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The Parent says “You’re the expert. You tell me.” – What Do You Do?

At the initial IFSP meeting, Amada’s parents listen quietly as the other team members discuss their daughter’s development with them. Amada’s parents have been relatively quiet during the IFSP meeting, offering little input so far. They agree with any suggestions that other team members have. When asked about what goals they have for their daughter, they hesitate. Amada’s father then looks at the service coordinator and says “We don’t know. You’re the experts. You tell us.”

What should the service coordinator (SC) say? What would you do?shutterstock_146536784

What Might the Father’s Demand Really Mean?

While it is important to respect the father’s request, and it can be very tempting to do just what he asks, it is equally if not more important to pay attention to what his demand may really be communicating.

“I feel insecure or upset about what is happening.” – We often worry that the initial IFSP meeting can be overwhelming for families. A parent who demands that the team make decisions could be shutting down from what is a painful experience.

“In my culture, you are important and out of respect, I need to agree with you and do what you say.” – Cultural values about people in what can be seen as important positions, such as teachers and doctors, can affect a parent’s interactions and feelings about how to participate.

“I really don’t know what my child should be doing next.” – It can be hard for a parent to communicate this insecurity to a group of professionals. For some, the “you’re the expert, you tell me” demand might be a way to “save face.” Or, it can be an honest sentiment from a parent who really doesn’t know what to suggest and needs your support.

How Should You Respond?

If you are on the receiving end of this demand, it can be challenging to know how to respond. When I’ve been the receiver, I remember feeling like I’d been put on the spot. The demand conflicted with what I believed about the parent’s role in developing the IFSP, which was that the parent should be an active contributor to a meaningful, individualized plan. However, I knew that my “should” did not necessarily match how the parent felt or what the parent thought his or her role was in the process. I had to remember what Brorson (2005) said – that early intervention is a culture that families have to learn how to be a part of. The professionals have to help families understand their roles and how to interact within that culture.

Rather than taking the easy route and writing the outcomes for Amada, here are a few suggestions for what the service coordinator or other team members might do next to support her parents:

Review the information gathered from the parents about their priorities for Amada – Revisit their priorities and explain how what was learned about Amada’s development relates to those priorities. For example, if Amada’s parents said they wanted her to walk so that she could move around the house to play with her older brother, and during the assessment it was determined that she had low muscle tone, the SC or provider might explain how these relate. From this discussion, the long-term outcome for mobility could be developed based on having Amada be able to play with her brother.

Ask the question a different way – If asking a question like “What is your long-term goal for Amada?” is too direct (which it probably is for most people), then try something like this: “What would you like to see Amada be able to do here at home?” or “When you think about taking care of Amada, what would make things easier?” Taking a less direct route and using more family-friendly language can also soften the question and make it easier to answer.

Describe a few of the skills or abilities that Amada might learn next – To get the discussion going, the SC or provider might review a few of the next skills for Amada that relate to her everyday activities. For instance, a team member could explain the developmental skills that will precede walking for Amada (such as being able to pull to stand at the sofa to look at a book with her brother). This would be a last resort strategy as the parents are likely to simply agree with whatever is mentioned. Remember that you need to find a way to support parents in understanding how the IFSP outcomes will be most effective when they relate to their daily life, rather than being mainly based on missing skills – so tread carefully with this strategy.

It’s important to remember to support parents in participating in the development of the IFSP development. For many parents, it may be the first time they’ve experienced something like this process. If you keep in mind your role as a support, rather than being “the expert,” you can help families make informed decisions and be active participants in the IFSP process from the beginning. Supporting their comfort with sharing input builds the parent-provider partnership and helps the family understand the key role they will play in their child’s intervention.

What other strategies do you use when faced with the “you’re the expert, you tell me” demand? How would you have handled the situation with Amada’s family? 

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Reference

Brorson, K. (2005). The culture of a home visit in early intervention. Journal of Early Childhood Research, 3(1), 51-76.

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8 Comments to “The Parent says “You’re the expert. You tell me.” – What Do You Do?”

  1. I would remind the parent they know their child better than anyone. Then ask, what would you like to see Amada do next? What is your top priority for her?

    • Yes, Carol. That’s an important thing to remind parents of, from the beginning. Sometimes, after asking the questions you suggest, just waiting a few extra seconds to give parents time to think can be helpful too.

  2. I agree with Carol that the team should encourage the parent on his expert knowledge of his child. I also wonder if one earlier issue might be that the team focused more on development according to domains (motor, language, adaptive, etc.) and the parent truly may not know what the “next steps” in those areas are. But, if the team focuses more on what parents want their child to be able to do next to function and engage more during daily routines (meals, bath, play, etc.), most parents know what they want to happen next during those specific times of each day.

    • I’m SO glad you caught that, Deidra! Yes, shifting the focus on isolated skills and domains to her engagement in everyday routines is key. I think it’s so important, critical really, to help families see how the developmental info learned during the assessment links to their everyday life and the child’s abilities. That’s how we create meaningful outcomes. Fantastic suggestion!

      What questions you would ask Amada’s family to help them think about what they’d like her to do next in her daily routines?

  3. I believe we can try to keep it from getting to that point by listening to the initial concern and reflecting about what it would look like to them when it is was no longer a concern. Sometimes you can have the goal established from the beginning if you really listen.

    • Excellent point, Belkis. You’re right, there are things we can do to keep this from happening. I love your point about really listening from the beginning. I absolutely think that parents “give” us the goals by sharing their priorities. We often have to help by asking good questions and guiding the discussion back to those priorities because the outcomes are there.

  4. After explaining the goal-writing process, I have heard many parents share: “I don’t know what she/he should be doing at that time.” This comes especially from first-time parents, who may not be as familiar with typical developmental sequencing. It’s important to remind the parents of why their input to the goals is crucial. It helps to explain to parents that we will work together in the natural environment, doing activities and routines that the family already does. Their priorities are the focus. Bring up the priorities that the parents mentioned earlier in the assessment, and begin a discussion on how those priorities will develop in the daily routines. Parents can usually easily identify times of the day or routines that are difficult, providing a great anchor point for the goals to be centered around.

    • You’ve done an excellent job of summing this up, Kate! It really is all about how we present the information and respond to the parent’s questions and statement. Just because a parent says he or she doesn’t know what the child should be doing and seems to want to rely on the “experts” doesn’t mean that he/she has given us permission to take over. I really appreciate the idea of anchoring the goals in the information the family shares. Thanks for enriching this blog post!

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