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.