Use of the child development review increases residents' discussion of behavioral problems.
OBJECTIVE
To assess whether use of a parent questionnaire, the Child Development Review (CDR), before health maintenance examinations (HMEs) increases parent identification and increases resident discussion and documentation of behavioral issues for toddler and preschool-aged children.


METHODS
Quasi-experimental design using convenience samples with comparisons before and after questionnaire implementation.


METHODS
Children 15 to 47 months of age and their parents attending a hospital-based, primary care clinic serving a low-income population, and the residents caring for them.


METHODS
Participants were enrolled into early control, concurrent control, and intervention groups. All parents completed an exit interview about 9 behavioral issues and were asked if they had discussed these issues with the doctor. Before the visit, the intervention group parents completed the CDR, which was available for the residents to review. Information from the CDR and exit interview, and resident documentation were compared for control and intervention groups.


RESULTS
There were 122 intervention and 135 control group HMEs. Parents using the CDR identified more behavioral issues for their children at the exit interview (median, 2.0 vs 1.0, P =.01). The 6 issues on both the CDR and the exit interview accounted for this increase. Intervention group parents reported discussion of more behavioral issues (median, 2.0 vs 0.0, P <.001). Discussion increased for all issues. Documentation was not increased for the intervention group.


CONCLUSIONS
Use of the CDR before HMEs increased parent identification and reported discussion of behavioral topics for toddler and preschool children.
Felt
Barbara T
BT
Division of General Pediatrics, University of Michigan School of Medicine, Ann Arbor 48109, USA. truefelt@umich.edu
O'Connor
Mary E
ME
D002653:Child Behavior Disorders / Q000175:diagnosis*; D002675:Child, Preschool; D003142:Communication; D002658:Developmental Disabilities / Q000175:diagnosis*; D005260:Female; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007396:Internship and Residency; D008297:Male; D010290:Parents; D010817:Physician-Patient Relations