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Paeds Topicsgrowth-development-and-behaviour

Paeds · growth-development-and-behaviour

Family-centred developmental care and goal setting

Also known as Patient and family-centered care · Family-centered developmental care · Goal attainment scaling paediatrics · COPM paediatric goals · F-words child development · Shared decision making disability · ICF-CY goal setting

Fellowship-level approach to family-centred developmental care and goal setting: PFCC principles, ICF-CY and F-words framing, SMART/GAS/COPM goals, shared decisions, structural barriers, and regional service models.

high14 referencesUpdated 11 July 20268 min readVerification in progress

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Target exams

RACP General PaediatricsRACP DWERACP DCERCPCH Progress+MRCPCH TheoryMRCPCH ClinicalABP General PediatricsACGME PediatricsRCPSC Pediatrics

Red flags

  • Family labelled 'non-compliant' without checking whether goals were realistic, understood or resourced
  • Child safety concerns hidden under partnership language — safeguarding still applies
  • Conflicting MDT goals that overload a single caregiver without a key worker
  • Adolescent voice excluded when the young person can participate in decisions
  • Service plan ignores poverty, transport, language or housing barriers blocking every goal
  • Token family presence at meetings with no shared power or written co-owned plan

Life stages

infanttoddlerpreschoolschool-ageadolescentyoung-adult-transition

Care settings

preventive-medical-homecommunity-schooloutpatientwarded-acutepicurural-remotetelehealth

Clinical exam formats

written-onlyracp-dce-long-casemrcpch-history-managementmrcpch-communicationrcpsc-structured-oral

Board mappings

  • General and Community Paediatrics
  • Developmental and Behavioural Paediatrics
  • Adolescent Medicine
  • Renewed curriculum for first-year trainees from 2027 — Learning goal 5: Clinical assessment – essential general paediatrics
  • Renewed curriculum for first-year trainees from 2027 — Learning goal 6: Clinical management – essential general paediatrics
  • Renewed curriculum for first-year trainees from 2027 — Learning goal 12: Communication with patients, families, and health professionals
  • Renewed curriculum for first-year trainees from 2027 — Learning goal 15: Essential general paediatrics
  • Renewed curriculum for first-year trainees from 2027 — Learning goal 20: Child safety and maltreatment
  • Clinical Applications
  • Long Cases
  • Communication
  • 4. Professional skills and knowledge: Patient management
  • 5. Health promotion and illness prevention
  • General Paediatrics: Works in partnership with children, young people and families
  • Foundation of Practice (FOP)
  • Applied Knowledge in Practice (AKP)
  • History
  • General Pediatrics Content Outline — Domain 1: Preventive Pediatrics/Well-Child Care
  • General Pediatrics Content Outline — Domain 4: Psychosocial Issues
  • General Pediatrics Content Outline — Universal Task 4: Management and Treatment
  • General Pediatrics Content Outline — Universal Task 5: Communication
  • Patient Care 5: Patient Management
  • Interpersonal and Communication Skills 1: Patient- and Family-Centered Communication
  • Systems-Based Practice 2: System Navigation for Patient-Centered Care
  • Medical Expert
  • Communicator
  • Collaborator
  • Health Advocate
  • Pediatrics: Foundations EPA #8 — Communicating assessment findings and management plans to patients and/or families
On this page
Study tools

Your progress

Saved on this device.

Practise this topic

  • Short-answer question1
  • Viva station1
  • Clinical case1

Target exams

RACP General PaediatricsRACP DWERACP DCERCPCH Progress+MRCPCH TheoryMRCPCH ClinicalABP General PediatricsACGME PediatricsRCPSC Pediatrics

Red flags

  • Family labelled 'non-compliant' without checking whether goals were realistic, understood or resourced
  • Child safety concerns hidden under partnership language — safeguarding still applies
  • Conflicting MDT goals that overload a single caregiver without a key worker
  • Adolescent voice excluded when the young person can participate in decisions
  • Service plan ignores poverty, transport, language or housing barriers blocking every goal
  • Token family presence at meetings with no shared power or written co-owned plan

Life stages

infanttoddlerpreschoolschool-ageadolescentyoung-adult-transition

Care settings

preventive-medical-homecommunity-schooloutpatientwarded-acutepicurural-remotetelehealth

Clinical exam formats

written-onlyracp-dce-long-casemrcpch-history-managementmrcpch-communicationrcpsc-structured-oral

Board mappings

  • General and Community Paediatrics
  • Developmental and Behavioural Paediatrics
  • Adolescent Medicine
  • Renewed curriculum for first-year trainees from 2027 — Learning goal 5: Clinical assessment – essential general paediatrics
  • Renewed curriculum for first-year trainees from 2027 — Learning goal 6: Clinical management – essential general paediatrics
  • Renewed curriculum for first-year trainees from 2027 — Learning goal 12: Communication with patients, families, and health professionals
  • Renewed curriculum for first-year trainees from 2027 — Learning goal 15: Essential general paediatrics
  • Renewed curriculum for first-year trainees from 2027 — Learning goal 20: Child safety and maltreatment
  • Clinical Applications
  • Long Cases
  • Communication
  • 4. Professional skills and knowledge: Patient management
  • 5. Health promotion and illness prevention
  • General Paediatrics: Works in partnership with children, young people and families
  • Foundation of Practice (FOP)
  • Applied Knowledge in Practice (AKP)
  • History
  • General Pediatrics Content Outline — Domain 1: Preventive Pediatrics/Well-Child Care
  • General Pediatrics Content Outline — Domain 4: Psychosocial Issues
  • General Pediatrics Content Outline — Universal Task 4: Management and Treatment
  • General Pediatrics Content Outline — Universal Task 5: Communication
  • Patient Care 5: Patient Management
  • Interpersonal and Communication Skills 1: Patient- and Family-Centered Communication
  • Systems-Based Practice 2: System Navigation for Patient-Centered Care
  • Medical Expert
  • Communicator
  • Collaborator
  • Health Advocate
  • Pediatrics: Foundations EPA #8 — Communicating assessment findings and management plans to patients and/or families
The fellowship answer

Family-centred developmental care means shared power, not polite presence. Start with what matters to the child and family, frame needs with ICF-CY participation and the F-words, co-write a small number of measurable goals (SMART, and when useful GAS or COPM), name who does what, and remove structural barriers. If a plan only works for the clinic timetable, it is not family-centred. [1] [5] [11] [13]

Overview & Definition

Developmental care fails when professionals set goals that families cannot own. The child may need therapy, equipment, school support and medical surveillance — but the family lives the timetable. Family-centred practice treats caregivers as experts on their child, shares honest information, and makes decisions together. That is clinical skill, not soft optional extras. [1] [7]

Patient- and family-centred care (PFCC) in AAP framing rests on dignity and respect, information sharing, participation and collaboration. In developmental services the same principles apply across clinic, home visiting, school and hospital. A family sitting in the room while you dictate six unprioritised targets is not family-centred care. [1]

Goal setting turns values into a plan you can review. Good goals are few, meaningful, observable and owned. Tools such as the Canadian Occupational Performance Measure (COPM) and Goal Attainment Scaling (GAS) help individualise and track change without pretending every child fits a standard score. [5] [6]

Two non-negotiable teaching points

1. Participation is the point. Fixating only on impairment scores misses school, play, friendships and family life — the outcomes families feel. [8] [11]

2. Systems can break partnership. Fragmented appointments, gatekeeping and inaccessible services create “non-engagement” that is structural, not moral. [13] [4]

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References14ShowHide
  1. [1]COMMITTEE ON HOSPITAL CARE and INSTITUTE FOR PATIENT- AND FAMILY-CENTERED CARE Patient- and family-centered care and the pediatrician's role. Pediatrics, 2012.PMID 22291118
  2. [2]Duffee JH Early Childhood Home Visiting. Pediatrics, 2017.PMID 28847981
  3. [3]Kuo AA Pediatricians and Public Health: Optimizing the Health and Well-Being of the Nation's Children. Pediatrics, 2018.PMID 29358481
  4. [4]COUNCIL ON COMMUNITY PEDIATRICS Poverty and Child Health in the United States. Pediatrics, 2016.PMID 26962238
  5. [5]Carman S Lower limb orthopedic surgery in children and adolescents with cerebral palsy is well captured using individualized Goal Attainment Scale (GAS) and Canadian Occupational Performance Measure (COPM) goals. Disability and rehabilitation, 2025.PMID 40257191
  6. [6]Hwang Y Individualized Goal Setting for Pediatric Intensive Care Unit-Based Rehabilitation Using the Canadian Occupational Performance Measure. Children, 2023.PMID 37371217
  7. [7]Britt K Family-centred service in childhood disability: a qualitative study of service providers perspectives on their approaches to practice. Disability and rehabilitation, 2026.PMID 41964287
  8. [8]Abbas R An international classification of functioning, disability and health-children and youth (ICF-CY) based assessment tool for evaluating impairments, function and participation of children and adolescents with cerebral palsy in special education schools. Pakistan journal of medical sciences, 2026.PMID 42369915
  9. [9]van Ossenbruggen RM Classification of patient-defined hand-arm treatment goals in young people with cerebral palsy and upper extremity spasticity undergoing upper extremity surgery. Disability and rehabilitation, 2026.PMID 42226630
  10. [10]Iype M Quantifying Disability in Children Challenged by Communicative and Cognitive Disorders Using the ICF-CY-Checklist: Results of a Cross-Sectional Study of a Retrospectively Assembled Cohort. Pediatric neurology, 2026.PMID 41780223
  11. [11]Canlas K Families' perspectives and experiences in using the F-words for Child Development in daily life and services. Disability and rehabilitation, 2026.PMID 42400954
  12. [12]Canlas K Exploring Health Care Providers, Families and Educators' Perceptions of an Online Self-Paced F-Words for Child Development Foundations Course. Child: care, health and development, 2026.PMID 41994940
  13. [13]King G Does the healthcare system support family-centred service?: linking structural issues in healthcare service delivery to parents' relational experiences of care. Disability and rehabilitation, 2026.PMID 41879330
  14. [14]Council on Community Pediatrics Providing care for children and adolescents facing homelessness and housing insecurity. Pediatrics, 2013.PMID 23713108

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