Whether recent advances in developmental pediatrics have influenced pediatric practice is uncertain. We interviewed, in their offices, 41 randomly selected, board-certified, primary care pediatricians in Connecticut to explore their attitudes and clinical approaches to developmental problems. Responses were compared with those from a similar survey of 97 New England pediatricians performed 15 years ago. Important changes in certain clinical approaches were found. For example, pediatricians are currently less likely to rely on history and physical examination alone to confirm a suspicion of mental retardation (p< .01) and are more likely to refer such a child for further assessment (p< .01); they are more likely to perform hearing screening in evaluating a child with delayed speech (p< .05); they are more likely to contact the school in evaluating a failing child (p< .01), and are more likely to refer such a child for further assessment (p< .01). Results indicate favorable changes in pediatricians' approaches to developmental problems and support the greater emphasis on developmental issues in pediatric education.J Dev Behav Pediatr 15:34-38, 1994