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(やまだぃちぅ) #1

Empowering Parent–Child Communication: Making


Visible the Invisible


Increasing scientific understanding and articulation of normal growth will enhance


our ability to help parents support children as they cope with changes they expe-


rience in their bodies. With each child, parents and caregivers must learn to read


and interpret new and often conflicting cues that are delivered through body lan-
guage, crying, and other aspects of temperament. Without an understanding of the


biochemical and architectural alterations occurring during development, parents


may agonize over the meaning of their child’s behavioral shifts and how best to


deal with them. Several ethnographic reports have endeavored to describe how


parents both react to and are affected by periods of discord. Long and Johnson


( 2001 ) found that frequent crying bouts greatly increased family strain and drove


parents to turn to medical solutions, searching for definitive clinical diagnoses for


their child’s behavior. Megel et al. ( 2011 ) specifically investigated mothers’per-


ceptions of behavioral outbursts and noted that an inconsolable infant decreased her


sense of competence and encouraged her to seek clinical explanations for the


crying. McCallum et al. ( 2011 ) similarly documented that parents and families


experiencing despair over their child’s emotional reactivity reached out more fre-


quently to obtain healthcare services. This often resulted in a lack of medical


support as well as conflicting advice. The lack of answers or treatment suggestions


that accompany many of these medical encounters ultimately fuel the very“hope


and despair cycles”(Megel et al. 2011 ) that initially drive parents to seek help.


The lack of scientific codification to describe normal growth biology and the


concomitant behavioral expressions leaves parents in a vacuum for understanding


their child’s fussy behavior. Feeling isolated and incompetent, parents often pres-


sure pediatricians intofinding a diagnosis for their child in order to validate their


distress. The increasing prevalence of diagnoses with gastroesophageal reflux dis-


ease (GERD) among infants (El-Serag et al. 2014 ) may, in part, reflect persistence
among parents who are seeking a diagnosis for unexplained cry/fuss behavior. This


is suggested by comparison with data from prolonged esophageal pH monitoring


which identifies that in the absence of vomiting, GERD is actually an uncommon


cause of infant irritability (Heine et al. 1995 ).


As diagnostic categories are the primary mode of communication between


physician and patient (Rosenberg 2002 ), assigning the growth experience a


definitive diagnosis could be empowering for both parents and children in coping


with a fundamental experience of life. A category like“Pre-growth syndrome”may


enhance parental identification of their experience and improve their understanding


of the behavioral expressions of saltatory growth. On the other hand, normal


children are not“patients”when they grow. To date, pediatric practice has not


embraced the reality of saltatory growth biology, limiting conversations about


growth-related behavioral phenomena between parents and pediatricians. Increasing


pediatric understanding of growth biology and the associated biobehavioral com-


plex has fundamental importance for parent–child relationships.


60 M. Lampl et al.

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