Child-physician rapport at a neurodevelopmental clinic: In the eyes of the beholder

Building rapport with young patients is crucial for fostering a sense of comfort that enhances their cooperation during clinical encounters and improves clinical outcomes. The available data on children with neurodevelopmental disabilities in community-based settings, including data on child-physician rapport, is limited.

To examine how children with neurodevelopmental disabilities perceive rapport with treating physicians compared to parents and treating physicians and to evaluate the relationship between the child-reported rapport and its impact on their cooperation.

One hundred two children with neurodevelopmental disabilities (M years = 9.63, SD = 2.42) completed the CHARM-C Questionnaire, which assessed their experience of rapport with their examining physicians following neurodevelopmental assessments. In parallel, their parents and physicians completed the CHARM-A Questionnaire, which assessed how they perceived the children's experience of rapport (a total of 306 questionnaires). The physicians also rated children's cooperation. The data were analyzed using correlation, regression, and mixed linear analyses.

Children's perceptions of rapport were significantly less positive than those of parents (d = -0.60) and physicians (d = -0.45). A moderate partial correlation (r = .37) was found between children's and parents' perceptions. Neither children's nor parents' perceptions were correlated with physicians' perceptions. Children's perceptions of rapport were positively associated with greater cooperation (β = .28).

Children with neurodevelopmental disabilities rated their rapport with physicians lower than parents and doctors. Their evaluations offer valuable insights, complementing caregivers' and professionals' perspectives. Training physicians to improve their assessments of children's needs during medical encounters is critically important.