Being the one to break the news – raising developmental concerns with families

Raising concerns about a child’s development can be a complex and confronting moment for early childhood education and care (ECEC) professionals. Despite these challenges, early intervention for children with additional support needs is vitally important, and as such, there is a need to act in the best interest of the child and sensitively raise concerns as soon as possible – but how? 

Parents may respond to the raising of concerns in a number of ways – they may be receptive and open to the professional perspective of the person sharing the news; they may feel grief, sadness or shame; or they may be in denial, and dismiss the concerns as being ‘interfering’ or ‘overreacting’.

While ECEC professionals are not doctors or allied health professionals, and as such, are not in a position to offer a hypothesis about any additional needs a child may have, they are close to the children in their care, experienced at working with children and observing developmental milestones, and have a deeper understanding of typical and atypical developmental occurrences. 

Armed with this knowledge and professional experience, ECEC professionals can, and should, work as a team to approach parents with concerns. 

Before raising a concern with a parent, it is important for a professional, or team of professionals, to take the time to ensure where, when and how the discussion will be had, and that all the required information has been gathered. 

Some of the following questions may support this thinking: 

Gather/bring: 

• Observations and examples of the concern (for example, if the concern is about a child’s communication, you may share video of the child during play, written observations from the educators caring for the child, or developmental checklists). 

Think about: 

• When and where the discussion will happen: parents who are rushing to or from work are unlikely to respond well to a long chat filled with confronting information. It’s also a good idea to have the discussion in private. 
• How the parent might respond: you might like to have a support person with you if you feel the parent will be volatile. You might like to have some tissues ready in case they begin to cry. 
• The sandwich technique: it can be overwhelming to be hit with a wave of bad news. Start the conversation with some positive points about the child and their strengths, and end on a note of hope. 

How to start: 

A good way to begin the conversation is to ask the parent/s how they feel about their child’s development, and if they have any concerns. It’s also useful to ask if family, friends, or other medical professionals have made any comments or raised any concerns with the parent/s.

Families may become emotional throughout the discussion. Try and give time and space for them to share their story, and practice active listening skills. 

As the meeting progresses, have some further support leads available, and be clear about what you and your service can offer. For example, you may work with an inclusion support professional, refer them on to an allied health professional, encourage them to follow up with their GP, or give them some information about services which could support. 

After the parents have left, take some time to document the meeting, and consider providing a copy of this document to families as well, for their own records. 

To learn more about the inclusion support available in your community, please see here. Information in this piece has been based around advice prepared by Gateways Support Services.