Efforts to address the growing needs of parents of children with IDD started at the University of Rochester in the late 1940s by providing diagnostic services and community outreach and consultation. At first, separate clinical and teaching programs were responsive to consumer needs, regarding both developmental and behavioral concerns. The Department of Pediatrics served as the venue for both program strands. Both strands evolved in different directions and were encouraged and supported by William Bradford, MD, second Chair of the Department. Both strands also included partnerships between academic medicine, allied health disciplines such as psychology, education physical therapy and other community-based initiatives. Both strands were built upon the foundation of Community Pediatrics, of which the University of Rochester is considered a pioneer. Community Pediatrics embodied a shift in child health care away from hospital-based practice to a model that placed the child and his or her family residing in a community setting at the center of decision-making (Haggerty, 1968).

Developmental Pediatrics

Ambulatory developmental diagnostic services were established by Wilbur K. Smith, MD. Dr. Smith was a neuroanatomist in the Department of Anatomy. In 1947 Dr. Bradford recruited him to the Department of Pediatrics and asked him to develop clinical services in child neurology, well before child neurology emerged as a specialty in medical schools around the United States. Dr. Smith mentored two pediatric neurology trainees, Agneta Borgstedt, MD, and Sandra Feldman, MD, and the three physicians established the first developmental evaluation clinic for IDD at URMC. A wide range of neurodevelopmental disorders were represented among referrals to the clinic, including IDD. Dr. Borgstedt left URMC in 1971 and established a community-based pediatric neurology practice specializing in learning disabilities, Attention Deficit Disorders, and Attention-Deficit/Hyperactivity Disorders.