THEY’RE the ones on whom parents rely for the medical care of their children with special needs.

They are developmental paediatricians, the professionals who help children realise their best selves — despite mental and/or physical challenges — and guide their parents, helping them to understand, among other things, what they need to do to boost learning outcomes.

Career & Education talks this week to Dr Sharon Smile for insight into the occupation. Smile has been a physician since 1997 and a practicing developmental paediatrician since 2004.

She currently works with the parent-support group Jamaica Autism Support Association to promote autism awareness, having only recently returned from Canada.

Smile did her medical degree at the University of the West Indies, before doing her initial training at Cornwall Regional Hospital (CRH) in St James.

“At the time the environment (at CRH) was very family-centered and all persons involved in patient care made it their priority. There was great cameraderie and it was a great environment for learning,” she related.

Smile pursued her subspecialty training in paediatrics at the University Hospital of the West Indies, where, according to her, she “met some great tutors in the form of — just to name a few — Professor Gray, Dr Millard and Dr Antoine”.

“They all embodied the true spirit of a paediatrician,” said the woman who did her post-training at the University Hospital of the West Indies before completing a fellowship in developmental paediatrics at the University of Toronto in Canada.

“The developmental paediatric fellowship programme is spearheaded through the Holland Bloorview Kids Rehabilitation Hospital in Toronto, Canada. I worked with an amazing team of professionals there and the Autism Research Unit. We also benefit from rotating through the Hospital for Sick Children for the first year of our training programme,” Smile noted.

Who is a developmental paediatrician?

A developmental paediatrician is a physician who treats and manages children with a wide range of developmental concerns and conditions. Some of the more common developmental disorders are autism spectrum disorder, cerebral palsy and developmental disability (mental retardation). We also evaluate and manage children with behavioural disorders, such as anxiety disorder, aggression and attention deficit hyperactive disorder (ADHD). Proactively, we monitor the developmental trajectory of children who are at high risk for developmental delay secondary to biological, environmental and/or social factors, for example, premature infants, genetic syndromes and children who are abused.

What is the value of the work that you do?

Developmental paediatricians strive to ensure that all children are given the opportunity to overcome developmental challenges and lead productive lives. We work alongside other health care professionals, researchers, communities, churches, educators, and non-profit organisations to promote an understanding of typical development, atypical development and factors which influence a child’s development, such as environmental factors, for example, violence, parenting factors, education, and a lack thereof. We try always to promote optimal development through advocating positive parenting, a healthy home and school environment, healthy diet and spending time with your child, having fun through play. We aim, through research, to identify aetiolgical (causal) agents for these debilitating developmental disorders. Another significant role or value of being a developmental paediatrician is to offer support to parents of children with developmental disorders.

What prompted your entry into the field?

As it pertains to medicine, I have always had a preference for treating children. It stems from their innocence and truthfulness. Subspecialising in developmental paediatrics was easy. Interestingly, children with developmental disabilities have a level of innocence and a strong desire to overcome the hardest obstacle presented to them. Most times they are misunderstood and cannot advocate for themselves and even their parents find it difficult to advocate for them. Thus, I wanted to be that advocate and ‘a voice’ for kids who are vulnerable and unable to self-advocate.

What is it that you most enjoy about the work that you do?

The kids. They say and do the most incredible, unexpected and mind-blowing things. To see how resilient, persistent, appreciative and energetic these children are in the face of significant challenges is amazing. It encourages you to keep trying and to be optimistic.

What are the challenges you face on the job?

The greatest challenge is getting appropriate interventions for children with developmental challenges. Cost is a prohibitive factor. It is heart-rending to know that if only ‘this family’ could afford or had access to a particular intervention then ‘the child’ would be able to change their developmental trajectory to one in which they become functional in their respective environments. The lack of awareness about disabilities and how others view and value a child or person with a disability is also a limiting factor to progress.

What are the educational requirements for entry into the field?

To become a developmental paediatrician you have to first be a medical doctor who has completed sub-specialty training in paediatrics. Then, you complete a two-year fellowship programme in developmental paediatrics in an international medical programme as this subspecialty training is not offered locally.

What other skills and/or competencies are required for the field?

The most important competencies required are an open mind and perseverance. It is also important that you enjoy what you do and that you are passionate about what you do.

As a developmental paediatrician, what sort of employment options are open to you?

Locally, recognition of this field is still in its infancy. As with all subspecialties, options in working in the public as well as private sector are available.

Why would you advise someone to get into this line of work?

It is a very rewarding field. You have the opportunity to be the voice for one of the most vulnerable groups in our community — our children. You are able to make a difference and have a positive effect on a child’s life. If that is not amazing, I don’t know what is.

NOTE: In certain parts of the United States, an average developmental paediatrician’s salary is US$125,000 annually. Smile, for her part, is committed to serving the local public health system to afford access to a wide cross section of Jamaicans, poor and wealthy alike.