Imagine you are the parent who’s child is newly referred to early intervention (EI). Someone calls you and asks to come by your 
home. “Why,” you wonder, “do they want to come here?” Then, when the service coordinator arrives for the intake, she asks you personal questions about your child’s medical history and your family finances. “Why do you need to know about my income?” you ask. The assessment is held and they say your child can’t stand on one foot or dump pegs from a bottle. You think, “So what? He’s never had a reason to before.” You’re exhausted but the group plows on and asks you about your goals for your child and what services you’re interested in. “I’m not sure, what do you think?” you ask, while wondering why they are asking you when they are supposed to be the experts. So many questions…it’s all overwhelming and puzzling. And then the therapist comes out for the first visit, and asks you more questions about your daily routines. Maybe if you understood why all these questions were important, you would know how to answer them…
Sure, this might be an exaggeration and some families might not feel this way at all. However, really try to put yourself in this parent’s shoes. If he or she has no previous experience with EI, all of these questions could seem like an intrusion. It’s easy for us (as early interventionists) to plow through these first visits because we know why we need the information and this is our world. Imagine for a moment what it must be like for a new parent, probably in a vulnerable position, to walk into this world and get asked so many questions.
Now consider – what can you do to make this easier for the parent?
ALWAYS Explain Why
Adults naturally need to understand why something is happening, why it’s important, why it matters. Not knowing can be a barrier to developing the relationship with the family so start off on the right track with building understanding. Remember that most parents have never been a part of a system like EI and you are there as a guide. Take a few extra moments before you ask questions or share information to explain why it is important and how the information is relevant to each step in the EI process. For example, rather than starting the conversation with “What are your goals for your child?” (which can really put some parents on the spot), start with an explanation such as “One of the things we do when we are writing the Individualized Family Service Plan, or IFSP, is talk about what you would like to see your child learn to do. We call these goals because they will help us understand what you’d like to get out of early intervention. The goals also help us figure out how to help you and which service provider might be best to come work with you. When you think about your child’s development, what would you like to see him be able to do in the next few months?” Sure, it takes longer but it helps the parent understand why the question and answers are important. It also encourages her active participation and decision making , which is key for a successful EI partnership.
Have a Conversation – not an Interview
Parents in EI should never feel like they are being interviewed. Everything we need to know can be gathered from a rich, engaging conversation. No matter how much paperwork you have to complete or how many questions are on your intake form, take the time to have a conversation and I bet you’ll learn all about the family’s priorities, concerns, resources, outcomes, and interests. Use open-ended questions, and follow them with feedback that lets the family know you’re listening. Dig deeper and listen for key information…then maybe you won’t have to ask so many questions.
Read the Situation and Adapt
Some parents will be ready to go – sharing information and freely asking and answering questions. For others, they might need to go a little slower and absorb what is happening at their own pace. Be mindful of where the parent is in the moment. You might have to make more than one visit to complete the intake. You might have to schedule the IFSP meeting at a different time because the parent has had enough with the assessment. Yes, we have our timelines, but our family-centered practices are important too. If the parent needs more time, or opts out of sharing something, that’s okay. Be sure to let the parent know that too and then document their decision. Afterall, we do this job to support them. It’s their IFSP and their EI experience. Let’s make it a great one.
What strategies would you add to this list?
How do you avoid overwhelming parents with too much information and too many questions at the intake, assessment, IFSP meeting, or the first service visit?
Share you great ideas in the comments below!
Dana, you are willing to tackle tough subjects and wade into real-life challenges and issues for frontline early interventionists. Thank you! As our agency has moved to family-centered practices over recent years these challenges have risen to meet us face-on. The 45 day timeline is a pressure on staff but is meaningless to a family who is only concerned about their child….and their family pressures.
It is important to balance the need for gathering rich information for a quality IFSP with the need from most families to start “doing something” instead of simply asking questions. It seems the most sensitive part of building a relationship in quick order is to ask frequently, especially if there is a sense of frustration, how the person is feeling about these questions, offering again the fact they do not need to share anything they’re uncomfortable with, and reassuring them that evidence-based practices in early intervention show these questions will lead to better outcomes for their child and family. In other words, bear with us and the result will be worth it!
Thanks, David. I really love what you said about families needing to start “doing something” from the beginning rather than simply answering questions. That collaborative, reciprocal relationship in which the parent is an active participant absolutely can begin from the first contacts and the first visits. Passively answering questions is not active participation! Thanks for also adding the point about letting parents know they can opt out of sharing any info. That is so important for parents to know!
I appreciated this post as well, Dana. You raise some good points. I particularly agree with the idea of having an open-ended conversation, not an interview. I liken it to authentic assessment as we get a much more holistic picture of the child by observing them in an open-ended, unstructured forum and are able to glean most of, if not all, the information we need. I also really like your idea, David, of checking in with families as you ask as merely showing interest in how they feel can soften some of that skepticism they have over the questions themselves. When they realize there is a caring person behind the questions, they are more likely to engage and answer more of what we ask. I guess it all goes back to that relationship.
So well said, Jeff! I just love what you said about having a caring person behind the questions – makes a huge difference!