Then and Now: A review of pediatric interview techniques

March 1, 2009

Dr. Michael S. Jellniek reivews a 1984 article from Dr. Morris Green on pediatric interview technqiues, finding that not much has changed regarding how to talk to kids and parents.

What makes this article timeless is the process described in the paper-interviewing and listening-skills intrinsic to medicine and to our humanity. Green describes in a sensitive manner how one person should elicit and listen to the concerns of another person. Written with wisdom, virtually every sentence in the article adds value. Some of the major points include:

There are many suggestions within the article for the wording of relevant questions. Some examples: "I am sure you must be very worried about your child's illness: Tell me about it." "You seem angry about something. Tell me what you think is wrong." "How have things been going between you and your husband?" "What was it like for you growing up?"

I had the honor of being the liaison representative from the American Academy of Child and Adolescent Psychiatry to the American Academy of Pediatrics' (AAP) Committee of Psychosocial Aspects of Child and Family Health, chaired by Green. Under his leadership this group issued "Guidelines for Health Supervision," numerous policy statements on key issues such as divorce and bereavement, and planted the seeds for the major initiative that Green led, Bright Futures.1 These handbooks provided the framework for high-quality, comprehensive pediatric primary care in the US, and were endorsed by dozens of leading professional organizations under the auspices of the AAP and Public Health Service.

Green also edited, along with Robert Haggerty, MD, the outstanding text Ambulatory Pediatrics.2 He wrote numerous articles including the Ask the Expert column in Contemporary Pediatrics where he responded to questions related to psychosocial issues. Many of the core concepts in his writings have been applied to the recent efforts defining a medical home for children and families.