Williams J
School of Nursing Sciences, James Cook University, Townsville, Queensland 4811, Australia.
Child Care Health Dev. 2007 May;33(3):282-90. doi: 10.1111/j.1365-2214.2006.00690.x.
Recent research has revealed increasing concerns over the number of children entering school with unidentified developmental problems, even though there are ostensibly comprehensive health services available for mothers and their children in the pre-school years. Recognizing that early detection and early intervention reduce the likelihood of long-term health and educational problems, it is important to understand why so many children are not detected with developmental problems in their pre-school years.
This doctoral study utilized the knowledge and experience of mothers to draw attention to reasons why children with subtle developmental problems are not identified until school age. A qualitative methodology utilized a synthesis of interpretive biography and literary folkloristics as a method of collecting, reading and interpreting personal stories. Three literary theories, arising, respectively, from the tenets of semiotics, neoMarxism and post-structuralism, were used to critically deconstruct the mothers' stories.
The findings highlight a number of factors that influence the interaction between mothers, health professionals and members of the community, and how these interactions impact on the early detection of children's developmental problems. The findings illustrate the influence of societal myths on how mothers and health professionals view their roles, and on how they think about and respond to the child's problem. They also confirm the value placed on professional knowledge and the role it plays in communications between mothers and health professionals. Finally, they draw attention to how competing arguments about diagnosis and labelling delay identification and access to intervention programmes for children.
Health professionals working with mothers and young children should be aware of how their values, beliefs and communication styles affect their professional practice, especially when interacting with mothers who raise concerns about their children. State policies that limit access to early intervention programmes should also be reconsidered so that young children are not excluded from assistance.
近期研究显示，尽管在学前阶段表面上有为母亲及其子女提供全面的健康服务，但人们对入学时存在未被识别的发育问题的儿童数量越来越担忧。认识到早期发现和早期干预可降低长期健康和教育问题的可能性，了解为何如此多儿童在学前阶段未被检测出发育问题非常重要。
本博士研究利用母亲们的知识和经验，以引起对有轻微发育问题的儿童直到学龄才被识别的原因的关注。一种定性方法采用解释性传记和文学民俗学的综合，作为收集、阅读和解释个人故事的方法。分别源于符号学、新马克思主义和后结构主义原则的三种文学理论，被用于批判性地解构母亲们的故事。
研究结果突出了一些影响母亲、健康专业人员和社区成员之间互动的因素，以及这些互动如何影响儿童发育问题的早期发现。研究结果说明了社会神话对母亲和健康专业人员如何看待自己的角色，以及他们如何思考和应对儿童问题的影响。它们还证实了对专业知识的重视及其在母亲与健康专业人员沟通中所起的作用。最后，它们引起了人们对关于诊断和标签的相互竞争的论点如何延迟对儿童的识别以及获得干预计划的关注。
与母亲和幼儿打交道的健康专业人员应意识到他们的价值观、信念和沟通方式如何影响其专业实践，尤其是在与对孩子表示担忧的母亲互动时。限制获得早期干预计划的国家政策也应重新考虑，以便幼儿不被排除在援助之外。
