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It's Not What It Seems

The Relationship Between Parents' Concerns and Children With Global Delays

Division of Child Development, Department of Pediatrics Vanderbilt University School of Medicine, Nashville, Tennessee

Parents of children with significant behavioral or emotional problems have tended to be concerned about their behavior or emotional well-being, whereas parents of children with speech-language impairments were more concerned about speech-language development. The present study was designed to assess whether a parallel relationship between type of parental concern and type of developmental problem continues when children have global delays. Subjects were 95 parents and their children from birth to 6 years of age who attended day-care centers. Parents' concerns were categorized into developmental domains. Children were given a criterion battery of intelligence and adaptive behavior tests. Global delay was identified in 18 children (19%). Concerns about global development were raised by only 5% of all parents. Concerns about speech-language and/or behavior were sensitive in detecting global deficits (83%), while the absence of such concerns had modest specificity in detecting normal development (47%). Parents' concerns continue to be useful in prescreening and can identify patients in need of further screening. However, pediatricians should anticipate that parents of children with global delays may raise concerns, not about global development, but rather about behavior/emotional status and/or speech-language skills. The best response to such concerns is to administer screening measures which assess multiple developmental domains.

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