Shared Understanding Between Parents and Clinicians Regarding Developmental Screening and Referrals

To investigate discrepancies between clinicians' and parents' recall of developmental concerns and referrals, and to identify factors associated with discrepancies.

This is a secondary analysis of data from the Achieving My Potential (AMP) study. English and Spanish-speaking families with children aged 12-42 months were recruited from community clinics. Data included demographics, developmental assessments, parental post-WCC surveys, and medical record abstractions. Two discrepancy types (concern and referral) were identified. Discrepancy frequencies were calculated, and logistic regressions examined characteristics associated with discrepancies.

Among 512 enrolled families, there were 94 (18%) concern discrepancies, of which 78% were concerns reported as discussed in parent surveys but not in the medical record. There were 43 (8%) referral discrepancies, of which 63% were referrals reported as made in the medical record but not in parent surveys. Children at moderate developmental risk had greater odds of concern (aOR 1.37; P < 0.05) and referral (aOR 2.65; P < 0.001) discrepancies. Parents' having at least a high school education was associated with lower odds of concern (aOR 0.59; P < 0.05) and referral (aOR 0.34, P < 0.001) discrepancies. Older parental age and higher family-centered care scores were associated with lower odds of referral discrepancies.

Discrepant understanding may arise from miscommunication, misinterpretations, recall, or documentation practices. Attention to shared understanding, particularly among families at high risk for discrepancies, may support early intervention.