Parent Developmental Concerns, Developmental Assessments, and Anticipatory Guidance for Young Undocumented Children in Los Angeles

Healthy Kids in Los Angeles County, California covers children in households under 300% of the federal poverty level who are not eligible for existing public insurance programs and lack private coverage. Most of the children who are covered are undocumented Latino children. In a two-wave telephone survey of just over 1000 parents of Healthy Kids children ages one to five, we asked parents about their developmental concerns for their children along numerous dimensions (for example, concerns about communication, behavior, and feeding). We also asked whether, during pediatric visits, the doctor asked about their concerns and addressed them, and whether the doctor did a formal developmental assessment or gave guidance about various important topics. About half of parents expressed some concern about their child's development, but only about a quarter had been recently asked about their developmental concerns by the child's provider. Parents were most concerned about emotional and behavioral issues (about a quarter of parents), as well as about how their child communicates. A relatively high rate of parents (about 60 percent) reported their child had had a developmental assessment, about the rate for all children nationally. However, often parents did not receive anticipatory guidance from their child's provider on the things with which they were most concerned. Pediatric providers may need more training in how to address such parents' concerns, in order to assure the adequate growth and development of children newly arrived in the United States.