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Comparative Study
. 2009 Oct;124(4):e705-13.
doi: 10.1542/peds.2009-0286. Epub 2009 Sep 14.

Sugar-coaters and straight talkers: communicating about developmental delays in primary care

Laura Sices  1 , Lucia Egbert, Mary Beth Mercer
Affiliations
Comparative Study

Sugar-coaters and straight talkers: communicating about developmental delays in primary care

Laura Sices et al. Pediatrics. 2009 Oct.

Abstract

Objectives: The goals were to investigate parents' and early intervention (EI) specialists' beliefs and experiences regarding discussing child development in primary care and to identify communication barriers and opportunities.

Methods: Focus groups were held with (1) mothers of young children with typical development, (2) mothers of young children who received EI services, and (3) EI specialists. Seven groups (N = 46 participants) were conducted in the greater Cleveland, Ohio, area. Meetings were audio-recorded, transcribed, coded, and analyzed, to identify themes.

Results: Most mothers reported a preference for a nonalarmist style of communication when developmental delays are suspected. In contrast, some mothers preferred a more direct style, including the use of labels to help them understand their child's development. The importance of preparation to accept information about developmental delays emerged as a theme in all groups. Elements contributing to preparedness included information about expected developmental skills, suggestions for promoting skills, and a specific time frame for follow-up evaluation. Mothers of children with disabilities perceived that early reassurance of normalcy by providers in response to their concerns led to self-doubt and increased difficulty accepting the diagnosis.

Conclusions: Mothers and EI specialists have clear ideas about factors that promote or impede communication regarding child development. This information can inform primary care providers' approaches to monitoring and screening the development of young children and to communicating with parents regarding suspected developmental delays.

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References

    1. Sices L, Feudtner C, McLaughlin J, Drotar D, Williams M. How do primary care physicians identify young children with developmental delays? A national survey. J Dev Behav Pediatr. 2003;24(6):409–417. - PubMed
    1. Sand N, Silverstein M, Glascoe FP, Gupta VB, Tonniges TP, O’Connor KG. Pediatricians’ reported practices regarding developmental screening: do guidelines work? Do they help? Pediatrics. 2005;116(1):174–179. - PubMed
    1. American Academy of Pediatrics. Council on Children With Disabilities. Section on Developmental Behavioral Pediatrics. Bright Futures Steering Committee. Medical Home Initiatives for Children With Special Needs Project Advisory Committee Identifying infants and young children with developmental disorders in the medical home: an algorithm for developmental surveillance and screening. Pediatrics. 2006;118(1):405–420. - PubMed
    1. Johnson CP, Myers SM. Identification and evaluation of children with autism spectrum disorders. Pediatrics. 2007;120(5):1183–1215. - PubMed
    1. Sices L. Developmental Screening in Primary Care: The Effectiveness of Current Practice and Recommendations for Improvement. Commonwealth Fund; New York, NY: 2007.

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