Disclosure of developmental disability: A study of paediatricians' practices

Objective: To investigate paediatricians' practices in disclosure of disabi lity and the influences on their practices, including attitude to people wi th disabilities. Methodology: Interviews were conducted with 26 paediatricians regarding the ir disclosure practices and their experience, training, contact with childr en with significant disabilities and influences on practices. Anonymous sel f-report questionnaires to the same group of practitioners relating to atti tude to disability were also employed. Results: Paediatricians' practices in the disclosure process scored relativ ely low on an index based upon recommended practices, No significant relati onships were found between index scores and the experience or training of t he paediatrician or the amount of contact of the paediatrician with childre n with disabilities. However, more experienced paediatricians were found to be more likely to mention the practice of informing both parents together and the presence of a support person at the time of disclosure. Paediatrici ans having more contact with children with disabilities were more likely to mention that they would disclose disability in a child as soon as possible . The major modifying influences on disclosure practices were reported to b e the intelligence of the parents and their emotional state of at the time of disclosure. Time was the most frequently reported constraint upon disclo sure practices. Conclusions: The low 'disclosure practice index' scores in this study are n ot necessarily an indication that practices are poor, as there are challeng es to the validity of the advocated practices. There were few significant a ssociations found between the practices of paediatricians in disclosure and their experience, training, contact with children with disabilities and at titude to people with disabilities.