Parents’ Priorities in Choosing Support Options for Preschool-Aged Children

Abstract

Parents’ priorities significantly influence decisions regarding their children’s support, reflecting parental attitudes, knowledge, and experiences. This research aimed to identify parents’ priorities when choosing professional support for their children, examine the link between these priorities and children’s current abilities, and examine which developmental domains children receive professional support and whether these domains align with parental priorities. The sample consisted of 82 parents of children aged three to six years, divided into two groups: 41 parents of children with developmental disabilities and 41 parents of children without. All participants completed a Treatment Priorities Questionnaire (TP). The results showed that parents of children with developmental disabilities prioritize Communication skills, Social relationships, and Pre-Academic skills. In contrast, parents of children without developmental disabilities focus on Self-Care and Pre-Academic skills. These priorities often relate to the child’s areas in need of improvement. While children with developmental disabilities receive appropriate support, those without often do not receive support in the areas their parents prioritize. This highlights the need for parents to also recognize and build on their child’s strengths, creating a more balanced approach to their development.

1. Introduction

The concept of early intervention, which began its intensive development in the 1970s [1], highlighted the importance of allowing parents to define their priorities when choosing professional support for their child. An important part of the early intervention concept is the family-centered approach, which promotes that parents have the deepest understanding of their children’s development and are best equipped to recognize and respond to children’s needs. The essence of the concept of families at the center is the provision of support tailored to the family’s specific needs, values, and resources, with cooperation and open communication with the expert [2].

One notable aspect of this concept is that experts are increasingly adopting a collaborative approach rather than maintaining a strictly authoritative role when providing support. This partnership between parents and professionals focuses on considering parents’ needs and priorities to guide the structure of support. The emphasis is now more on the child’s natural development, empowering parents to use everyday situations (such as eating, dressing, bathing, and preparing a meal) as opportunities to foster their child’s growth [1,3].

In this approach, parents’ priorities are not a secondary element, but a central starting point for planning support. Defining priorities with parents helps clarify what they see as most important, sets more realistic goals, fosters greater family empowerment, and increases the likelihood of positive outcomes for the child. In other words, parental priorities operationalize the principle that the family is an active decision-maker and partner in the creation and implementation of interventions, which is the essence of a family-centered approach. When professional assessments are integrated with what parents see as most important, a shared decision framework is created that increases the relevance of the intervention and the likelihood of sustainable outcomes. Parental priorities serve as a bridge between family values and professional interventions, helping adapt the support plan to the family’s actual capabilities, strengths, and daily routines [2,3].

Research has demonstrated that when parents are allowed to define their priorities in choosing support for their child, they become more actively involved in implementing that support. This involvement leads to reduced levels of parental anxiety and stress, increased satisfaction with the support provided, and a quicker acceptance of the child’s condition. All of these factors contribute to the overall effectiveness of the child’s support, resulting in the timely achievement of established goals [4]. Since priorities are closely linked to parents’ expectations, which can sometimes be unrealistic, it is essential to assist parents by providing relevant information as they define their priorities when choosing support [5,6]. The literature indicates that parents of children with higher levels of functioning are generally more engaged in providing support [7]. Therefore, it is crucial to encourage and facilitate the involvement of parents whose children face significant developmental challenges.

Research indicates that when choosing support, parents often prioritize areas where their child exhibits the lowest functional abilities or the most significant challenges [8,9]. The most common focus for parents of children with motor development issues is mobility and self-care. In contrast, parents of children facing speech, language, and socialization challenges tend to prioritize communication and social interactions [8,10]. While it is crucial to consider family priorities in the early stages of support, these priorities evolve as the child develops, necessitating periodic reassessment [11,12]. At an early age, priorities typically revolve around enhancing abilities within specific developmental domains. As the child matures, the focus shifts to fostering life skills for functioning within the household, community, or workplace [13]. Brandao et al. [14] conducted research involving children with motor development challenges aged 3 to 16 years and found that Self-Care skills remain a priority for parents when selecting expert support, regardless of the child’s age.

Research on this topic typically does not concentrate solely on preschool children; instead, the age range of respondents spans from 2 to 21 years. The emphasis is mainly on the priorities of parents with older children, adolescents, and young adults [8,9,15,16,17,18]. While the preschool years are crucial for developing a child’s abilities and skills, the literature indicates that parents of younger children are generally more involved in supporting their children, highlighting the need to encourage this engagement [7]. Furthermore, a review of the literature reveals a lack of studies focusing on the priorities of parents with children who do not have developmental disabilities. Although these children do not exhibit detectable disturbances in any specified domains, this does not rule out the potential for challenges in acquiring specific skills and the corresponding need for support. Research suggests that even children without developmental disabilities may experience difficulties with certain activities, such as those in the Self-Care domain. Success in these activities can be influenced by various factors beyond the presence of a disability in one or more domains of development [19].

Local Context in Serbia

According to the latest census, Serbia has approximately 6.8 million inhabitants, of whom about 6.5% are children under 7 years old [20]. While the exact number of children with developmental disabilities in Serbia is not known, it is estimated that 3–22% of children worldwide have some form of disability. This statistic can also be applied to Serbia [21].

A situational analysis conducted by United Nations Children’s Fund (UNICEF) [22] assessed the services available for infants and young children in Serbia. The results revealed that the support provided to children is often not aligned with their parents’ priorities. Additionally, parents are frequently not well-informed about available services. Many search for support independently due to long waiting lists and a shortage of qualified experts. Furthermore, the fear of stigma often leads parents to delay seeking help for their child, even when they recognize developmental issues. While parents generally perceive their child’s work with a specialist as beneficial, they also see it as a break for themselves. This leads to a more passive role in providing support. Their limited involvement is further affected by the fact that interventions typically occur in various institutions-both private and public- where the child engages only with the expert while parents wait in separate areas. As a result, some recommendations from the situational analysis emphasize the need for a better understanding of family needs, increased parental involvement in the support process, and the incorporation of everyday situations as learning opportunities.

In the past six years, two surveys have been conducted in Serbia focusing on family needs and priorities. The first survey, conducted by Pejović-Milovančević et al. [15] involving 231 parents of children with autism with an average age of 10.5 years, found that parents of children with developmental disabilities prioritize professional support in areas such as Communication, Social relationships, and Self-care skills. The second survey by Đorđević et al. [9], involving 141 parents of children with autism, with an average age of 11.4 years, indicated that parents also prioritize communication and social interactions, but also emphasize academic skills and skills necessary for community life. Furthermore, 50–60% of children receive professional support that aligns with their parents’ identified priorities, indicating partial alignment between parental priorities and professional support within the Serbian system.

Previous research in Serbia was mostly focused on older children or on specific diagnostic groups (children with autism), while the priorities of parents of preschool children, especially parents of children without developmental disabilities, remained insufficiently researched. In addition, the situational analysis results point to systemic challenges, including insufficient parental information, long waiting lists, fragmented services, and limited parental involvement in the support process [9,15,22]. These systemic challenges can affect how parents define their priorities and the extent to which professional support aligns with them. Based on the above, this research builds on existing findings in Serbia. Still, it expands them by focusing on children aged three to six years, including parents of children without developmental disabilities. Therefore, based on previous national findings, it is expected that communication and social domains will emerge as dominant priorities among parents of children with developmental disabilities. In contrast, potential differences may emerge in the group of parents of children without developmental disabilities, given that previous Serbian studies did not include this population.

Understanding parents’ priorities when choosing professional support is crucial, as it provides insights into how parents perceive the importance of developmental support and their child’s functioning across various skills. Moreover, it is essential to consider the relationship between parents’ priorities, the support provided by professionals, and the availability of different types of support. Research in this area sheds light on parents’ perceptions and offers insights into professionals’ focus, helping us determine whether their efforts align with parents’ priorities.

Consequently, this research aimed to identify parents’ priorities when choosing professional support for their children, examine the link between these priorities and children’s current abilities, and examine which developmental domains children receive professional support and whether these domains align with parental priorities.

2. Methods

2.1. Procedures

The research was conducted at two institutions: a preschool and a speech and language therapy center, both established in cooperation with the Center for Social Work in a municipality within the Zapadnobacki District of Vojvodina, Serbia. These institutions were selected because they are representative of that region. These institutions were selected because they represent the primary public service providers for preschool education and early intervention within the municipality. In addition to children without disabilities, the preschool institution includes children with developmental disabilities from across the municipality in regular groups. Graduate and professional educators, as well as nurse educators, conduct educational activities. This preschool is the largest institution in the municipality and the only one to provide full-day care for children. All preschool and school-age children in the municipality receive support from the speech-language therapy center, as determined by the Interdepartmental Commission. Within the municipality, this center constitutes the sole institution providing this type of service. These institutions include large numbers of children and reflect the typical organizational and service characteristics of early childhood support systems in Serbia. This support is provided by speech therapists, special educators, and psychologists. Before conducting the research, permission was obtained to use the instrument that assesses parents’ priorities when choosing professional support (Treatment Priorities Questionnaire), developed by Pituch et al. [18]. After receiving permission from one of the authors, Jeff Sigafoos, a double-anonymized translation of the instrument was performed. One translator first translated the instrument from English to Serbian, and a second translator then translated it back to English. The text’s consistency was then checked, revealing no deviations. All relevant documentation was submitted to the Faculty of Medicine Ethics Commission in Novi Sad, which granted permission to conduct the research (decision number 01-39/173-1). The questionnaire was distributed to the preschool head teacher and the speech and language therapy center coordinator, who then forwarded it to the employees who interact directly with the children’s parents. Within the institution, all parents completed a questionnaire during their children’s drop-off or pick-up at the preschool or treatment sessions at the end of the school year. Employees assisted parents in filling out the questionnaire, if needed, and clarified the meaning of items without influencing their answers. Parents wishing to participate in the research provided written consent before completing the questionnaire. Only one parent, either the father or the mother, filled out the questionnaire for each child. If a parent had multiple children aged three to six, they completed a separate questionnaire for each child. Participation was voluntary and anonymous, and parents could withdraw at any stage. The questionnaire included an email address and a phone number for the principal researcher to facilitate communication in case of questions. A total of 100 questionnaires were distributed (50 per institution), of which 90 were completed and returned, while 10 remained unfilled. Of the 90 questionnaires received, eight were excluded due to incomplete responses.

2.2. Sample

The sample consisted of 82 respondents, all parents of children aged three to six years. The participants were divided into two groups: the first group included 41 parents of children with developmental disabilities, and the second group included 41 parents of children without developmental disabilities. Most questionnaire respondents were mothers (90%), with fathers making up the remaining 10%. The average age of the parents in the entire sample was 36.56 years (SD = 5.99). The average age of children with developmental disabilities was 4.54 years (SD = 0.98), while the average age of children without developmental disabilities was 4.34 years (SD = 1.09). The children’s age range was determined to align with the preschool educational group categories (younger, middle, older, and preparatory preschool groups). Among the children with developmental disabilities, those whose parents answered “yes” to the question “Does your child exhibit a disability/problem in some aspects of development?” were included. According to parents, the majority of children with developmental disabilities (58.54%) exhibited problems in speech and language development, 31.71% had combined disabilities, 4.88% had sensory impairments, 2.44% showed emotional development problems, and 2.44% faced challenges in socialization. Notably, no child was reported to have an isolated motor or cognitive development disorder. Within the group of children with combined disabilities, parents noted that 76.92% exhibited problems related to speech and language, emotional development, and socialization. Additionally, 15.38% demonstrated difficulties in speech, language, and motor development. One child (7.69%) was reported by their parents to have delays across all listed developmental domains.

No statistically significant differences were found between the essential socio-demographic characteristics of families with children who have disabilities and those with children who do not. The only exception was work status, where a significant difference was observed. Results from the Chi-square test (χ² = 4.986; p = 0.026) indicated that a higher percentage of parents of children with disabilities were unemployed compared to parents of children without disabilities (17.1% versus 2.4%).

The socio-demographic characteristics of the sample are presented in

Table 1. Differences in the socio-demographic characteristics of the examined sample.

Sample Description	Without Developmental Disabilities (N = 41)	With Developmental Disabilities (N = 41)	Total Sample	Hi-Square Test
Parents’ gender				0.554
Female	36 (87.8%)	38 (92.7%)	74 (90.2%)
Male	5 (12.2%)	3 (7.3%)	8 (9.8%)
Parents’ age				−0.220
Range	25–50 years	23–50 years	23–50
(M; SD)	36.41 (6.50)	36.71 (5.51)	36.56 (5.99)
Marital status				1.167
Married	34 (82.9%)	34 (82.9%)	68 (82.9%)
Divorced	4 (9.8%)	2 (4.9%)	6 (7.3%)
Extramarital union	3 (7.3%)	5 (12.2%)	8 (9.8%)
Place of residence				0.265
Urban	30 (73.2%)	32 (78.0%)	64 (78%)
Rural	11 (26.8%	9 (22.0%)	18 (22%)
Parents’ education				8.830
Elementary school	0 (0.0%)	1 (2.4%)	1 (1.2%)
High school	17 (41.5%)	15 (36.6%)	32 (39%)
College	4 (9.8%)	0 (0.0%)	4 (4.9%)
Faculty	16 (39.0%)	14 (34.1%)	30 (36.6%)
Master	4 (9.8%)	10 (24.4%)	14 (17.1%)
Ph.D	0 (0.0%)	1 (2.4%)	1 (1.2%)
Work status				4.986 *
Employed	40 (97.6%)	34 (82.9%)	74 (90.2%)
Unemployed	1 (2.4%)	7 (17.1%)	8 (9.8%)
Monthly income				0.905
10,000–50,000 RSD	10 (24.4%)	8 (19.5%)	18 (22%)
50,000–100,000 RSD	19 (46.3%)	17 (41.5%)	36 (43.9%)
Više od 100,000 RSD	12 (29.3%)	16 (39.0%)	28 (34.1%)
Number of households				3.222
Two members	1 (2.4%)	1 (2.4%)	2 (2.4%)
Three members	15 (36.6%)	10 (24.4%)	25 (30.5%)
Four members	20 (48.8%)	25 (61.0%)	45 (54.9%)
Five members	2 (4.9%)	4 (9.8%)	6 (7.3%)
Six members	3 (7.3%)	1 (2.4%)	4 (4.9%)
Number of children				2.094
One child	16 (39%)	12 (29.3%)	28 (34.1%)
Two children	22 (53.7%)	23 (56.1%)	45 (54.9%)
Three children	3 (7.3%)	5 (12.2%)	8 (9.8%)
Six children	0 (0.%)	1 (2.4%)	1 (1.2%)
Child’s gender				1.268
Boy	22 (53.7%)	27 (65.9%)	49 (59.8%)
Girl	19 (46.3%)	14 (34.1%)	33 (40.2%)
Child’s age				2.042
Three years	11 (26.8%)	6 (14.6%)	17 (20.7%)
Four years	13 (31.7%)	15 (36.6%)	28 (34.1%)
Five years	9 (22%)	12 (29.3%)	21 (25.6%)
Six years	8 (19.5%)	8 (19.5%)	16 (19.5%)

Note: * p < 0.05.

.

2.3. Instrument

Respondents began by completing a general questionnaire in two parts. The first part collects general information about the parents through 10 questions covering the following aspects: gender, age, place of residence, education, employment status, marital status, monthly income, number of children, and number of households. The second part gathers general information about the child. It includes four questions addressing the child’s developmental disability, the specific domains affected (such as speech and language, motor skills, cognitive/intellectual abilities, emotional development, socialization, combined disabilities, and sensory impairments, either visual or hearing), and the child’s gender and age. The question regarding the child’s level of functioning is included in a separate questionnaire, the questionnaire for examining parental priorities (Treatment Priorities), under the Current Abilities section, and is not part of the general questionnaire. Most questions in the general questionnaire are closed-ended, allowing parents to select the response that applies to them or their child. However, a few open-ended questions require respondents to provide additional information. These open-ended questions pertain to the number of household members, the number of children in the family, and the types of combined disorders affecting the child.

The study utilized a Treatment Priorities Questionnaire (TP) designed to examine parental priorities in choosing support options for their children, developed by Pituch et al. based on the International Classification of Functioning, Disability and Health (ICF) [17]. In its original format, the questionnaire consists of questions about 54 skills categorized into 10 areas of development. These areas and their respective skills include: Self-Care (7 items): for example, personal hygiene skills such as bathing, hand washing, and body care (brushing teeth, dressing); Life skills within the household (5 items): For example, cooking (preparing meals/snacks) and housekeeping (washing dishes, making the bed, grocery shopping); Community skills (5 items): for example, visiting public places like restaurants, cafes, and cinemas, as well as using public transport; Work skills (4 items): these include work ethics (punctuality) and social skills in the workplace; Recreation skills (5 items): related to playing with toys and peers and engaging in sports; Communication skills (8 items): skills in expressing wants and needs, naming objects, describing events or feelings, and following instructions; Motor skills (6 items): Gross motor skills like sitting upright and carrying objects, and fine motor skills like handling and buying objects; Social relationships (7 items): skills related to showing affection, initiating interactions, and communicating appropriately with others, including those with disabilities; Academic skills (6 items): initially aimed at traditional academic skills, this area was renamed “Pre-Academic skills” for the intended age group. Skills were adapted to include listening to educators, reading picture books, counting, and graphomotor exercises; Behavior problems (10 items): addressing issues such as eating problems, sleep disturbances, tantrums, physical aggression, self-harm, hyperactivity, insistence on routine, and resistance to change. For this study, which included children aged three to six years, the areas of life skills within the household and community, and skills required for work were excluded from the questionnaire because these skills do not apply to the age of the respondents.

The Behavior problems area is different, so it implies a focus on difficulty controlling behavior; 0 indicates no problem, and 4 indicates a significant challenge. Each mental area was organized into three sections.

The first section assessed the child’s current level of functioning and the extent of support required for each specific skill. Items were rated on a 5-point scale: Functions are independent-(0), Needs reminding-(1), Needs some assistance-(2), Needs considerable assistance (3), Is totally dependent-(4). Higher scores indicated greater support needs. Domain scores were calculated as the mean of all items within each area, with higher scores reflecting greater overall dependence. The second section assessed parental priorities for each skill within the domain. Parents rated each item on a 5-point scale: Not at all priority (0), Low priority (1), Medium priority (2), High priority (3), Very high priority (4). A domain-level priority score was computed as the mean of item ratings, with higher scores indicating greater perceived importance of that developmental area. The third section examined whether the child was currently receiving professional support for skills identified as priorities. Responses were coded as 0 (yes), 1 (no), and 2 (not sure). For descriptive analyses, frequencies and percentages were calculated for each response category.

The Content Validity Index for the questionnaire was 0.97 [23], and it takes approximately 10 min to complete.

Our research examined the internal consistency, or reliability, of the Parental Priorities Questionnaire (TP) using Cronbach’s alpha.

Based on

Table 2. Internal consistency of the Treatment Priorities Questionnaire (TP).

Dimensions of the Questionnaire		Number of Items	Cronbach’s Alpha Coefficient
Child’s Current Abilities	Self-Care skills	6	0.919
	Recreation skills	4	0.846
	Motor skills	5	0.882
	Communication skills	7	0.950
	Social relationships	5	0.821
	Pre-Academic skills	5	0.863
	Behavior problems	10	0.836
Priorities for parents	Self-Care skills	6	0.978
	Recreation skills	4	0.947
	Motor skills	5	0.969
	Communication skills	7	0.994
	Social relationships	5	0.975
	Pre-Academic skills	5	0.977
	Behavior problems	10	0.977

, the Treatment Priorities Questionnaire (TP) dimensions are highly reliable for assessing current abilities and priorities. All dimensions demonstrate strong metric characteristics, as indicated by Cronbach’s alpha coefficients ranging from 0.821 to 0.977.

2.4. Statistical Analysis

Data entry and processing were conducted using SPSS 27. Frequency and percentage displays were utilized to illustrate the representation of specific categories or responses when analyzing and describing the sample structure based on relevant variables. Descriptive statistical methods were employed to determine the central tendency measures (arithmetic mean), variability measures (standard deviation), and extreme values (minimum and maximum) of the observed numerical features. To investigate potential differences between children without developmental disabilities and those with developmental disabilities across various socio-demographic variables, a series of Chi-square tests for independent samples was performed. Cronbach’s alpha coefficient assessed the scale’s overall internal consistency. Although some measures met the criteria for continuous (numerical) variables, the observed non-normal distributions allowed the use of non-parametric methods for specific hypotheses. To explore differences between parents of children with and without developmental disabilities in their definitions of priorities and assessments of the child’s current abilities, Student’s t-test for independent samples was applied. Alternatively, Mann–Whitney U tests were used when the data failed normality assumptions. Therefore, the direction of group differences was interpreted based on the mean values of each group. The effect size of the differences between the two groups was estimated using Cohen’s d. Spearman’s correlation coefficient was used to examine the relationship between parental priorities and the child’s current abilities. In all applied tests, the significance level was set at 95% (p < 0.05), indicating that the differences in statistical parameters are considered significant.

3. Results

To examine differences between the two groups (parents of children with and without developmental disabilities), independent-samples t-tests were used for normally distributed variables, while the Mann–Whitney U test was used for variables that did not meet the assumptions of normality. The negative t-test reflects the order of the group comparison and does not indicate the direction of the differences. In the present analysis, the group of children without developmental disabilities was entered first, followed by the group of children with developmental disabilities. Given that children without developmental disabilities generally had lower mean scores across domains, negative t-test values were expected. In addition to statistical significance, effect sizes were calculated using Cohen’s d to assess the magnitude of the observed differences.

A review of

Table 3. Differences in average achievement between the two examined groups on the Treatment Priorities Questionnaire (TP) dimensions.

	Developmental Domain	Without Developmental Disabilities (N = 41) (M ± SD)	Min–Max	With Developmental Disabilities (N = 41) (M ± SD)	Min–Max	t/U	p	Cohen’s d
Child’s Current Abilities	Self-Care skills	0.75 ± 0.81	0–4	1.41 ± 1.14	0–4	−3.027	0.003 **	0.67
	Recreation skills	0.27 ± 0.45	0–4	0.96 ± 1.04	0–4	U = 486.0	≤0.0001	0.86
	Motor skills	0.03 ± 0.16	0–4	0.43 ± 0.85	0–4	U = 530.5	≤0.0001	0.65
	Communication skills	0.22 ± 0.41	0–4	1.45 ± 1.24	0–4	−6.071	≤0.0001	1.33
	Social relationships	0.11 ± 0.22	0–4	0.65 ± 0.79	0–4	U = 447.5	≤0.0001	0.93
	Pre-Academic skills	0.91 ± 0.46	0–4	1.67 ± 0.86	0–4	−4.990	≤0.0001	1.10
	Behavior problems	0.26 ± 0.33	0–4	0.83 ± 0.65	0–4	−5.029	≤0.0001	1.11
Priorities for parents	Self-Care skills	1.91 ± 1.42	0–4	2.38 ± 1.37	0–4	−1.517	0.133	0.34
	Recreation skills	1.48 ± 1.42	0–4	2.23 ± 1.26	0–4	−2.527	0.013 *	0.56
	Motor skills	1.10 ± 1.31	0–4	1.91 ± 1.42	0–4	−2.672	0.009 **	0.59
	Communication skills	1.48 ± 1.41	0–4	2.90 ± 1.23	0–4	−4.850	≤0.0001 **	1.08
	Social relationships	1.54 ± 1.38	0–4	2.51 ± 1.26	0–4	−3.332	0.001 **	0.73
	Pre-Academic skills	1.83 ± 1.48	0–4	2.80 ± 1.11	0–4	−3.372	0.001 **	0.73
	Behavior problems	1.29 ± 1.34	0–4	2.15 ± 1.40	0–4	−2.824	0.006 **	0.62

Note: * p < 0.05, ** p < 0.01.

reveals a statistically significant difference between the two groups examined: parents of children with disabilities and parents of children without disabilities. This difference is evident in assessing the current abilities across several domains, including Self-Care skills, Recreation skills, Motor skills, Communication skills, Social relationships, Pre-Academic skills, and Behavior problems. Generally, children with developmental disabilities scored higher in these domains, indicating greater difficulties and a greater need for support in performing various activities. Within the group of children with developmental disabilities, the lowest level of ability is observed in the Pre-Academic skills domain, followed by the Communication and Self-Care domains. Conversely, in children without disabilities, the lowest level of ability is seen in the Pre-Academic skills domain, followed closely by Self-Care. The magnitude of these differences, as indicated by Cohen’s d, ranged from moderate to large across most domains, with particularly large effects observed in Communication skills, Behavior problems, and Pre-academic skills. Furthermore, Table 3 highlights a significant difference in the priorities for choosing support options between the two groups across all domains—Recreation skills, Motor skills, Communication skills, Social relationships, Pre-Academic skills, and Behavior problems—except for the Self-Care domain. Parents of children with developmental disabilities assigned higher importance to these domains compared to parents of children without developmental disabilities. Among children with developmental disabilities, the highest average scores were achieved in Communication skills, Pre-Academic skills, and Social relationships. In contrast, children without developmental disabilities scored highest in the Self-Care and Pre-Academic skills domains. Both groups recorded the lowest average scores in the Motor skills domain, indicating lower prioritization of this area when choosing support options. Although Behavior problems were not among the highest-ranked priorities overall, this domain showed a statistically significant difference between the groups, indicating that it is more salient for parents of children with developmental disabilities.

Spearman’s rank correlation coefficient was used to examine the relationship between parents’ priorities and their child’s current abilities in specific developmental domains.

Table 4. The correlation between the child’s abilities and the parents’ priorities in choosing support options.

Without Developmental Disabilities (N = 41)		Child’s Current Abilities
		Self-Care Skills	Recreation Skills	Motor Skills	Communication Skills	Social Relationships	Pre-Academic Skills	Behavior Problems
Priorities for parents	Self-Care Skills	0.087	−0.169	−0.015	−0.103	−0.235	−0.120	−0.049
	Recreation skills	0.226	0.019	0.093	0.126	−0.015	0.174	0.020
	Motor skills	−0.046	0.017	0.186	0.001	−0.053	0.089	0.018
	Communication skills	−0.007	−0.181	−0.112	0.106	−0.082	0.053	0.025
	Social relationships	−0.204	−0.336 *	−0.165	−0.180	−0.085	−0.139	−0.112
	Pre-Academic Skills	−0.068	0.004	−0.002	0.029	−0.117	0.097	0.040
	Behavior problems	0.016	0.041	0.202	0.125	−0.045	0.116	0.096
With Developmental Disabilities (N = 41)
Priorities for parents	Sel -Care Skills	0.269	0.270	0.251	0.114	0.321 *	0.170	0.191
	Recreation skills	0.321 *	0.386 *	0.274	0.292	0.491 **	0.278	0.381 *
	Motor skills	0.019	0.012	0.118	0.019	0.172	0.140	−0.017
	Communication skills	0.006	0.003	−0.044	0.292	0.087	0.011	−0.002
	Social relationships	0.171	0.138	0.128	0.265	0.324 *	0.176	0.143
	Pre-Academic skills	0.047	0.091	0.087	0.274	0.102	0.133	0.153
	Behavior problems	0.250	0.234	0.131	0.223	0.302	0.432 **	0.387 *

Note: * p < 0.05, ** p < 0.01.

illustrates a positive correlation between low and medium intensity in each aspect of functioning. These correlations range from r = 0.118 to r = 0.387. U values represent the Mann–Whitney U test statistics. The most significant statistically meaningful correlation, showing the highest intensity, occurs within the Behavior problems, Recreation skills, and Social relationships domains. Conversely, the lowest intensity correlations are found in the Motor skills and Pre-Academic skills domains. In the group of children with developmental disabilities, parental priorities are significantly positively correlated with the child’s current level of functioning. This indicates that parents tend to prioritize domains where their child faces greater challenges. In contrast, no statistically significant correlations were observed in the group of children without developmental disabilities, suggesting that parental priorities in this group are not directly determined by the child’s current level of ability.

We analyzed responses from both groups in the TP questionnaire to determine the frequency with which professional support is received in the child development areas that parents prioritize.

Table 5. The frequency of responses regarding obtaining professional support.

Indicate Whether Your Child Has or Has Had Professional Support in the Area of Skills/Behavior:	Parents of Children Without Developmental Disabilities			Parents of Children With Developmental Disabilities
		Yes			Yes
Self-Care skills		8 (19.11%)			9 (23.17%)
Recreation skills		5 (11.59%)			16 (38.41%)
Communication skills		5 (11.59%)			17 (41.46%)
Social relationships		4 (10.80%)			28 (69.34%)
Pre-Academic skills		4 (10.73%)			17 (40.00%)
Motor skills		6 (15.61%)			24 (59.02%)
Behavior problems		2 (4.88%)			8 (18.54%)

provides an overview of the frequency of responses regarding expert support received by parents of children with and without developmental disabilities. Among children with developmental disabilities, the highest proportion of parents reported receiving support in the domain of Social relationships (69.34%), followed by Motor skills (59.02%), Communication skills (41.46%), and Pre-Academic skills (40.00%). In contrast, support was less frequently reported in Self-Care skills (23.17%) and Behavior problems (18.54%). Notably, more than half of the parents in this group indicated that no support was provided in Self-Care (62.20%) and Behavior problems (77.56%). When these findings are considered alongside previously identified parental priorities (Table 3), partial alignment can be observed in domains such as Social relationships and Pre-Academic skills. However, discrepancies emerge in domains such as Communication and Self-Care, where a substantial proportion of parents identified these areas as priorities, yet a lower percentage reported receiving professional support. In contrast, in the group of children without developmental disabilities, professional support was reported far less frequently across all domains. The highest proportions of reported support were observed in Self-Care skills (19.11%) and Motor skills (15.61%), whereas in most other domains, more than 75% of parents indicated that their child did not receive support. For example, 81.10% reported no support in Communication skills, and 82.58% in Social relationships.

4. Discussion

This research aimed to identify parents’ priorities when choosing professional support for their children, examine the link between these priorities and children’s current abilities, and examine which developmental domains children receive professional support and whether these domains align with parental priorities. The results indicate that parents of children with developmental disabilities prioritize the domains of Communication, Social relationships, and Pre-Academic skills when choosing support options for their children. In contrast, parents of children without disabilities place higher importance on Pre-Academic and Self-Care skills. Differences in parental priorities were further supported by effect size estimates, with moderate-to-large effects observed across most domains, particularly in Communication, Social relationships, and Pre-academic skills, indicating that these differences are not only statistically significant but also meaningful in practical terms. These findings align with research conducted by other authors in which parents of children with disabilities across various age groups participated [8,9,17,18]. It is not surprising that Pre-Academic Skills appear on the priority list for both groups, as the literature indicates that one-third of children are not sufficiently prepared to start school. This milestone is significant for both children and parents, as academic success is closely tied to the Pre-Academic skills developed in early childhood. Pre-Academic skills encompass various aspects of a child’s functioning, including socio-emotional, cognitive, and behavioral dimensions [24]. Furthermore, Marušić et al. [25] highlight the connection between Pre-Academic skills and the child’s speech and language abilities. Stimulating speech and language skills in early childhood enhances a child’s readiness for school and contributes to academic achievements. Ghanadzade et al. [8] emphasize the importance of Pre-Academic skills for parents of children with developmental disabilities, noting that a child’s success in this area can influence whether they are enrolled in a regular school or a school designed for children with developmental disabilities.

In our research, parents frequently identify the Communication domain as a top priority when choosing professional support. This finding aligns with the work of Ghanadzade et al. [8] and Đorđević et al. [9]. It is important to note that the majority of children with developmental disabilities in our sample exhibit significant challenges in speech and language development. The enhancement of speech and language abilities plays a crucial role in communication, impacting aspects such as initiating conversations, expressing wishes and needs, naming objects, seeking information, describing events and emotions, following instructions, and responding to questions. In addition to the Communication domain, parents in our research also prioritize the Social relationships domain, even though it is not categorized as an area where their child has a low level of ability. This might stem from the parents’ recognition of the connection between Communication and Social relationships. The interrelation of these domains is supported by Guillén-Chávez et al. [26], who state that advances in communication skills contribute to improvements in social skills. Furthermore, the significance of social skills and the ability to form friendships is reaffirmed by parents in Petrina et al.’s [27] research, which found that these aspects are more important than academic achievements and intellectual and motor skills.

In contrast to our findings, numerous studies conducted by other authors highlight the Self-Care domain as a high priority for parents of children with developmental disabilities [8,16,17,28]. Chiarello et al. [10] identify this domain as the most frequently prioritized when choosing professional support. Interestingly, the Self-Care domain remains a high priority even for parents of children without disabilities. In the Self-Care domain, we observe a high average score for children’s current abilities. This indicates that these children need support with activities, although it is not a top priority for parents. One explanation for this is that parents of children with developmental disabilities focus on achieving goals to enhance abilities in developmental areas, particularly speech-language, socio-emotional, and cognitive development. Another possible reason for including the Self-Care domain among the high priorities of parents of typically developing children may be a tendency toward overprotection, in which parents perform tasks for their child rather than allowing them to do so independently. This lack of independent engagement can affect the child’s opportunity to develop essential Self-Care skills [29]. Parents must recognize that fostering independence in Self-Care skills can positively impact other areas of the child’s future functionality, such as leisure activities, work, and educational pursuits [14]. Thus, promoting independence in Self-Care skills should be emphasized between the second and third years of a child’s life. Achieving greater independence in this area requires greater parental involvement. Research examining the independence of children without developmental disabilities supports the notion that skills vary. For instance, children tend to be more independent in eating, toileting, and dressing than in bathing and brushing their teeth [19]. It is common for parents to identify specific skills as very challenging for their child, yet not include them in their priorities in choosing support options. Research by Đorđević et al. [9] reveals that this discrepancy occurs regarding academic and household skills. In their study, household skills are often rated more problematic than child abilities, while academic skills are prioritized when considering professional support.

In contrast to the other domains of child functioning, the Behavior problems domain is not a high priority for parents in both groups studied. This lack of emphasis on addressing behavioral problems may stem from a differing perception among parents, who often view these issues as separate from their child’s overall disability. Additionally, parents may focus primarily on specific behaviors, such as tantrums and stereotypies, and consider only these behaviors as behavioral problems [16,28]. Conversely, other research indicates that parents also recognize eating and sleep issues as behavioral problems [16,30,31]. Previous studies by Pituch et al. [16] and Rodger et al. [28] found that the Behavior problems domain was a priority in their research, which contrasts with our findings.

Our research, as well as that of Đorđević et al. [9] and Pejović-Milovančević et al. [15], was conducted in Serbia. However, it included children of different ages and showed a tendency for parents to prioritize the same areas, most often communication, social interactions, and academic skills. This can be interpreted in the context of Serbian culture. First of all, the successful inclusion of a child in a kindergarten group and later in the school system largely depends on his ability to understand instructions, express needs, and engage adequately with peers and adults. In an educational system organized around collective work and group activities, communication and social relationships form the basis for functional participation. Therefore, parents can recognize these skills as crucial for the child’s inclusion and further educational development.

In addition, communication and social relationship problems are among the most visible aspects of development in everyday situations, thereby increasing parental sensitivity to this area. In environments where social acceptance and fitting into the peer group are of great importance, parents may perceive communication and social skills not only as developmental needs but also as prerequisites for reducing stigmatization and facilitating the child’s functioning in the community.

Also, the structure of available early intervention services in Serbia can shape parental priorities. Speech therapy support is one of the most accessible and recognizable forms of professional help, so parents can more clearly identify communication difficulties and more often list them as a priority alongside other developmental domains.

Finally, communication is a fundamental developmental area that affects a child’s social relationships, academic skills, and overall independence. Parents may intuitively recognize that improving communication has broader developmental implications, which further explains why this area consistently appears as a priority in national research [9,15,22].

The leading philosophy of the new approach to working with children and families emphasizes not only parents’ involvement in defining support priorities but also the importance of observing the child’s strengths. Research indicates that the significance of certain areas in choosing professional support increases with the severity of a child’s problems, and vice versa. Our study found a statistically significant association between the child’s current abilities and the parents’ priorities in the domains of Behavior problems, Recreation skills, and Social relationships. Although the connection in the communication domain was not statistically significant, it closely follows the other areas of importance. This suggests that if a child has a lower level of ability in these developmental domains, they are more likely to be prioritized by parents in choosing support options. Conversely, if a child demonstrates a high level of ability in these areas, they are less likely to be prioritized.

The persistence of Social Relationships as a priority among parents of children with developmental disabilities, despite the absence of the highest overall levels of reported difficulty in this domain, represents a theoretically meaningful finding. Importantly, although this domain did not show the most pronounced average deficits, significant correlations between current abilities and parental priorities indicate that parents remain responsive to variations in social functioning. This pattern suggests that parental prioritization may not be exclusively difficulty-oriented. Rather than reacting only to the most severe difficulties, parents may recognize the developmental centrality of social competence for inclusion, peer interaction, and later school adjustment.

In this sense, prioritizing Social Relationships may reflect an anticipatory, future-oriented perspective in which parents aim to strengthen domains perceived as foundational to long-term functioning. This pattern may reflect a strengths-oriented perspective, in which parents aim not only to remediate difficulties but also to build on existing social capacities to promote long-term participation and well-being. In this sense, prioritization may represent proactive developmental planning rather than a response limited to deficit correction.

At the same time, the apparent discrepancy may also point to potential limitations in the Treatment Priorities instrument’s sensitivity to subtle or context-dependent social challenges. Social functioning in preschool-aged children is often situational and nuanced, and certain difficulties may not be fully captured through structured rating formats, even though they remain salient in everyday parental experience.

Taken together, these findings indicate that parental priorities are shaped not only by the severity of observable deficits but also by broader developmental expectations and future needs. This highlights the complexity of parental decision-making processes in early childhood intervention contexts [32,33,34]. It should be noted that the relatively low mean values observed in several domains are partly attributable to the instrument’s scoring structure, in which a score of 0 indicates independent functioning.

According to Pituch et al. [16,17], the relationship between the child’s abilities and the parents’ priorities in Academic skills, Communication, and Household skills shows that priority increases as the child’s abilities decline. However, once abilities fall to a very low level, the priority decreases again. In the research conducted by Đorđević et al. [9], a statistically significant relationship was found across all domains, except the Academic skills domain, highlighting its importance to parents, regardless of the child’s ability level. Interestingly, other studies show that the correlation between parents’ priorities and the child’s current abilities is often absent in adaptive skills, such as household management, community involvement, and work skills [8,16,17,18]. Additionally, expert support focuses less on these areas and more on Communication or (pre)Academic skills [9,16,17,18]. However, Finke et al. [12] note that parents regard independence, happiness, social connections, and employment for their children as the most important outcomes.

The results of our research suggest potential differences in the way parental priorities are conceptualized between parents of children with developmental disabilities and parents of children without developmental disabilities. Although children without developmental disabilities do not exhibit significant difficulties across developmental domains, their parents tend to prioritize Pre-academic skills and Self-care. This pattern may indicate that, within this group, priorities are shaped less by observable challenges and more by social expectations and a preventive orientation toward future functioning. Pre-academic skills are widely recognized as foundational for later academic achievement, while self-care skills contribute to long-term independence within the household, the community, and later employment contexts. Thus, parental prioritization among parents of children without developmental disabilities may reflect anticipatory planning and broader developmental expectations rather than immediate developmental concerns. Accordingly, McIntyre et al. report that parents of children without developmental disabilities express concerns about later academic skills, following instructions at school, regulating behavior, and interacting with peers [14,24,35].

The encouraging finding from our research is that parents of children with developmental disabilities report that their children have received support in key areas, particularly in Social relationships. Interestingly, parents perceive support in the Social relationships segment as more frequent than in Communication, which is their top priority. Similar observations apply to the Pre-Academic skills domain. This may be attributed to the interconnection of different functional areas, especially in younger children. While children may not present significant difficulties in this domain, parents recognize it as a vital foundation for social interaction and participation in various aspects of life. The results also indicate that support in Motor Skills is notably present despite parents not prioritizing this domain or seeing it as an area where their child needs support. This discrepancy likely stems from children with developmental disabilities engaging in various forms of developmental stimulation, in which motor skill development is often emphasized as a basis for overall growth. Furthermore, since parents report that support focuses on Motor Skills and lacks emphasis on Self-Care skills, it suggests that they may not fully recognize the importance of motor skills development for enhancing self-care abilities. Therefore, it is crucial to educate parents about the significance of support in fostering their child’s skills across different domains of functioning, viewing development holistically, where all areas are interconnected.

Parents of children without developmental disabilities report that their children do not receive support in areas that are a priority for the parents. This may be because the parents have not yet sought support. Given that the child does not have a manifest problem in any developmental domain, parents may delay seeking support in the domains of pre-academic skills and self-care due to fear of stigmatization and labeling of the child. Another reason for the lack of support may be insufficient information about the availability of support and the ways it is provided. Therefore, parents usually seek support themselves through trial and error. Also, waiting lists for professional support and inadequate intersectoral coordination can be a demotivating factor for parents. To avoid this, parents need specific, relevant, and individualized information to help them make informed decisions about the support their child will receive [5,22,36,37].

Results of the study by Pappas et al. [38] indicate that 47% of parents participated in the support process, and only 38% had the opportunity to present their priorities and make a final decision about the goals to be achieved with the support. This is certainly influenced by several factors, including the institution’s policy regarding the child’s support, the experts’ experience, the time frame, the parents’ beliefs, and the parents’ attitudes.

Previous national studies have consistently shown that parents of children with developmental disabilities prioritize communication and social functioning. The current results confirm this pattern and further demonstrate that, although certain domains—particularly Social Relationships—are relatively well represented in professional support, full alignment between parental priorities and received services has not yet been achieved. The relatively high proportion of reported support in Social Relationships suggests partial responsiveness of the system to parental concerns.

However, lower coverage in domains such as Communication and Self-Care indicates that significant gaps persist.

5. Limitations and Implications

It is important to acknowledge the limitations and implications of this study. These primarily relate to the sample size and the limited number of institutions from which data were collected. Increasing the number of respondents and institutions involved in the research would provide a more comprehensive understanding of parental priorities. Additionally, because only respondents who agreed to participate completed the questionnaire, parents who chose not to participate may have different perceptions of their child’s abilities and may prioritize different things.

A limitation of the research is also the lack of clearly defined developmental disabilities in the child, including the type of disability and degree of severity, the limited range of results, and low correlation values. The relatively low correlation values observed in the present study may reflect the multidimensional nature of parental decision-making rather than simple linear associations between child abilities and priorities. One more limitation of the study concerns the distribution of the data, as several domains showed low mean values and a high frequency of zero responses, particularly among parents of children without developmental disabilities. This pattern reflects the instrument’s scoring structure, where a score of 0 indicates independent functioning, suggesting that many children in this group perform the assessed skills independently. Consequently, the distribution is naturally skewed toward lower values, which should be considered when interpreting group differences and effect sizes.

Future research should incorporate more detailed clinical characterization of participating children, including clearly defined diagnostic categories, standardized severity indicators, and functional classifications. Such stratification would enable more nuanced analyses of how parental priorities vary across developmental challenges of different types and levels. In addition, the use of standardized diagnostic documentation and validated measures of functional impairment would improve the precision of group comparisons and enhance the interpretability of findings. Future studies could address this by employing larger samples and multivariate analytical approaches, such as regression or structural modeling, to capture complex interaction effects better. Finally, longitudinal designs may provide deeper insight into how parental priorities evolve in relation to changes in children’s developmental trajectories and service provision. Future research could also examine the influence of factors such as the child’s age and gender, and the parents’ socioeconomic status and educational level, on parents’ prioritization of professional support. This would provide a more complete insight into what shapes parental priorities. Finally, in line with the gap in the literature regarding the priorities of parents of children without developmental disabilities, future research could focus on this group. This would more fully explain the difference in decision-making and what shapes the choice of priorities between parents of children without disabilities and parents of children with developmental disabilities.

Despite these shortcomings, the authors stress the significance of this topic and its research at the highest possible level, as it may yield valuable new data, develop new tools for assessing parents’ priorities, and shed light on other practical issues. Furthermore, there is potential to introduce new instruments as tools for family intervention, which could help parents consider various developmental areas and their child’s functionality. This approach may encourage parents to collaborate with professionals to establish priorities and to actively participate in support initiatives aligned with those priorities by organizing training programs for both parents and professionals that emphasize a family-centered approach.

6. Conclusions

The results indicate that parents of children with developmental disabilities prioritize Communication, Social relationships, and Pre-Academic skills, selecting them based on their child’s abilities. Specifically, parents focus on the areas where their child demonstrates the most significant challenges. Interestingly, the Social relationships domain remains a priority for parents despite children in this area not exhibiting pronounced difficulties. This suggests a potential shift towards appreciating the child’s strengths when choosing expert support and recognizing the importance of social skills for their overall well-being. It is encouraging that parents of children in both groups recognize the Self-Care skills as an important domain and their significance for their daily functioning. A surprising finding is that a higher percentage of children with developmental disabilities receive support in the Motor skills, which is not a priority for parents, rather than in the Communication domain, which is a top priority. This highlights the need for experts to understand parents’ priorities better and design support accordingly. Additionally, parents noted that even among children without developmental disabilities, challenges arise in the areas of Pre-Academic and Self-Care skills. This is a positive aspect, as it encourages parents to seek out support and prompts experts to consider the needs of both children with and without disabilities and their families.