title: Sugar-coaters and straight talkers: communicating about developmental delays in primary care.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Pediatrics, Division of Child Development, Boston Medical Center/Boston University School of Medicine, Boston, Massachusetts 02118, USA. laura.sices@bmc.org
authors.forename: Laura
authors.initials: L
authors.lastname: Sices
authors.forename: Lucia
authors.initials: L
authors.lastname: Egbert
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Mercer
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D003142:Communication; D003144:Communication Barriers; D002658:Developmental Disabilities / Q000175:diagnosis* / Q000453:epidemiology; D018479:Early Intervention, Educational / Q000379:methods*; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D009034:Mother-Child Relations; D011320:Primary Health Care / Q000379:methods*; D011336:Probability; D011368:Professional-Family Relations; D011795:Surveys and Questionnaires; D014342:Truth Disclosure; D014481:United States