Conversation starters for pediatricians to use with families whose kids are struggling

Some families may know they can come to you for help when they see signs of learning or behavior challenges, or if they’re worried that their child isn’t progressing, whether it’s very early on or as their child gets older. Others may not think to bring it up. Either way, families might not be comfortable talking about their child’s challenges or know what to say.

When it comes to finding the right help for a child, pediatricians and families are equal partners. It may be particularly important for pediatricians to be aware of conversation starters to help partner with families on addressing their child’s needs.

These conversation starters can make it easier to talk with families and help them make sense of what they’re seeing in their child.

Be welcoming.

Families need to know they’ve come to the right place to share their concerns and that you’re their partner.

What you can say: “I understand you have some concerns, and I’m glad you came in. Let’s figure out what’s going on.”

Start with open-ended questions.

Some parents and caregivers have detailed information to share. They’ve carefully observed their child and talked to teachers.

What you can say: “What’s been happening at home or at school that’s brought you here? How can I help?”

Ask for details.

Other times, parents are vague or don’t share specifics and you’ll need more information.

What you can say: “Can you describe what you mean when you say that homework is hard? What type of behavior do you see?” (Observations can be supported by structured questionnaires as described in the AAP policy on school-age children who are not progressing academically.)

Request more information.

You may need more information, like homework samples, notes from teachers, or report cards.

What you can say: “It would really help if I could see the actual math work. Do you have an example at home? You can mail it, email it, or drop it off.”

Explain your role.

Help parents understand your role and expertise, and the role and expertise of other providers.

What you can say: “This sounds like a challenging situation that can be caused by a number of things. I can work with you, and we can find others to help answer some of your questions, as needed.”

Let them know you’re there.

If you refer the family to a specialist, make sure they know you’re still their child’s doctor.

What you can say: “The school will do the actual testing, but I’d like a copy of the results. Please let me know how things are going.”

A conversation where you raise concerns may be challenging in a different way. Parents can have different reactions — and different barriers to getting help. But again, it’s important to let them know that as your child’s doctor, you’re a partner in the process.

Reviewed by

The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists, and pediatric surgical specialists dedicated to the health, safety, and well-being of infants, children, adolescents, and young adults.


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