This study investigates factors associated with satisfaction with medical communication at the time of diagnosis of a child's severe mental or physical disability. Two competing social psychological models that have been used to account for parent patient satisfaction are tested: Korsch's (1968) affective model and Ley's (1977) cognitive model. One hundred and sixty six mothers of children with severe learning disabilities were questioned about the time when their child's disability was first diagnosed. Measures included the child's age when diagnosis was made, the length of time parents had been anxious, and how satisfied they were with the way they were told the diagnosis. They were asked to rate the doctor's affective behaviour and their understanding and memory of the information they received. Fifty-eight per cent of parents reported dissatisfaction with the communication. Stepwise multiple regression analysis showed that Korsch's affective scale was much the strongest predictor, entering the equation first, and explaining 35.7% of the variance in satisfaction. Ley's cognitive scale entered second, explaining a further 1.4% of the variance. Further analysis including the other predictors found that six predictors explained 40% of the variance. The implications of the findings for the training of medical staff are discussed.