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Handling Parent Denial

  • 1.  Handling Parent Denial

    Posted 10-04-2019 01:52 AM
    Would welcome tips/tactics for bringing a parent out of denial to come to the realization their child should be tested/evaluated to identify (or eliminate) the possibility of being on the autism spectrum. ( FYI- I clearly stated I was in no way diagnosing-but was concerned about some "red-flags" I was observing and documenting and encouraged further discussion with their pediatrician.)

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    Sara Larsen

    Concordia MO
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  • 2.  RE: Handling Parent Denial

    Posted 10-04-2019 08:23 AM
    I just posted something similar.  We also are not diagnosing anything, but I think the parents are not hearing me.​

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    Barbara Sharofsky
    Director
    Adath Israel Early Childhood Learning Center
    Merion Sta PA
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  • 3.  RE: Handling Parent Denial

    Posted 10-08-2019 08:21 AM
    As I always tell my students in Early Childhood Education classes, you have to speak with parents in very specific, objective terms.  Describe the behavior that is causing you concern. And you have to say why it matters. For example, explain how this behavior stands out from that of the student's same-age peers (often the best, earliest indication that the student may be exhibiting a special need). If the behavior is a constant disruption to your program, that is a valid concern. If they student appears uncomfortable (i.e., sensory overload) in significant ways, that is a concern for the student. Again, use descriptors of what you observe, not subjective language like: disruption, uncomfortable, etc., but what he is actually doing or not doing throughout the day. BUT, you have to be patient. Parents rarely hear this the first or second time. It is difficult to process, accept and act upon. Your director must support you. If the child is disrupting the program and impacting the other children's experiences, the parents may have to be given an ultimatum to take action. Also, parents would probably benefit more by taking their children to Child Find. Every school district has to have one. Or an office with a similar name. Its required under IDEA. I would suggest that more than the child's physician or at least in tandem. The school district or its surrogate should be provide testing free of charge to the family. And they will likely ask you for documentation, so take good notes of what you are observing.

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    Joan Ehrlich
    Associate Professor
    Northern Virginia Community College
    Annandale VA
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  • 4.  RE: Handling Parent Denial

    Posted 10-10-2019 02:54 PM
    Joan, excellent idea. Just want to share that Child Find now uses the acronym ECTA (Early Childhood Technical Assistance) I work for Child Find of America, Inc., and I'm afraid the mix-ups are endless.The best number we have for ECTA is 1-919-962-2001, and the caller will be given information as to the state resources regarding IDEA (Individuals with Disabilities Education Act) options.

    As for Child Find of America, we do offer a 6.5 hr. training entitled Difficult Conversations with Parents. Very importantly, the parents must be acknowledged as the experts of their own children, and forging a personal (as possible) relationship early on is vital before approaching a parent with concerns. As importantly, parents seek and appreciate reciprocal relationships. Lots of great ideas in these comments, and those recommending that sharing behaviors you've observed - free of judgment-laden descriptors - is a wonderful way to approach these conversations.

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    Shari Doherty
    Program Director
    Child Find of America, Inc.
    New Paltz NY
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  • 5.  RE: Handling Parent Denial

    Posted 10-05-2019 08:30 AM
    In fact, denial is the normal response when parents hear something that sounds as a problem in their child. However, two strategies have helped me communicate with parents better and to start these kinds of conversations on the right foot. First, I ask parents how they see their child, and ask key questions about specific milestones. Sometimes parents have observed behaviors at home and are not aware that those are red flags. Second, I describe what I see; I describe the observed behaviors without using any labels. Usually they will ask for suggestions. If they don't, I encourage them to talk to their pediatrician by stating that he is the right person who can really provide expert advice.

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    Danay Naranjo
    Medellin
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  • 6.  RE: Handling Parent Denial

    Posted 10-05-2019 09:24 AM
    Echoing Danay:  It is not unusual for parents to be in denial and it's important to have clear documentation of what you are seeing that concerns you.  As an outside consultant coming into the classroom I often create with the teachers a brief report with a list of strengths and a list of concerns.  It's important that the list of strengths comes first and that hopefully it has more on it than the list of concerns.  Stretch it if you have to--"He loves music and often joins into singing time."  Parents need to know that we see the good stuff about their child and that we appreciate them before they can take in the concerns.

    Depending on the situation I often say something, after having given some examples, like: "We have questions about how he's processing information.  A developmental evaluation will help us know how his brain works and that might help us to better support him."  I do tell parents that the testing might or might not end up with a diagnosis so they're not blindsided if this happens.  Parents often say no on a first pass. Then I write in the meeting report that we'll check in again in a few weeks to see if anything has changed.  I never attach any type of label/diagnosis to my concerns--I am not qualified to diagnose.

    Parents often say they don't want their child labeled.  I answer that very valid concern with, "The best way for your child to not be labeled throughout their schooling is for them to get the help they need now."  It's also important for teachers and administrators to understand the difference between screenings, assessments, and developmental testing.  Referring a 3 or 4 year old child to the school department for screening and assessment does not get them a diagnosis if they have ASD.  School departments screen for academic readiness.  A developmental neuropsych evaluation is done by a psychologist, preferably a pediatric neuropsychologist.  A developmental pediatrician can also do testing. Sorry this is so long--hope it's helpful.  Sometimes the best we can do is know that somewhere down the line this child will be helped, even if the parents aren't ready until they leave our care.

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    Aren Stone
    Child Development Specialist
    The Early Years Project
    Cambridge, MA
    she/her
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  • 7.  RE: Handling Parent Denial

    Posted 10-05-2019 08:00 PM

    It can take years of patience to help parents see that their child may need more than s/he can get from your program.  As has been said before, document, document, document.  I'm assuming you have fully assessed the child multiple times in various ways before speaking with the family.  As I teach in my workshops, when you speak of specifics, make sure all of the positives are outlined and fully explained. Then, try to lump the difficulties under as few umbrellas as you can, so the family is not overwhelmed.  I would not use the phrase "to identify (or eliminate) the possibility of being on the autism spectrum".   If they see that there are a few areas of concern and see that you would like more information to see some other ways to help the child, it's not as scary. 
    As far as the child's pediatrician - many years ago, I said if I had a nickel for every pediatrician who said, don't worry, he/or she will grow out of it, I'd be very rich.  For the most part, they are not trained in child development. I know because with a hospital, I started a pediatric rotation in the hospital's child care center (which I directed).  The first batch of doctors included a parent of a child in our center.  EVERY one of them said the same thing at the end of just 3 mornings at the center - "I couldn't believe it!" "Those kids are amazing!" None of their training included seeing children who weren't either sick or in severely special needs programs.  They had no idea what "typical" children were like.  Our center served children from 1-4 and included children who were slower and faster to develop and those in between as well.  That program lasted at least 10 years after I left the hospital position.



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    Ellen Cogan, MS Ed
    HILLTOP Early Childhood SERVICES
    www.earlychildinfo.com
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  • 8.  RE: Handling Parent Denial

    Posted 10-06-2019 10:41 AM
    Helping a parent see that their child needs evaluation for special needs is a very sticky, tricky situation. It needs to be approached softly. It may take time to convince them that this is the best approach to getting their child the help they need. It is not just about documentation. I would invite them to observe their child in class and then discuss with them the situation. The documentation is important but the school's ability to persuade a family of the importance of helping their child now while the child is very young is the best course of action.

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    Nora Krieger, PhD
    Associate Professor Emerita/Past Chair NJEEPRE
    Bloomfield College/NJ Educators Exploring the Practices of Reggio Emilia
    Highland Park, NJ
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  • 9.  RE: Handling Parent Denial

    Posted 10-06-2019 04:00 PM
    As both a parent of a now young adult on the autism spectrum, and a teacher...I wear both hats.  I think the main thing to realize is that parents are scared.  It is true that some actually don't have a clue that something is up with their child (maybe they are first time parents, not people that are familiar with children in general, don't have experience with child development), but most are probably secretly worried that something is up, since they are likely having challenges with their kiddo at home as well.  And they are scared.  So when we come to them with compassion as the overarching attitude, we will usually find a little more wiggle room in their response, and we will certainly be more careful and sensitive about how we are talking.

    I totally agree with the fact that we will also have those parents who just won't listen, can't listen, are too freaked out to listen, blame us, blame our classroom, blame our program.  But if we have compassionately planted the seed, there is hope that down the road the child will get some help.  We can't force a parent, but we can support the child and direct the parent to resources if they are willing.

    The most common argument that I get is, "Oh no, there's nothing wrong with him/her, s/he is just like their dad/mom was, and look s/he is fine now."  But if the child is suffering and having a challenging impact on your staff and the classroom, there are now ways to help that perhaps were not present when the parent in question was a child.

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    Joanie Calem
    Music and Inclusion Specialist
    Sing Along
    Columbus, OH
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  • 10.  RE: Handling Parent Denial

    Posted 10-09-2019 09:39 AM
    Hi Sara,
    Our staff has found it helpful to record in-class observations by taking notes and sharing information with the parents. Often, in early childhood, special needs manifest as challenging behaviors. In those cases, we document the behaviors, what preceded the behavior, how the teacher handled the situation, and how the child responded to the teacher's intervention. When parents see things in writing, it often helps them to understand how serious the situation is. If the teacher's reports aren't making an impact, I will ask the parent's permission to observe the child in the class. I write only what I see. I do not add opinions only facts. I write about interactions with peers or teachers, and I write dialogue that I hear. The parents know that I am an objective observer, and I present the information to them in a meeting.
    It takes time, but usually, once parents feel safe, they are able to accept support.

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    Amee Borys
    Director, Early Childhood Education
    Earthplace Preschool
    Westport CT
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  • 11.  RE: Handling Parent Denial

    Posted 10-11-2019 12:48 AM

    CDC's "Learn the Signs. Act Early." (LTSAE) has FREE research-based, parent-friendly resources on child development to help you boost family engagement. The training below is an excellent resource for partnerships with parents that support developmental monitoring. www.cdc.gov

    Watch Me! Training

    Peggy Kemp
    LTSAE Ambassador
    KS

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  • 12.  RE: Handling Parent Denial

    Posted 10-11-2019 01:05 AM

    Another resource you might be interested in is the following article available open access online. As a professional and as a parent, this article has been extremely helpful.

    Working With Families:
    Rethinking Denial
    Peggy A Gallagher, Ph.D., Georgia State University, Janice Fialka, MSW, Parent,
    Cheryl Rhodes, MSW, Georgia State University, and Cindy Arceneaux, Parent
    Reprinted with permission
    Young Exceptional Children: Vol. 5

    Excerpt:
    Shifting Your Perspectives on Denial
    Suggestions for professionals:
    • Support parents' hopes and dreams for their child.
    • Suspend judgment of families and their behavior.
    • Be patient. People need time to find their own personal way through unexpected events.
    • View this time as an opportunity to strengthen trust.
    • Educate other professionals and family members to rethink denial

    Peggy Kemp

    Wamego KS
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  • 13.  RE: Handling Parent Denial

    Posted 10-11-2019 06:54 AM
    Great question.  I'm a preK teacher dealing with this exact situation right now, so all the responses are helpful. One thing I'm trying to communicate to the parents is that there are a lot of resources ready to help. We are not alone! Thanks all.

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    Dominic Tejeda
    Beacon City School District
    New Windsor NY
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  • 14.  RE: Handling Parent Denial

    Posted 10-17-2019 12:41 PM
    Here are some related resources from the Center for Inclusive Child Care:


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    Beth Menninga
    St. Paul, MN
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  • 15.  RE: Handling Parent Denial

    Posted 10-20-2019 09:55 PM
    Hi Beth,
    The first two links don't work.  Is there any other way to see this information?
    Thanks!

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    Joanie Calem
    Music and Inclusion Specialist
    Sing Along
    Columbus, OH
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  • 16.  RE: Handling Parent Denial

    Posted 10-21-2019 09:44 AM
    Joanie,

    Hmm...they work for me. Did you try copying and pasting into your browser? Another way to find them is to go to our website:  www.inclusivechildcare.org
    then go to the Resources tab and you can do a search: entering the keywords "sharing developmental concerns" should pull it up.

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    Beth Menninga
    St. Paul, MN
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