Learning from mothers: how myths, policies and practices affect the early detection of subtle developmental problems in children

Background. Recent research has revealed increasing concerns over the number of children entering school with unidentified developmental problems even though there are seemingly comprehensive health services available for mothers and their children in the pre-school years. Recognising that early detection and early intervention reduces the likelihood of long-term serious health and educational problems, it is important to understand why so many children have not been detected with developmental problems in their pre-school years. Utilising the knowledge and experience of mothers’ whose children had not been diagnosed with developmental delay until school age, this study draws attention to reasons how and why children with subtle developmental problems ‘slipped through the net’. Research Question. What can be learned from the mothers’ experiences of their child’s development that will contribute to improving the early detection of subtle developmental problems in children? Aims. This study had four specific aims: (1) to document mothers’ stories about their experiences of raising a child with developmental problems that remained undiagnosed until school; (2) to ascertain the extent to which mothers’ were ‘aware’ of developmental problems with their child prior to school entry; (3) to determine the environmental characteristics associated with parent’s experiences and their interpretation of these experiences and, (4) to ascertain ways in which child health professionals may utilise the experience of parents to improve early recognition and diagnosis of subtle developmental and behavioural problems in children. Theoretical framework, methodology & method. Recognising that parenting does not occur in a vacuum, but is influenced by the immediate surrounds, the community and the larger socio-economic, cultural, political and historical environments, a social constructionist perspective was utilised as the framework for this research. A synthesis of interpretive biography and literary folkloristics provided a method of collecting, reading and interpreting the life stories of mothers whose children had not been detected with developmental problems until school age. The life stories were obtained through individual, in-depth interviews of eight mothers who lived in the North Queensland region of Australia, and were read through the lens of three literary theories, arising respectively from the tenets of semiotics, neoMarxism and Foucauldian poststructuralism. Findings & Conclusions. Findings draw attention to a number of factors that influence the interaction between mothers, health professionals and community members and how these impact on early detection of children’s developmental problems: • competing messages about motherhood affect how mother’s decide on the best course of action when concerned about their children; • societal myths influence how mothers and health professionals view their roles, the child’s problem and subsequent action; • health professionals’ knowledge is valued over mothers’ knowledge; • expectations of the role of the health professional, influenced by mythical ideals and ideological notions, differ between mothers and health professionals; • communication between health professionals and mothers is distorted due to different approaches to language and understanding; • competing arguments about the value of diagnosis and labelling delay identification and access to assistance programmes for their children; • a medical diagnosis plays an important role in how support and assistance is determined. Significance. This research has raised awareness of constraining social, historical and political factors on how mothers and health professionals interact, and the effect this has on the early detection of childhood developmental problems. Bringing these constraints to the attention of health professionals working with mothers and their young children will hopefully encourage active engagement with parents and the acknowledgement that health professionals and parents can work together to improve the early detection of developmental problems in children