Emerging Subspecialties in Neurology: Neurodevelopmental disabilities.

Abstract

Approaching clinical neurology through the lens of child development and behavior is an old and well-established concept. Take for example Sir William Osler's 1894 description of the breadth of symptoms of what is now known as Sydenham chorea extending far beyond hyperkinetic movements: “The entire disposition may be changed, and the child becomes irritable, cross and unmanageable. Emotional disturbances are common, the child crying on the least provocation.”1 He demonstrates that adequate characterization of a child's neurologic status requires a thoughtful review of behavioral functioning compared to age-referenced norms. Through specific and systematic training in the variation of typical child development, neurologists may then begin to diagnose and manage the entire scope of neurologic disease and its impact across the lifespan. Osler drew upon 410 cases of chorea to develop his expertise; in 2001, the American Board of Psychiatry and Neurology and the American Board of Pediatrics created the subspecialty training program in neurodevelopmental disabilities (NDD) to create the future generation of neurologically trained pediatric specialists to provide comprehensive assessment, personalized treatment, and superior outcomes for children and youth with complex conditions affecting the developing nervous system.