Scoping review on noticing concerns in child development : A missing piece in the early intervention puzzle

Background: Between 13 and 32% of children in developed nations are at-risk for developmental delays. In order to identify concerns, there is a need to understand the mechanisms that facilitate becoming aware of it.

Aim: A scoping review was conducted to understand this process of “noticing”, through existing literature on parent experiences.

Methods: Records from major academic databases and grey literature sources were searched using key terms. Thematic analysis was then conducted to synthesise findings.

Results: Twenty papers meeting inclusion were identified. Noticing a delay was found to be an interplay between who notices – parents or other – and how they do so. How concerns are noticed was through two mechanisms: knowledge of child development, and comparison with other children.

Conclusions: This review highlights the nuanced complexity of noticing concerns with a child’s development. Understanding how this process occurs and the key ingredients that enable it is vital to supporting early detection of developmental delays.

Implications for rehabilitation
• Noticing developmental delays is a complex process that evolves over time, derived of ‘who’ notices and ‘how’ this occurs.

• When asking parents about child development, professionals need to listen for both bolder “aha moments” as well as more subtle “niggling” comments as indicators of parental concerns.

• Building baseline parental knowledge of developmental milestones may facilitate noticing of atypical development.

• Encouraging parents to engage in social opportunities with other children promotes both positive child development and enables developmental monitoring through use of comparison.