The diagnosis announcement : a complex situation

I have chosen to write about an internship experience that raised questions for me and helped me understand more about the status of the psychologist in a team. This experience is related to my M1 internship in a Centre d’Action Medico-Social Précoce that allowed me to have an insight into different areas of care for children with special needs, which is the field of expertise in which I would like to practice. It is a structure that offers consultations for children from 0 to 6 years old and allows global and early care of the child who presents or is at risk of having developmental difficulties. The health professionals working in this structure are responsible for the early detection of disorders, if not already done, additionally to the children’s care. This experience that I want to describe is related to my subjective perception of the situation. Thus, this reflection is in no way a reconsideration of the work done by health professionals.

During a feedback meeting, which is a meeting where the team that follows the child welcomes the parents to explain the Individual Care Project of the child to them, the doctor had to announce to the parents a possible Autism Spectrum Disorder. However, the doctor used a lot of particularly scientific terms that the parents did not seem to understand clearly. Yet, they did not have any questions and seemed to be in denial about their child’s condition. Nevertheless, the psychologist supported the doctor’s explanations to clarify what this disorder is about, which remains complex for those who do not know what is it about. Thus, they left agreeing with the proposed care even though I felt like they were still doubtful and lost.

There is no good way to announce a diagnosis since there will often be negative, heavy, and lasting consequences. I, therefore, think that how things are said will influence the acceptance of the disorder by the parents and that here, the doctor may have gone a little too quickly in explaining the ASD instead of bringing things forward little by little. Hence, the parents have probably selected and retained only a few elements. However, I also understand that it is difficult to announce some specific aspects of the disorder without medical terms, which we are working with every day.

At the end of my internship, I attended other feedback meetings that made me understand several things. The doctor was able to clearly explain the suspicion of ADHD to other parents, pointing out the caution to take because of the young age of the child and approaching the question of treatments in a precise way. The parents also played a role that day because they were very demanding and asked specific questions. Therefore, I understood that both professionals and families influence each other in their speech and their way of reacting.

In short, I do not bring a solution or a better way of doing things. Nonetheless, it gave me ideas for my future practice (preparing disorder explanation with simple words; having additional information on hand…). To help families, we need to inform them as much as possible, give them keys to break their representations, and be sure that they measure the situation and the possibilities of evolution of the child. It is the empathy, the kindness, and the listening of the professionals who announce, which can lessen the pain that the words will cause. That is how we built a relationship based on trust.