Understanding Factors That Enable or Hinder Parent and Early Childcare Provider Communication About Developmental Concerns Using the LTSAE MaterialsKris Barnekow, PhD, OTR/L,Department of Occupational Science & Technology, University of Wisconsin-MilwaukeeGail Chodron, MA, PhD (expected August 2015), Waisman Center, University of Wisconsin-MadisonSabrin Rizk MS, OTR/L Department of Occupational Science & Technology, University of Wisconsin-MilwaukeePaige Mission, MS, Waisman Center, University of Wisconsin-MadisonAlexandra Puk, BS, Waisman Center, University of Wisconsin-Madison

Methods

How providers and parents communicateRelated to research questions 1 and 2, we found that childcare providers and parents currently use a range of mechanisms to communicate about child growth, learning, and developmental concerns. We categorized these mechanisms as formal or informal types. By formal we mean planned and scheduled communication mechanisms (e.g., newsletters, parent-teacher conference). By informal we mean unscheduled communica-tion occurring during normal daily childcare operations (e.g., communication at child drop o or pick up).

What providers and parents say went well and what could have gone betterRelated to questions 3 and 4, we found that childcare providers and parents described similar factors that enable or inhibit communication. By enable we mean factors that allowed a conversation to occur that par-ents and providers perceived went well. By inhibit we mean factors that impeded communication from oc-curring or were associated with parents and providers perceiving that communication did not go well. Based on our method of coding, preliminary ndings suggest that a trusting and respectful relationship was a key factor for both childcare providers and parents. We found indications that childcare providers and parents dif-fered in their view of what makes a relationship trusting and respectful. In the table below, we provide typical quotes for enabling and inhibiting factors for both childcare providers and parents.

Table: Typical quotes illustrating factors that enable and inhibit communication

Data Collection: Focus group methods6 were used. A childcare provider and a parent focus group was held in each of two Midwestern cities, for a total of four focus groups. Open-ended and follow-up questions were used in each 90-minute focus group.

Participants: Parents (N=17) and childcare providers (N=11) attending center- or family- based childcare programs Parents 10 Mothers, 7 Fathers 13 White or Caucasian, 3 Black or African American, 1 Multiracial 16 non-Hispanic, 1 Hispanic 4 High School or Associates Degree, 13 Bachelors or Post-Graduate Degree Childcare providers: 11 Mothers 11 White or Caucasian and non-Hispanic 2 High School or Associates Degree, 9 Bachelors or Post-Graduate Degree

Analytic Strategies: Three members of the research team reviewed and coded dierent focus group transcripts for factors that inhibit or enable communication. Coding was rened through the constant comparison method.7 Specically, team members reviewed coding decisions and discussed until consensus was reached.

It is estimated that 1 in 68 children has an autism spectrum disorder and 1 in 6 has a developmental disability of any type.1 The majority of these children enter kindergarten with unidentied delays and without having accessed early intervention.2 Early intervention helps children with developmental delays maximize developmental gains.3 Over half of U.S. children under the age of 5 attend some form of childcare,4 therefore, childcare providers play a key role in early identication of delays.5 The Centers for Disease Control and Prevention (CDC) provides research-based resources to educate parents and early childhood professionals through the Learn the Signs. Act Early. (LTSAE) campaign. LTSAE is designed to increase knowledge about developmental milestones, facilitate conversations about child development, increase awareness of red ags, and increase knowledge of next steps to take when there is a concern. There is a need for research on implementing LTSAE in community programs, including childcare settings.

The purpose of this study was to solicit and describe input from childcare providers and parents about using LTSAE in childcare settings to monitor, and support conversations about, how children are developing. The specic research questions are:

1) How do providers and parents communicate about the childs growth and learning?2) How do providers and parents communicate when there is a concern about how a

child is reaching developmental milestones? 3) What do providers and parents say went well during this communication? 4) What do providers and parents say could have gone better in this communication?

Problem Statement

References

1. CDC. (2012). Prevalence of ASDAutism and Developmental Disabilities Monitoring Network, 14 sites, United States, 2008. MMWR Surveillance Summary. 61(3), 1-19.

2. Boyle, C.A., Decoue, P. & Yeargin-Allsopp, M. (1994). Prevalence and health impact of developmental disabilities in U.S. children. Pediatrics, 93(3), 399-403.

3. Croft, C. (2010). Talking to families of infants and toddlers about developmental delays. Young Children, 44-46. 4. NSECE Research Brief, OPRE Report 38. (2013)Number and Characteristics of Early Care and Education (ECE) Teachers

and Caregivers: Initial Findings from the national Survey of Early Care and Education (NSECE),October.5. Tips for Child Care Providers to Communicate with Parents Concerns about Children's Development. (2011, December 2).

www.extension.org/pages/28228/tips-for-child-care-providers-to-communicate-with-parentsconcerns-about-childrens-development retrieved on July 3, 2015.6. Krueger, R., & Casey, M. (2015).Focus groups: A practical guide for applied research(5th ed.). Thousand Oaks: Sage.7. Glaser, B., & Strauss, A. (1967). Discovery of grounded theory: Strategies for qualitative research. Chicago: Aldine Press.8. Sices, L., Egbert L., & Mercer, M. B. (2009) Sugarcoaters and straight talkers: Communicating about developmental delays

in primary care. Pediatrics, 184(4). e705-e713.

Preliminary Findings

For more information, contact Kris Barnekow at krisb@uwm.edu or Gail Chodron at chodron@wisc.edu

Discussion

This poster was supported by the Disability Research and Dissemination Center (DRDC) through its cooperative agreement number 5U01DD001007 from the Centers for Disease Control (CDC) and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the ocial views of the DRDC or the CDC. The project described was supported by the Clinical and Translational Science Award (CTSA) program, through the NIH National Center for Advancing Translational Sciences (NCATS), grant UL1TR000427. The content is solely the responsibility of the authors and does not necessarily represent the ocial views of the NIH.

Family engagement and communication are important topics in the eld of early childhood care and education today. Our nding that childcare providers and parents currently use a range of mechanisms to communicate about child growth, learning, and developmental concerns is consistent with the existing literature on parent-provider communication in childcare settings.3 The existing early childhood literature suggests providers need a greater awareness of the complexity of communication with parents surrounding developmental concerns, and there is a need for more research regarding communication styles.8 Research on using LTSAE to support communication about developmental milestones and concerns is emerging, however there appears to be insuenct information about the factors that enable or inhibit communication surrounding developmental concerns. In our study, providers and parents reported a range of enabling and inhibiting factors, and we found important overlap between factors reported by both types of participant. Further research is needed to establish what associations, if any, exist between factors and later referral and child outcomes. The match or mismatch of provider and parent expectations and preferences regarding communicative relationships should also receive greater attention. Finally, it will be important to consider how to use LTSAE in both formal and informal communication.

Enabling

I would say that were more able to build a relationship with the parents, and then theyre more receptive to concerns in the future because weve built that relationshipto speak with them

keeping that honesty and being comfortable and not being the know it all

trust is important

be kind and caring in how you bring something up, and how you talk about it

I think it helps when the teachers are upfront and direct. When they dont just drag it out or try to sugar coat it.

I think it would be nice if they gave a copy of everything that we went over. Like a written out version or something. Just, like, for my own record.

framing it in that way is very helpful and feels supportive as opposed to evaluative.

And I like the fact that she not only makes things for her to work on but she also throws in some positive things throughout the week that has happened.

What we nd is hard too is when you might have something that might be dicult for parents to hear is for them not to only accept it.hear you say that but just how to handle their reaction cause weve had families who will at out deny it in the midst of the issue oc-curring and also just like kind of snub us

one challenge about that is that sometimes there are other families or other kids around, and it just seems like, I dont know, it kind of depends on how many other people are around as far as how much detail I get.

Inhibiting

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Research Purpose and Questions

Learn the Signs. Act Early. Sample Materials