Monday, May 4, 2015

Incorporating Parenting Into Ongoing Family Consultation

Sonny McWilliam with her daughter, Tinsley, at the Outer Banks

Early intervention is, at its core, a parenting program. I mean it is designed to help parents rear their children in ways they want to, with added information about what’s good for their child, considering his or her disabilities, delays, or risk status. The child’s situation is the key unlocking the door for the family and us to get together, but, once we’re in the same room, parenting is what we’re talking about—at least when implementing the Routines-Based Model.
I don’t mean to imply that parents are deficient in their parenting. Rather, as we engage in joint solution finding around the individualized goals, we have the opportunity to encourage five evidence-based parenting strategies.


Most people in early intervention are aware of the landmark study by Hart and Risley (1995) showing the relationship of the number of words a child hears to the child’s language development and the relationship of socioeconomic status to the number of words heard (poorer = fewer words). Hart and Risley also saw that the poorer children heard a greater proportion of negative words (stopping child engagement, redirecting unnecessarily, harsh words) than less poor and richer children heard. Other researchers have also stressed the importance of the quality of language used with and around children (Konishi, Kanero, Freeman, Golinkoff, & Hirsh-Pasek, 2014).


Reading to the child can start even before birth. Reading is a good way for families that find talking to nonverbal children strange to provide them with words. On the other hand, “reading” isn’t as important as shared book time, when the adult talks to child about the pictures or about the story (Whitehurst & Lonigan, 2001). Reading with children is probably a good way to teach children to appreciate books.


You’d think play comes naturally to parents, but not necessarily. I’m not talking about playing with a toy, necessarily. More about being playful. The key is really getting in tune with the child and keeping him or her engaged. Knowing when to expand on the play “schema” and when to stick with the existing one. It involves loosening up adult inhibitions. In addition to social play with adults, children do benefit from learning to play with objects independently.


Children learn from their parent, whether you want them to or not! But what is it parents do? They use reinforcement principles, for one. We point out to parents how there need to be good consequences when children are doing what the parents want him or her to do. And there should be a dearth of attention when they do what the parents don’t want him or her to do. We sometimes help parents with the timing of their interactions with the child, to promote their effectiveness at making those interactions teaching moments. Cultural anthropologists have said that, in many societies, children learn their cultural norms by observing adults who are not necessarily actively teaching them (Lancy, 2014).

Behavior Management

Behavior management of very young children is still about teaching them. Some parents have an easy time of it, either because they’re masters at behavior management or they’re blessed with children who don’t give them much trouble. Other parents might face challenges in this area, so early intervention is very much about helping families feel in control without getting into power struggles.

In the Routines-Based Model

In this model, the topic of conversation with families, especially in early intervention for children under 3, is often a child’s engagement, independence, or social relationships (EISR)—things addressed through goals, if a good Routines-Based Interview was conducted. If you focus on EISR, you still get to traditional developmental domains.
Even when we’re talking about outcomes/goals, however, we’re doing so in the context of routines. Routines as we define them (naturally occurring activities and rituals) are when parenting occurs; they provide the context both for goal-related interventions and for parenting strategies.
If we think of early intervention as a parenting program, we normalize the experience. The five parenting strategies listed above aren’t for parents of children with disabilities; they’re for all parents. Most parents are already doing at least some of these things, so our attention to parenting allows us to build on adult strengths and sometimes to point out things they could do more.