Engaging Families, Intervention Visits, IFSP Development, Practical Strategies, Service Coordination

Listening to the Family’s Story

Consider this quote: “When we know the facts about people, we know what they are. When we  know their stories, we know who they are.” (John Quincy Adams)

We gather tons of facts in early intervention. We ask exhaustive and often intrusive questions about medical history, resource needs, financial information, priorities for the child’s development, daily routines, etc.  We ask questions each time we see families to check on progress. We do this to gather facts for the IFSP, facts for contact note documentation, and to find out what we need to know for ongoing assessment and intervention. Here’s what I wonder – Do we really need to ask so many questions to learn about the child and family? Are the facts what are important or do we want to know who the child and family really are?

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We have choices in how we gather information. We can conduct an “informal” interview where families have questions fired at them that are often out of context and in a jumbled order (think about an intake or assessment with multiple professionals present). OR, we can have a conversation that flows from the family sharing their story. Every family has a story and the birth and development of a child adds to it. Children develop within the context of their family’s story so that’s where the information we need lies.

Here are a few strategies for moving from a focus on questions and facts to a conversation about the family’s story:

Strategy #1: Know What Information You Need to Gather

To learn from a family’s story, it helps to know what information you need. For example, if you’re doing an assessment, make sure you are familiar with the testing instrument across all areas of development, especially if you’re the facilitator of the assessment. That way, if the mother tells you a story about the child playing with his food, you can ask her to talk about how he interacted during this game, how he used his fingers, and if he used any words. One story usually includes multiple areas of development and gives you a truer picture of how the child functions in his everyday life. This is also a much more efficient use of time than asking separate questions for each area of development.

Strategy #2: Really Listen

“Really” listening for the story in the conversation involves being flexible, purposeful and open. It involves asking good open-ended questions then paying full attention to the answers. There’s a difference between listening for the answers we think we want to hear (like the answer that allows us to put a plus or minus on the assessment item) and listening for the functional big picture (yes the child can feed himself but how? when? what food? – this is what’s really important). This might seem to contradict the first strategy, but it doesn’t. Knowing what info you need to know is not the same thing as assuming you already know the answer. Really listening involves putting aside your bias and being open to what the family has to say.

Strategy #3: Follow the Family’s Story

Following their story is like driving along a path. You know where you need to go but you take their path to get there. When you really listen and help the conversation along with good questions and elaborations, you can gather such rich information. You might still be directing the conversation because you know what info you need, but it’s done gently without monopolizing the conversation. It’s their story, after all.

Strategy #4: Summarize & Use What You Learn

Once you’ve heard the story, paraphrase and check with the parent to see if you understood. Explore feelings, priorities, outcomes, or whatever it is about the story that relates to the EI process. Collaborate with the family to develop meaningful and responsive intervention that can easily be woven into their story.

Sometimes what you learned from a family’s story is not something you actually put on the IFSP – instead it’s something that tells you a little bit more about who they are and that’s okay too. It’s easy to forget that we are just one small part of the family’s story. It’s the process of learning about them and respecting their story that’s so important.

My Challenge to You – On your next assessment or visit, approach your information gathering as an opportunity to hear the family’s story. Try these strategies and see if you notice any differences in the flow of the conversation, how much information you gather, the quality of the information, or the comfort level of the family.

What strategies do you use to help the family share their story? Any ideas for families who are reluctant to share?

 

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7 Comments to “Listening to the Family’s Story”

  1. Such a timely post, Dana, as I sit and work on the syllabus for a family course at JMU. I think your strategies “hit the mark” and I would be really interested if practitioners try some of them and see a difference, particularly in how the IFSP and outcome development come together.

    • I’d love to know, too, what students think and how they compare it to what they observe when they do their field work. I think this is part of developing their “informed clinical opinion,” don’t you think?

  2. Great topic and strategies! I’m always looking for ways to get more of the family’s story:)

    • Thanks Jessica! As a speech pathologist, how do you help families share their stories about the child’s communication development? I’m thinking, in particular, about when you’re working with families who say that they just want the child to talk. Any suggestions for how to gather more information from them?

      • I definitly encounter a lot of families who say just that, Dana! – that “I just want him/her to talk.” I often try to expand that by asking open-ended questions that will hopefully get more information, such as “what does that look like? Are there times of the day that he/she is frustrated or you are frustrated because he/she is having difficulty communicating.” Sometimes families are still a bit stuck, so I will then try to pull on some of the information they have shared previously about their routines, sometimes from as early as intake, and things that they have shared already are challenging, or things that they pointed out as being important to them and things they do together with their child everyday….that typically leads to good goal development and a good picture of the family’s priorities 🙂

        • These are fantastic suggestions, Jennifer! You’ve got it – it’s all about how we facilitate the discussion and what we ask. I really like how you pull from what the family said earlier. So much rich information is often gathered before the IFSP meeting. Going back to that can really help families realize all that they know and support their decision-making and active involvement in the process. Thanks for sharing your strategies!

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