Why doctors should empower parents, not dismiss symptoms of developmental delay


When it comes to parental concerns about their child, much of what is needed is personal empowerment to address those concerns. — 123rf

IN A majority of children’s developmental delay cases, parents often consult professionals about their concerns, or for a diagnosis to better explain and understand their child’s unusual behaviour or delayed development. They hope to gain more insight into what is going on and what they can expect in the future.

But as parents, have you had your healthcare professional deny, dismiss, downplay or discredit concerns about your child’s development?

This does happen and it can be a rather disempowering experience for parents who are also likely to feel more isolated and unsupported in their worries and struggles to understand more about their child’s condition.

My experience with parental worries is that it comes from the place of uncertainty and disempowerment. Not knowing what would happen or what to do about their concerns can bring about significant stress.

When worries are not addressed well, they tend to get bigger. When told to ‘not worry because there’s no real problem’, there is a sense of dissonance and usually, a feeling of disempowerment and isolation.

This disconnect can also result in parental self-blame, usually for overthinking, leading to even further insecurity about being a parent.

Effectively, parents may start questioning their competency in being a parent. This adds to the initial concern that has not been addressed. Neither are likely to be beneficial to the family.

For all you know, there may not be a problem at all and it really is due to overthinking. However, regardless of the actual problem or diagnosis, it is better to relieve parents off their worries so that they can focus on what’s more important.

Dismissing concerns without really providing evidence on why, doesn’t help because chronically worried parents cannot parent effectively.

Dismissive attitude

Research on communications between healthcare professionals and their clients reveal that a number of factors contribute to the former being dismissive to the latter, when it comes to concerns about their child.

Some studies identify the functions of denials as a way to silence the parents, discredit them or to be consistent with personal biases such as stereotyping parents as “overthinking”.

One reason for denial is that the healthcare provider is in a hurry. It seems that when doctors or developmental specialists are in a rush, they tend to downplay problems that may be significant to the parents, but may seem trivial to the professional.

In this rush, it is also normal that parents may have had little time to provide enough information for the professional to better understand their concerns.

So, rushing, coupled with the lack of information, can result in miscommunication that dismisses parental concerns.

It is also usual that some concerns brought up are not within the competency or knowledge of the professional, so these issues tend to be brushed off because the focus is only on what that professional knows.

This can also lead to rushing, because the professional would want to focus on their own personal competencies in practice, rather than something else that they’re unfamiliar with.

Research also reveal another reason for dismissal of parental worry is that the professional doesn’t believe the parents in the first place.

Obviously, such outcomes are not favourable to the parent, often the mother who is typically the main caregiver. There are cases where mothers also don’t get support from their husbands. Imagine how isolating this can feel to them.

Therefore, it is very important for health professionals to support parents when they address their concerns about their child’s development. This is much more about parent empowerment than it is about the presenting symptoms in children.

Supportive communication

Providers may want to avoid these behaviours and could consider obtaining training in supportive communication behaviours such as providing validation to patients and listening to them in order to enhance patient satisfaction.

Parents can also receive communication training to take on a more active role in their medical encounters by learning how to effectively ask questions, express preferences and speak up for themselves.

Parents can also be encouraged or facilitated to communicate concerns in a way that brings up measurable deficits of knowledge and skills so that healthcare professionals are able to help reduce concerns and empower them further in dealing with their issues.

For example, professionals can help parents identify resources that would provide answers to uncertainties, and also to learn new competencies in investigating for evidence that could determine the severity of their child’s condition.

There is much parenting literature out there that both parties can look into for better understanding of their concerns and what can be done, as well as where to go for continued support when one professional is unable to address a specific concern.

My involvement with the International Congress on Evidence-based Parenting Support (I-CEPS) by the Parenting and Family Research Alliance (PAFRA) tells me that current technologies for parenting are evolving at a very rapid pace.

We now have a growing wealth of information that can help support parents.

Healthcare providers play the role of an educator and are in a position to address parental concerns using a task-sharing approach. It is about partnerships in getting mutually competent in shared ‘parenting’ – a way that increases resilience in parents and families dealing with concerns about child development.

Fruitful collaboration

Both healthcare provider and parents can collaborate in seeking evidence-based parenting support information to explore methods that can reduce parental concern about their child’s progress.

This is of course, easier said than done and may seem more time-consuming but in the long run, this method promotes efficiency in parent-professional communications.

When parental concerns are addressed and parents feel competent, there are less barriers such as denials and resistance in communicating with healthcare professionals.

When it comes to parental concerns about their child, much of what is needed is personal empowerment to address those concerns.

Education on information resources, measurements and professional networks can be of great help where there is uncertainty on the part of parents.

Such empowerment of parents is beyond the role of just the healthcare providers, but extends to various other agencies including public health, education, information technology and human resources sectors.

It takes a village to nurture a child, and we’re all part of that community, after all.

Dr Alvin Ng Lai Oon is a professor at the Department of Psychology, School of Medical and Life Sciences, Sunway University. He is a clinical psychologist by training and is passionate in promoting mental health literacy in the community.

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