Shared Understanding Between Parents and Clinicians Regarding Developmental Screening and Referrals.

Abstract

Background: Lack of shared understanding between parents and clinicians regarding developmental concerns and referrals during well-child care (WCC) may hinder early intervention.

Objective: To investigate discrepancies between clinicians' and parents' recall of developmental concerns and referrals, and to identify factors associated with discrepancies.

Methods: This is a secondary analysis of data from the Achieving My Potential (AMP) study. English and Spanish-speaking families with children aged 12-42 months were recruited from community clinics. Data included demographics, developmental assessments, parental post-WCC surveys, and medical record abstractions. Two discrepancy types (concern and referral) were identified. Discrepancy frequencies were calculated, and logistic regressions examined characteristics associated with discrepancies.

Results: Among 512 enrolled families, there were 94 (18%) concern discrepancies, of which 78% were concerns reported as discussed in parent surveys but not in the medical record. There were 43 (8%) referral discrepancies, of which 63% were referrals reported as made in the medical record but not in parent surveys. Children at moderate developmental risk had greater odds of concern (aOR 1.37; p < 0.05) and referral (aOR 2.65; p < 0.001) discrepancies. Parents' having at least a high school education was associated with lower odds of concern (aOR 0.59; p < 0.05) and referral (AOR 0.34, p < 0.001) discrepancies. Older parental age and higher family-centered care scores were associated with lower odds of referral discrepancies.

Conclusions: Discrepant understanding may arise from miscommunication, misinterpretations, recall, or documentation practices. Attention to shared understanding, particularly among families at high risk for discrepancies, may support early intervention.