Concerns About Development, Behavior, and Learning Among Parents Seeking Pediatric Care

Abstract

To describe responses to the questions “Do you have concerns about your child’s behavior? Development? Learning?” among parents seeking pediatric care, and to analyze their correspondence to formal screening questionnaires. Of 465 parents of children ages 3–65 months recruited at pediatric primary care practices in greater Boston, 451 provided complete data for analysis. After completing a questionnaire that asked if they had any or all of these concerns parents filled out a developmental screener (Ages and Stages Questionnaire-3) and a behavioral screener (Ages and Stages Questionnaire-Social/Emotional). 108 parents (24%) reported having at least one concern about their child. Greater child age, male gender, and lower family income were associated with more concerns about development, behavior, and learning. Moderate agreement was found between parents’ concerns and their responses on screening instruments. Compared to children who were not identified on either screener, parents of children identified only on the behavioral screener were more likely to have concerns about behavior and parents of children identified on both screeners were more likely to have noted concerns about both behavior and development. No type of concern was associated with identification on the developmental screener alone. Among parents who identified no concerns, 18% were identified as at risk on one or both screening tests. Parents’ self-report of concerns showed moderate agreement with the results of developmental and behavioral screening instruments. Agreement was higher for behavioral concerns than for developmental concerns.