Does Developmental Content Influence the Effectiveness of Anticipatory Guidance?

Abstract

We conducted a prospective, controlled study to evaluate the value of discussing developmental stages with mothers while providing anticipatory guidance during health maintenance visits. Eighty-three inner city mothers and their healthy, first-born infants were recruited within three days of birth and randomly assigned to either a control or intervention group. All mother-infant pairs were seen by the same pediatric provider for health maintenance visits when the infants were 2 weeks, 2 months, 4 months, and 6 months of age. At each visit, anticipatory guidance for all mothers included discussions of such age-appropriate issues as nutrition, safety, sleep, and common problematic behaviors. For the 39 intervention group mothers, the basis for such information was explained through age-specific discussions of affective, cognitive, and physical development. Dependent variables measured after the 6-month visit included maternal-infant interaction; maternal perceptions of infant temperament, family adaptation and adjustment, and satisfaction with the infant's behavior and development; and maternal satisfaction with pediatric services. Analyses of variance demonstrated no significant effect of treatment group on any of the outcome measures. These results do not support the importance of routinely discussing developmental stages during anticipatory guidance and suggest that specific, age-appropriate issues may be discussed without emphasizing the developmental basis for such information.