Objective: To investigate parents' experiences of surveillance for early talking difficulties. Design: Qualitative study nested within a randomised controlled trial. Setting: Interviews with the parents of 20 children identified as having early difficulties. Results: Most parents were in favour of surveillance of children's language. Parents do not totally welcome surveillance, however, as it also potentially medicalises their children's early lives. The study also revealed that many of the parents felt stigmatised by their children's difficulties. Conclusions: Listening to parents' accounts can increase professionals' understanding of their responses to monitoring of their child's development and referral to specialist services. Copyright # 2004 John Wiley & Sons, Ltd.
IntroductionDuring the twentieth century, observation of children's growth and development became the norm in the UK. Many aspects of children's development are now regularly monitored and children are screened for a variety of abnormalities and diseases throughout their early lives. Learning to talk is a major milestone in young children's development. Of all the impairments present in early childhood, it is suggested that language difficulties may be the most common. At any one time a fifth of parents in Britain are concerned about their child's language development (Law, 1992). Community child health professionals such as health visitors routinely monitor children's acquisition of language. Where difficulties are suspected, referral is usually made to speech and language therapy (SLT) departments, often based in community clinics.Over the last decade there has been a growing expectation that parents would take on a significant rô le in monitoring their children's development and work alongside professionals in the early identification of problems. Parents' participation in surveillance and early identification of difficulties is now emphasised and encouraged (Sure Start, 2002;Glascoe and Sturner, 2000). In spite of this increase in parental responsibility, little research has been undertaken to explore parents' understandings of their part in this process and to investigate their views on the risks and benefits of identification of children 'at risk' of language disorders.Within many fields of healthcare, increasing importance is being attached to ways in which patients and carers perceive the services and intervention received. Muir Gray (1999), in an examination of postmodernism in relation to medicine, called for attention to values as well as evidence and the need to take the views of consumers as well as clinicians into account. Kleinman (1988) and Nettleton (1996) also drew attention to the importance of considering lay accounts and beliefs, particularly with regard to chronic illnesses and disabling conditions. Both claimed that understanding of lay accounts and beliefs is critical to ensuring the effectiveness of health education and promotion programmes and interventions. Nettleton also stressed the importance of gaining knowledge of i...