Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Impact of “Learn the Signs. Act Early.” Materials on Parental Engagement and Doctor Interaction Regarding Child Development

Gadomski, Anne M., MD, MPH*; Riley, Moira R., PhD; Scribani, Melissa, MPH; Tallman, Nancy*

Journal of Developmental & Behavioral Pediatrics: December 2018 - Volume 39 - Issue 9 - p 693–700
doi: 10.1097/DBP.0000000000000604
Original Article

Objective: To measure the effectiveness of the “Learn the Signs. Act Early.” (LTSAE) educational materials in increasing parent engagement in developmental monitoring during well-child visits.

Methods: Exit surveys and analysis of audio-taped well-child visits were compared pre- versus post-LTSAE exposure. Before the LTSAE, parents were exposed to usual pediatric clinic developmental surveillance practices. After the LTSAE, parents received LTSAE materials before well-child visits, received age-specific LTSAE checklists at the clinic visit, and were exposed to LTSAE posters in examination rooms. Pediatricians attended a didactic session on developmental screening and LTSAE materials. Children evenly distributed among the ages of 2, 4, 6, 9, 12, and 18 months and 2 and 3 years were consecutively recruited at their well-child visits. After the visit, all parents completed exit surveys that assessed 5 a priori outcomes: milestone awareness, level of concern if the child is late in reaching a milestone, likelihood of bringing up a concern to the doctor, level of confidence in knowing what to do if concerned, or talking about child development during the visit. A 25% visit subsample was audio-taped, transcribed, and coded for parental engagement and nurse/doctor response to parental concern.

Results: No demographic differences were found between the 181 parents enrolled before the LTSAE and 182 after the LTSAE. LTSAE exposure was significantly higher after the LTSAE (p < 0.0001). After the LTSAE, parent awareness of the number of milestones increased (p = 0.03). Audiotape analysis showed that parents were more engaged in discussions about development post-LTSAE versus pre-LTSAE.

Conclusion: The LTSAE may improve developmental surveillance by increasing parent's awareness of and discussion about milestones.

*Center for Evaluating Rural Interventions, Bassett Research Institute, Cooperstown, NY;

Bassett Research Institute, Center for Biostatistics, Bassett Medical Center, Cooperstown, NY.

Address for reprints: Anne M. Gadomski, MD, Bassett Research Institute, Bassett Medical Center, Bassett Healthcare Network, One Atwell Road, Cooperstown, NY 13326; e-mail:

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 official views of the DRDC or CDC.

Disclosure: The authors declare no conflict of interest.

Received February , 2018

Accepted June , 2018

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.