Date of Submission

2026

Degree Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Psychology

Department Chair

Jessica Glass Kendorski, PhD, NCSP, BCBA-D

First Advisor

Amanda Guld Fisher, PhD, BCBA-D,

Second Advisor

Kate Tresco, PhD

Third Advisor

Erik Langenau, DO, MS, MAPP

Abstract

This study examined factors influencing pediatric primary care providers’ adherence to recommended guidelines for developmental, behavioral, and psychosocial screening, surveillance, and referral practices. Although early identification is emphasized in pediatric care, implementation remains inconsistent. A cross-sectional survey was administered to pediatric primary care providers in the United States with at least one year of independent practice experience. Variables examined included provider and practice demographics, training, confidence, caseload, and perceived barriers. Descriptive statistics and group comparisons were used to evaluate patterns in screening and referral practices. Results indicated variability in adherence across domains, with greater consistency in developmental and behavioral practices compared to psychosocial practices. Higher levels of provider confidence and training were associated with increased adherence. Time constraints, high caseloads, and limited access to community resources were identified as primary barriers. Practice characteristics, including setting and patient funding source, also influenced implementation. Findings underscore the need for enhanced training, increased provider support, and improved access to community-based resources to promote consistent adherence to recommended practices. Improving implementation may increase early identification and access to services, ultimately supporting better outcomes for children and families.

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