Using parents' concerns to detect and address developmental and behavioral problems.

PURPOSE: Half of all children with disabilities are not identified before school entrance, precluding their participation in early intervention programs with known value in reducing high school dropout rates, increasing employment, delaying child-bearing, and reducing criminal behavior. Screening tests that can greatly improve detection rates have not been popular in primary care. This article describes an alternative approach in an evidence-based technique relying on professional elicitation and interpretation of parents' concerns. POPULATION: 971 children from pediatric practices, day-care centers, public schools, and their siblings.
CONCLUSIONS: Research shows that parents' concerns are as accurate as quality screening tests and that parents are equally able to raise important concerns regardless of differences in education and child-rearing experience. Parents' concerns can be elicited quickly, and 92% of parents can answer questions in writing while in exam or waiting rooms. Parents' concerns can help make a range of other important decisions about children's developmental and behavioral needs.