his language and social skills. She stated that he spoke primarily with unintelligible sounds and often communicated by pointing with his finger. He spoke only 10 words that were clear enough...

IMPORTANCE Early intervention for substance use is critical to improving adolescent outcomes. Studies have found promising results for Screening, Brief Intervention, and Referral to Treatment (SBIRT), but little research has examined implementation. OBJECTIVE To compare SBIRT implementation in pediatric primary care among trained pediatricians, pediatricians working in coordination with embed...

CASE Jaquette, a 4-month-old African-American infant, is brought to the pediatrician for a health supervision visit. She was born full term after a healthy gestation, labor, and delivery. She nurses vigorously, developmental milestones are normal, and her physical examination reveals an emotionally robust, active, and physically healthy child. When the pediatrician inquires about her sleep-wake...

The identification of hematuria or proteinuria in an otherwise healthy child can cause anxiety to both the family and the pediatrician. The etiology of hematuria and proteinuria includes a long list of conditions, and detailed workup can be exhaustive, expensive and not essential in most of the patients. As will be described in this paper, most of the children with proteinuria or hematuria have...

Seizures in children are among the most common neurological disorders. A pediatrician should know how to approach a child who presents with a seizure. This review will focus on points that are important in the evaluation of children who have experienced seizures. A comprehensive and neurologically focused framework for history taking and a thorough clinical examination are the cornerstones in d...

Despite a decreasing trend in premature births, greater numbers of infants born at the limits of viability are surviving to discharge. Most of these infants have complex medical problems requiring multidisciplinary care. These infants are primarily cared for by the general pediatrician, but their needs are quite different from those of a full-term healthy newborn. The paucity of data regarding ...