Developmental Interview

Preparation

Gathering important background information facilitates optimal interviewing, especially in children with intellectual and developmental concerns. This involves first noting the patient referral source and the reason for referral and obtaining and reviewing the child’s medical records and any prior evaluations and treatment plans. Parent questionnaires aimed at gathering information on medical, family, and social history, as well as behavioral [Page 384]scales, are very useful for guiding the clinician’s interview. School information, including academic and social functioning, should be obtained for school-age children, and behavior scales completed by the teacher can be compared with those completed by the parent.

Setting

Children can be more comfortable in a “child-friendly” setting with bright colors and a play area, but some may have adverse reactions to excessive sensory stimulation. The interview room should be quiet and private, with the interviewer sitting at a comfortable distance and sufficient seating to accommodate everyone. Having developmentally appropriate toys or other activities available in the room can help keep younger children busy when the parents are occupied. Facial tissues should be available, as discussing disabilities can be emotionally charged.

Participants

The parents are usually the primary informants, but with parents' permission, extended family members and friends can also provide additional information and support. In cases where the parents are not together or do not have an amicable relationship, interviewing each parent separately is preferable. With infants and young children, most of the information will be obtained from the caregiver, but parent–child interactions and verbal and motor skills can be observed.

Children are included in the interview when they can express wishes and feelings (around age 5 or 6 for typically developing children). By age 9 or 10, children can provide meaningful information about themselves and are actively involved. Adolescents who do not have significant intellectual impairment are interviewed separately from their parents, and their privacy needs to be respected. If the child is too disruptive, or if sensitive information needs to be discussed, it can be helpful to have the child stay in the waiting room with someone else.

Content and Process

At the start of the interview, the clinician greets the family in a friendly and welcoming manner and introduces himself or herself; some appropriate small talk may be beneficial in putting nervous or anxious people at ease. The clinician explains his or her role and learns the relationships among family members if these relationships aren't already clear. The clinician asks participants how they would like to be addressed, elicits the parents' expectations, and sets the agenda jointly with them. It is important to utilize appropriate communication skills (including active listening, repetition and review, elaboration, and clarification) and to show empathetic support verbally or nonverbally. Allowing for periods of silence can help the parent reflect and organize thoughts. Tracking involves subtly adapting language and behavior to that of the family and can help the family feel more comfortable and relaxed. Confrontation, or asking a direct question or statement, may be needed if there are inconsistencies or contradictions in the history. At the end of an interview, the clinician offers his or her interpretation and summary, which can give the interview cohesion and provides an opportunity for the patient to ask questions or offer comments.

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