2004 Jordan Institute
9, No. 2
Family-Centered Practice with Parents with Cognitive Limitations
In family-centered child welfare practice the family is the primary unit of attention. Respecting, strengthening, and supporting the familywhile guaranteeing child safetyare the hallmarks of this method.
Using this approach with any parent requires resourcefulness and conscious effort. To identify and build on a parents strengths, child welfare workers must first believe that the parent has strengths to build on. This can be difficult when, as so often happens, there are significant cultural and socioeconomic differences between the worker and the parent. When the parent in question has cognitive limitations, workers may find the family-centered approach doubly challenging.
This suggests that child welfare workers values and attitudes towards parents with learning difficulties are just as important as their knowledge and skills (Booth & Booth, 1993).
People with cognitive limitations can be good parents. Research has found that the ability of a parent to provide adequate child care is not predictable on the basis of intelligence alone (Booth & Booth, 1993; Field & Sanchez, 1999). When they succeed as parents, people with intellectual disabilities often do so on the strength of their emotional interactions with their children andespeciallyon the strength of their social supports.
This is not to say that every adult with developmental delays is or can be a good parent. Like everyone else, the ability of people with learning difficulties to parent successfully depends on a wide range of factors, including environmental stresses (unemployment, housing issues, other crises), the models of parenting to which they have been exposed, and the strength of their support network.
Studies have shown that people with intellectual limitations often exhibit similar parenting deficits, such as failure to adjust parenting styles to changes in their childs development, a lack of verbal interaction with the child (especially failure to praise), and insufficient cognitive stimulation. Critics of these studies point to their methodological flaws, most notably their failure to control for the effects of poverty (Booth & Booth, 1993).
Children can do well in these families. Many children raised by parents with cognitive limitations go on to lead healthy, normal lives, despite the fact that the environments in which they are raised are filled with difficulties (Booth & Booth, 1998a). Protective factors that make it possible for these children to succeed include personal traits (sociable, responsive to others, outgoing), family characteristics (warm, stable, and secure), and external factors such as supportive relationships outside the home and participation and involvement in the wider community (Booth & Booth, 1998b).
At the same time, research has found that children of parents with cognitive limitations are at risk for a number of negative outcomes, including developmental delay, poor school performance, and removal from their families. Though they may be due more to poverty than parental disabilities, these risks are recognized by our service delivery system. For example, having a parent with cognitive limitations is one of the risk factors that can make a young child eligible for early intervention services in North Carolina.
Parents with cognitive limitations who need improvement can often learn to be better parents. Even when people with cognitive limitations have clear deficits in their parenting skills, research suggests appropriate training can help them improve (Thompson, 1984; Feldman et al., 1989; Whitman et al., 1989). Specially designed training courses have been shown effective in teaching parents to nurture their children, to express their affection appropriately, and to learn essential parenting skills such as menu planning, grocery shopping, and techniques for managing problem child behaviors (Field & Sanchez, 1999).
Reflecting on this research, the bottom line is that people with cognitive limitations are like other peoplesome will be good parents, some will not. The only way to assess and support them is on an individual, person-by-person basis.
For example, a child welfare worker could react with dismay at the sight of a mother and her children eating off a newspaper table on the floor. Alternatively, he could see it as a demonstration of the mothers ability to establish a mealtime routine and to solve the problem of having no furniture. If he can see and build on small successes in a difficult situation, the social worker has the opportunity to build the parents self-esteem, dignity, and competence (Espe-Sherwindt & Kerlin, 1990).
In seeking to support parents with cognitive limitations, child welfare workers should actively seek out and/or try to develop benefactors for them. A benefactor is someone without learning difficulties who helps with the practical difficulties of coping with everyday problems (Edgerton, 1967). The one feature that has consistently been shown to distinguish families where the children remained at home from families where the children were removed is the presence of another adult able to give extended daily support (Booth & Booth, 1993).
The presence of a benefactor can be essential to the success of one of the most important family-centered strategies practiced in North Carolinachild and family team meetings.
and Family Team Meetings
Joan Pennell, of NC State Universitys Family-Centered Meetings Project, has these suggestions for involving parents with cognitive limitations in child and family team meetings:
Janice Doyle, a family assessment worker from Alamance County DSS, has held child and family team meetings with parents with cognitive limitations. She urges caution when inviting people to meetings. Because parents with developmental disabilities typically have so many issues and can be involved with so many systems, she says, child welfare workers may be tempted to invite lots of people. Sometimes, she says, that can be a mistake.
Like other people, these parents can feel threatened when surrounded by professionals and strangers in child and family team meetings. Doyle says that one mother she worked with felt so overwhelmed that she shut down. She stared at the ceiling without responding, Doyle says. People didnt know what to think. But when I talk to her one-on-one and let her be the expert I find shes a totally different person.
We hope the points below, taken from the articles in this issue, will prove useful to you in your efforts to provide family-centered services to parents with cognitive limitations.