The Pediatrician as a Source of Information about Child Development

The health care system has the potential to fulfill parents' needs for information on child development and behavior, yet well-child visits rarely devote much time to developmental topics. Two obstacles to effective family counseling were considered in this study: Pediatricians may not receive adequate training in child development; or parental expectations about the health provider's role, in concert with the pediatrician's reluctance to assume nontraditional responsibilities, may restrict permissible topics of conversation to clinical and care taking concerns. Pediatricians and developmental psychologists in the first part of the study were equally competent on a measure of knowledge of infant development, casting doubts on the training deficit hypothesis. A second sample of pediatricians provided information on the types of issues parents usually raise during visits. Clinical and caretaking issues were given more weight than behavioral and parenting concerns. Comparisons with other reports on parental concerns reinforces the conclusion that one barrier to effective anticipatory guidance is the expectation, shared by pediatricians and parents, that the well-child visit is not a forum for behavioral concerns.