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Abby’s Mother Asks Again: “Is it my fault?”

Abby has significant motor delays. Her mother asks you some version of this question during every visit: “Is it my fault that Abby isn’t walking yet?” orshutterstock_148422014 “What did I do to cause this?” The question itself makes you uncomfortable, because you can’t really answer it well and because you feel like you’ve tried to answer it for the past several weeks. Each time Abby’s mother asks, you say that you don’t really know what is causing Abby’s delay but what’s important is that we keep supporting Abby’s development so that she can learn to move. You and Abby’s mother both recognize that this is the best one you’ve got…so why does she keep asking?

Emotional Questions Matter

It can be incredibly challenging to manage the emotions that pop up during EI visits – both with parents and within ourselves. When we see a parent struggling with guilt over her child’s developmental delay or disability, it can be difficult for us to know what to do or how to help. With a question like this about fault, it can be especially challenging because we really don’t have the answer. In most situations, the child will have a delay and we won’t know what caused it. It might be easy to think, well, it doesn’t really matter what caused it…what matters is what we do now. However, it probably matters ALOT to the parent.

When a parent asks a question like this, it’s important that we have an honest and appropriate answer. It’s also important to recognize (and say so) that sometimes we don’t have the answer but we can still acknowledge the emotions behind it. Abby’s mother is not hoping that her service provider will place the blame on her shoulders; instead, she may be hoping to share her anxiety and fear with someone she trusts. You may be the person she’s chosen to voice her fear to…what do you do then?

Answering this Tough Question

Here are a few things to consider when a parent asks you if it’s her fault:

Be honest and be kind

In most cases, the answer is that you really don’t know what caused the delay. Most likely, it wasn’t something the parent did, and you can say that too. If you DO think it was something that happened (or didn’t happen) in the child’s environment, like when a child has experienced neglect or there is a history of substance abuse, you can be gentle about this and redirect the focus of the conversation to what the parent is doing well now. I remember working with a parent who struggled to interact with her child during the day because she had so much else to do. Honestly, I felt that the lack of interaction had probably affected the child’s communication and interaction skills. Rather than answer “yes, not paying attention to him contributed to this delay” – which I would never say because how do I really know? – we talked about the changes she’d made since she found out that he needed more interaction and I praised her efforts. It was a tricky conversation because she did have a learning curve, but as she began to feel more like she was making a positive impact on her child’s development, the guilt she felt about the past seemed to lessen.

Acknowledge the parent’s feelings

I think it’s very appropriate to ask the parent to tell you more about how she’s feeling. You might invite it by saying something like “You’ve asked me that question several times on the last few visits. We can talk more about how you’re feeling about Abby’s development if you like.” You can open the door and see if she decides to share more. Inviting this discussion can also be tricky, though, because what comes through the door could be more than you can handle. Since most interventionists are not counselors, follow your instincts. If you suspect that the parent could benefit from more professional support, or maybe even another parent to talk to, offer to make that connection or see if the service coordinator can help. Sometimes, interventionists are afraid to have these conversations because they might distract from the “real” work of the visit. I would suggest to you that the real work might not be possible, or be unnecessarily challenging for the parent, if these feelings are left unacknowledged.

Acknowledge your own feelings & examine your own response

If a parent asks a question like this over and over, it could be because she is not getting an adequate answer. If you avoid answering, she may sense that and think you really do think it’s her fault. While we can’t be in control of how a parent interprets what we say, we can be mindful of the messages we send. Reflecting on your tone of voice, the words you choose, and your body language are important.

Follow your answer with encouragment

The question might really be a cry for hope and encouragement. A parent who asks this question may be very worried about the future. Follow your best answer by pointing out what the parent is doing well, how it’s a wonderful thing that she’s involved in early intervention, and that the child is making progress (if this is the case). Offer genuine reassurance and help the parent see that, regardless of why or what happened in the past, she has the opportunity now to make a big difference in her child’s life and you are there to help her do that.

There will be times when answering Abby’s mom’s question are easier than others. Just remember that this question is probably harder for the parent to ask than for you to answer. Answering it as best you can and following it with encouragement for what’s to come can be just what is needed.

How have you answered this question before? What do you do when a parent expresses fear or anxiety over the child’s delay or disability?

Share your insights and suggestions below in chat.

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10 Comments to “Abby’s Mother Asks Again: “Is it my fault?””

  1. I had found that when a parent ask a question like this over and over I believe it is because they are still grieving, trying to process and understand their child disability. I also learned that some parents have that movie reel going through their head and trying to analyze everything they did over the past 9 months. What I have done to support parents who are “stuck”, is validate and acknowledge their feelings, listen to them vent and ask open ended questions. I connect them to support groups and when the parent ask those kind of questions again, I gently move the conversation along and say something like ” I am not sure why Susie is not walking yet but isn’t she doing an amazing job of grabbing for the toys and look at her cooing/babbling/looking at you” This helps the parent focus on the present and look at how their child is progressing.

    • Thanks for sharing your insights, Michelle. I think your point about grieving and the movie reel is very true. I really like your example of how you help families focus on the present. You’ve provided a wonderful example for others to follow. 🙂

    • I agree completely with these responses. It is so important to validate feelings and to acknowledge the stage of grief the family may be facing. When a family is asking this question, I feel as humans we want to automatically respond “no!” We don’t want parent to feel this added guilt, or stress. Most of the time, we know that it is not anything that the parent did “wrong” that caused a delay. What do others do when a parent may be to blame? I know it’s a horrible thought, but we all have those families on our case loads. Mothers who were using during pregnancy or child abuse cases. How do you address these? When one parent has custody because the other parent caused significant damage due to SBS and the parent is asking you is the other parent is really to blame for the delay.
      It is a heart breaking conversation. I try to focus on what the family is doing now to support the development and how hard they are working to be positive role models for the child. Does anyone else come across these situations and how do you respond?

      • Thanks for your insights, Allison. The question you raise is a very real one. When I was faced with it, I did exactly what you did – emphasized the positive and what the parent could do moving forward. Sometimes it was unavoidable to talk about a possible source, such as a parent’s drug use or abuse, especially when the parent brought it up. I think it’s a balance between being honest, professional, and subjective yet still supportive. In most cases, we really don’t know for sure what caused a problem. We can, however, emphasize good choices that the parent is making now and will hopefully continue to make in the future.

  2. I love your comment about how the “real work” of early intervention may not begin until the parent can process their feelings. I strongly believe that if the parent has something else going on that is impacting their ability to participate in intervention (whether it’s poverty, mental health, or guilt), our job is to support THEM so that they can support their child. I have several families who spend large portions of their sessions just “venting,” because they really need someone to talk to about their concerns! If it becomes an ongoing conversation, I do refer them to our Family Counseling and Support Staff, but I am still the primary provider and still address it when I do a visit.

    • Very well-said, Lauren. I think, with most families, supporting the emotional side of their adjustment to their child’s delay or disability is a critical piece of early intervention. We are often with them as they begin their journey. Family-centered practices required that we consider the big picture of the family’s experience, and their emotional experience IS part of it. I do think that skilled early interventionists are usually able to manage both the emotional support and intervention activities quite well. Thanks for adding your perspective to this topic!

  3. Oh yes! I just had this this week following a diagnosis of ASD. That was one of the first questions out of the parent’s mouth. I tried to support her in the fashion that you described above. Listening empathically and supporting parents in the way that you describe “cools” their brains down so that they can operate on a more rational level to mobilize and actually get going toward helping their child. Great article!

    • Thanks Jeff! I love the idea of “cooling” the parent’s brain down. When I’ve been in the parent role, I know how stressful it is to worry that something could be your fault. For example, my son is 11 and broke his arm when he was 3…and to this day I still feel guilty that I could have done something differently to prevent it (he fell off of his bed). In that intense time, my brain felt very stressed and I could have used someone to help me move forward and really “let go” of that worry. Maybe I still could…haha. 🙂

  4. I love this post – thank you.
    I think in cases where we DO kind of know the cause, like diagnosed ASD, we really can reassure parents that they did not cause the ASD, most likely. I think we can talk about the current research and help provide parents with information that may help them let go of those anxious feelings that it was something they did that cause the disorder.
    For general developmental delay – we don’t know, but we could say something like usually parenting alone does not cause developmental delay except in instances of abuse, neglect, substance abuse. I know this is risky because we never REALLY know that one of those things hasn’t happened in the past saying this depends on your relationship with the parent, but sometimes just to have that information can help a parent with a child who has speech delay of unknown etiology let go of the idea that too much screen time has CAUSED the delay – we don’t KNOW that it didn’t, but I believe we know enough to help parents let go of the idea that it definitely DID cause a delay. Contributors and causes are very different things.

    • Thanks Leah! I really agree with your last statement. Most of the time time DON’T know what caused the delay or disability and whenever we can help families move through their grief or anxiety with honest answers that don’t go beyond what we do know, that’s a good thing. I truly believe that families know when we are dancing around the subject so being honest about what we do and don’t know can at least preserve the rapport we build. You’ve shared some well-stated advice – thank you!

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