You’ve been working with Brenda, Emma’s mother, for several weeks now. She is a mother who, from the very first visit, seemed hungry for adult interaction because, as she says, she’s “stuck at home all day with her kids and no one to talk to.” At each visit, you hear about her relationship with her boyfriend, about things she needs for her family (like needing diapers, food, clothing), about her favorite TV shows, and about her irritation with her family for not helping her more. She talks about her daughter, Emma, who is the child enrolled in the EI program, but has a very hard time focusing on interacting with Emma during the visit. You keep trying to bring the conversation back around to Emma but each time it veers off again. You find yourself doing more “hands-on therapy” with Emma than you’d like because it’s so challenging to interact with her mother. After several weeks of these visits, you just aren’t sure that you are providing the best intervention support to Brenda and Emma.
What do you do?
This situation is not at all uncommon in early intervention. We see families on a regular and often frequent basis and we work hard to build a trusting and comfortable professional relationship with them. This relationship, though, especially for a parent like Brenda who lacks other social supports, can present a challenge. We know that the best way to provide early intervention support is to support the child’s development within the context of parent-child interactions that occur during natural family routines and activities. Making this happen with a parent who, herself, needs a great deal of attention is not impossible but just needs a different approach.
Here are a few ideas:
Consult with the family’s service coordinator – Always a great place to start. He/she might want to pull together an IFSP meeting to see how intervention is going, revisit Brenda’s priorities for Emma and the IFSP outcomes. Maybe there are more important issues happening with Brenda and their family right now that are understandably distracting, such as not having enough food or clothing. The service coordinator can help Brenda find these resources to try to stabilize the situation.
Have a conversation with Brenda – Re-explain the purpose of EI so that Brenda understands the importance of her role in the process. Do this in a gentle way that invites Brenda to be more of an active participant. Remember that parents don’t come to EI knowing how they are supposed to participate.
Seize an intervention opportunity that will directly involve Brenda – When she mentions a struggle she’s having with Emma, have a coaching conversation or observe the routine. It’s YOUR responsibility to help her participate in the visits!
Use a Joint Plan – If you’ve not used it before, start using a joint plan with Brenda to give the visits some structure (see Rush & Shelden’s book, The Early Childhood Coaching Handbook, for guidance on how to develop and use a joint plan).
Be flexible in how you approach intervention – Maybe visits with Brenda and Emma will look differently from visits with another family where the total focus of the visit is on the child’s development. That’s okay. Maybe Brenda and Emma’s visits move in and out of these activities, with time spent supporting Brenda in focusing on Emma’s development and other time spent just talking with Brenda. You can do both.
Acknowledge Brenda’s efforts when she does focus on Emma – Especially if, at first, these interactions are short before a distraction pops up, be specific about acknowledging what Brenda did well. Point out how Emma responded. Ask Brenda if she can do it again to try to prolong the interaction.
Be vigilant about your own focus – It may take a lot of effort, especially in this situation, but be mindful to avoid falling back into a child-focused role where you are providing all of the intervention to Emma during the visit. Keep looking for ways to pull Brenda back in by talking about a struggle she mentions, asking to observe a routine, or asking her to try a handling technique or play activity. Remember that you are there to support her learning too!
So what would you do if you were supporting Brenda and Emma? How would you try to turn the conversation and activities of the visit toward more of a focus on Emma’s development?
If you are a service coordinator, what would you do?