Caring For and About Children with Disabilities and Special Health Care Needs

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Who are these children?

Photo of a clinician interviewing a smiling young patient.

Children with disabilities have any condition of the body or mind that makes it more difficult to do certain activities and interact with their environment. Disabilities are characterized by impairments, activity limitations, and participation restrictions.
Children with medical complexity have multiple significant chronic health problems that affect multiple organ systems and result in functional limitations, high health care needs or utilization, and often the need for or use of medical technology.
Children with special health care needs have, or are at increased risk for, a chronic physical, developmental, behavioral or emotional condition and who also require health and related services of a type or amount beyond that required by children generally.

Why does this matter to pediatric trainees and early career physicians?

15% of children have a developmental disability.
Approximately 1% of children have medical complexity, but account for 30% of all health care spending for children.
Close to 20% of children have a special health care need.

They’re Your Patients, Too: Every pediatrician will care for these children in practice. There are numerous career pathways to explore, and many resources available to support trainees and early career physicians.

Career Pathways

General Pediatrics General Pediatrics Certifying Examination Requirements, American Board of Pediatrics	General pediatricians provide primary care for children with a broad range of special health care needs, including children with and without disabilities and medical complexity. General pediatricians must complete a pediatric residency and may complete a fellowship depending on their academic goals and interests. General pediatricians interested in caring for children with disabilities and medical complexity are often employed in academic medical centers and complex care clinics.
Developmental and Behavioral Pediatrics Developmental-Behavioral Pediatrics Certification Requirements, American Board of Pediatrics	Developmental and behavioral pediatricians evaluate, treat and manage children and adolescents with or at risk for developmental and behavioral concerns. Common areas of focus include children with autism spectrum disorder, attention deficit hyperactivity disorder, intellectual disability, and learning disabilities. Developmental and behavioral pediatricians must complete a pediatric residency and a 3- year fellowship in developmental and behavioral pediatrics. The AAP Section on Developmental and Behavioral Pediatrics provides more resources about this subspecialty.
Neurodevelopmental Disabilities Neurodevelopmental Disabilities Certification Requirements, American Board of Psychiatry and Neurology	Neurodevelopmental disabilities pediatricians care for children with a range of neurodevelopmental disorders including cerebral palsy, autism spectrum disorder, communication disorders, and intellectual disability. Neurodevelopmental disabilities pediatricians must complete two years of pediatric training and four years of combined training in neurology and neurodevelopmental disabilities. Neurodevelopmental disabilities pediatricians are board certified by the American Board of Pediatrics in General Pediatrics and by the American Board of Psychiatry and Neurology.
Physical Medicine and Rehabilitation/Pediatric Rehabilitation Medicine Pediatric Rehabilitation Medicine Certification Requirements, American Board of Physical Medicine & Rehabilitation	Pediatric physical medicine and rehabilitation physicians, also known as physiatrists or pediatric rehabilitation physicians, specialize in caring for children with musculoskeletal conditions. Common conditions treated by pediatric physiatrists include spina bifida, cerebral palsy, muscular dystrophy, and acquired brain injuries. Pediatric rehabilitation physicians can complete their training in two different ways: Completing a 5-year combined residency in pediatrics and physical medicine and rehabilitation Completing a 4-year residency in physical medicine and rehabilitation and a 2-year fellowship in pediatric rehabilitation medicine.
Note: This table is designed to highlight a few common career pathways of interest to pediatric trainees and early career physicians. This table is not inclusive of all potentially career pathways and subspecialties that provide care for these populations. For more information on these and additional career pathways, contact the COCWD to connect with experts in the field. Email Alex Kuznetsov, akuznetsov@aap.org, COCWD staff manager, to connect with COCWD leadership.

General Pediatrics General Pediatrics Certifying Examination Requirements, American Board of Pediatrics General pediatricians provide primary care for children with a broad range of special health care needs, including children with and without disabilities and medical complexity. General pediatricians must complete a pediatric residency and may complete a fellowship depending on their academic goals and interests. General pediatricians interested in caring for children with disabilities and medical complexity are often employed in academic medical centers and complex care clinics.
Developmental and Behavioral Pediatrics Developmental-Behavioral Pediatrics Certification Requirements, American Board of Pediatrics Developmental and behavioral pediatricians evaluate, treat and manage children and adolescents with or at risk for developmental and behavioral concerns. Common areas of focus include children with autism spectrum disorder, attention deficit hyperactivity disorder, intellectual disability, and learning disabilities. Developmental and behavioral pediatricians must complete a pediatric residency and a 3- year fellowship in developmental and behavioral pediatrics. The AAP Section on Developmental and Behavioral Pediatrics provides more resources about this subspecialty.
Neurodevelopmental Disabilities Neurodevelopmental Disabilities Certification Requirements, American Board of Psychiatry and Neurology Neurodevelopmental disabilities pediatricians care for children with a range of neurodevelopmental disorders including cerebral palsy, autism spectrum disorder, communication disorders, and intellectual disability. Neurodevelopmental disabilities pediatricians must complete two years of pediatric training and four years of combined training in neurology and neurodevelopmental disabilities. Neurodevelopmental disabilities pediatricians are board certified by the American Board of Pediatrics in General Pediatrics and by the American Board of Psychiatry and Neurology.
Physical Medicine and Rehabilitation/Pediatric Rehabilitation Medicine Pediatric Rehabilitation Medicine Certification Requirements, American Board of Physical Medicine & Rehabilitation Pediatric physical medicine and rehabilitation physicians, also known as physiatrists or pediatric rehabilitation physicians, specialize in caring for children with musculoskeletal conditions. Common conditions treated by pediatric physiatrists include spina bifida, cerebral palsy, muscular dystrophy, and acquired brain injuries. Pediatric rehabilitation physicians can complete their training in two different ways: Completing a 5-year combined residency in pediatrics and physical medicine and rehabilitation Completing a 4-year residency in physical medicine and rehabilitation and a 2-year fellowship in pediatric rehabilitation medicine.
Note: This table is designed to highlight a few common career pathways of interest to pediatric trainees and early career physicians. This table is not inclusive of all potentially career pathways and subspecialties that provide care for these populations. For more information on these and additional career pathways, contact the COCWD to connect with experts in the field. Email Alex Kuznetsov, akuznetsov@aap.org, COCWD staff manager, to connect with COCWD leadership.

General Pediatrics
General Pediatrics Certifying Examination Requirements, American Board of Pediatrics

General pediatricians provide primary care for children with a broad range of special health care needs, including children with and without disabilities and medical complexity.
General pediatricians must complete a pediatric residency and may complete a fellowship depending on their academic goals and interests.
General pediatricians interested in caring for children with disabilities and medical complexity are often employed in academic medical centers and complex care clinics.

Developmental and Behavioral Pediatrics
Developmental-Behavioral Pediatrics Certification Requirements, American Board of Pediatrics

Developmental and behavioral pediatricians evaluate, treat and manage children and adolescents with or at risk for developmental and behavioral concerns.
Common areas of focus include children with autism spectrum disorder, attention deficit hyperactivity disorder, intellectual disability, and learning disabilities.
Developmental and behavioral pediatricians must complete a pediatric residency and a 3- year fellowship in developmental and behavioral pediatrics. The AAP Section on Developmental and Behavioral Pediatrics provides more resources about this subspecialty.

Neurodevelopmental Disabilities
Neurodevelopmental Disabilities Certification Requirements, American Board of Psychiatry and Neurology

Neurodevelopmental disabilities pediatricians care for children with a range of neurodevelopmental disorders including cerebral palsy, autism spectrum disorder, communication disorders, and intellectual disability.
Neurodevelopmental disabilities pediatricians must complete two years of pediatric training and four years of combined training in neurology and neurodevelopmental disabilities.
Neurodevelopmental disabilities pediatricians are board certified by the American Board of Pediatrics in General Pediatrics and by the American Board of Psychiatry and Neurology.

Physical Medicine and Rehabilitation/Pediatric Rehabilitation Medicine
Pediatric Rehabilitation Medicine Certification Requirements, American Board of Physical Medicine & Rehabilitation

Pediatric physical medicine and rehabilitation physicians, also known as physiatrists or pediatric rehabilitation physicians, specialize in caring for children with musculoskeletal conditions.
Common conditions treated by pediatric physiatrists include spina bifida, cerebral palsy, muscular dystrophy, and acquired brain injuries.
Pediatric rehabilitation physicians can complete their training in two different ways:
- Completing a 5-year combined residency in pediatrics and physical medicine and
  rehabilitation
- Completing a 4-year residency in physical medicine and rehabilitation and a 2-year
  fellowship in pediatric rehabilitation medicine.

Note: This table is designed to highlight a few common career pathways of interest to pediatric trainees and early career physicians. This table is not inclusive of all potentially career pathways and subspecialties that provide care for these populations.

For more information on these and additional career pathways, contact the COCWD to connect with experts in the field. Email Alex Kuznetsov, akuznetsov@aap.org, COCWD staff manager, to connect with COCWD leadership.

From the American Academy of Pediatrics Council on Children with Disabilities (COCWD) webinar titled, “Caring for and About Children with Disabilities and Special Health Care Needs.” (PDF)