Telling friends their child has a problem: when to step in and when to step backSarah Werthan Buttenwieser
Years ago, I ran into an old friend whose son had been daycare buddies with mine. She’d moved, and since then we’d each had one more child. “My little girl,” she told me, “is going to be the death of us. She’s wild. She crashes into everyone and everything, and she doesn’t sleep, but she is really good-natured.”
Her thumbnail sketch described a little girl, who quite possibly did not feel boundaries other kids did, which I blurted out, along with the suggestion that an occupational therapist could probably help her child obtain a better sense of herself in the world. “I learned about sensory issues, trial by fire,” I explained. My friend stared at me, jaw agape. “That sounds absolutely right,” she said. “I’m calling on Monday.”
According to everyone I spoke with, what I did was as wrong as could be, so I was lucky it turned out well.
Our preschool director explained why an insight like mine is usually unwelcome: “Parents are often in denial that their child isn’t perfect to the rest of the world. This makes raising concerns about a child a pretty challenging task.”
Since triggering a parent’s defensiveness might backfire, you need to be clear about that risk before deciding whether or not to say anything. Educators, social workers, and physical or occupational therapists alike agree that assessing your relationship with the parent is essential.
Desire not to offend the parents is counterbalanced by a sense of urgency, though. “The window of those early years is short,” a pediatric physical therapist says. “It’s by far the most effective period during which to treat kids. If parents of clients know enough to recognize issues, I encourage them to say something.”
An occupational therapist concurs. “Professionals or those who have had experience with developmental red flags should speak up – for the child’s sake,” she says. “While your input may be delivered at the expense of the parent’s feelings, you should ask yourself whether you’d have wanted your feelings spared over being offered an opportunity to help your child.”
So let’s say you’ve deliberated, and you’re compelled to say something. How should you proceed? I asked a few professionals in the health and childcare industries, and this is what they had to say:
Ask open-ended questions. For example, questions like “Is this your first child?” and “What activities do you do together as a family” can help you feel out whether or not the parents can see their own child in the context of other children and how receptive they might be to your own observations.
Share stories. By tapping moments in which you had problems with your own kid and sought help, you give both compassion and a concrete angle on how to proceed.
Offer concrete information and resources. Whether it’s the less intrusive suggestion of internet resources, or (gently) encouraging parents to get an evaluation, this is a place where specifics can really help.
Timing is everything. Sometimes, it’s really just best to wait for an opening. Obviously, these kinds of conversations go best when parents are receptive, so unless there’s real urgency to the matter, try not to inundate parents with unasked for information and opinions.
Be creative about how you choose to make your approach. Face-to-face conversations can be trying even when there’s very little at stake. If you fear your conversation is going to come off like a confrontation, try another route. One couple I talked to, both speech pathologists, noted their niece’s speech delay. Rather than broaching the topic in conversation, they decided to write a letter instead. The aunt reflected, “Initially, the parents panicked. No parent wants to hear that something might be clinically wrong. Once they’d digested the information though, they sought help for my niece.”
Consider whether you are the best person to deliver the news. Sometimes, it’s best to leave things to the professionals, even if you are a professional! A preschool teacher I talked to opted not to bring her concerns about her nephew’s speech impediment to his parents. “Because I felt his parents would take the news better from a teacher, I decided to let it wait,” she said. The kindergarten teacher identified the issue and they got him into speech therapy.”
Remember that immediate action is not guaranteed. Just because you bring it up doesn’t mean that the parents will be ready to act on what you’ve said. Practice patience. If you’re right, the next teacher or professional will probably bring up the same issue. Some professionals call it knocking on that door, as in, someone knocked on that same door already, so maybe it’s time we take a look.
Be specific when you do share your observations. Being direct is the best route, as is to describe what you are seeing without therapeutic or diagnostic language (no one likes to feel at the mercy of someone else’s judgment).
Try not to over-share. “The principle is to listen more and say less,” a social worker offers. “Later, you can reflect back on what the person has shared.” Less is more.
In the best of worlds, a parent is receptive. A mother I talked to recalled: “My friend is a speech pathologist. She explained that my son’s inability to pronounce the ‘f’ sound could be a concern. She thought he should be screened. I was grateful for the heads-up. Although he didn’t qualify for services, areas of concern were identified and I was given some activities to do with him. Without her encouragement, I wouldn’t have known to do anything. The bottom line is that I was glad to help my son.”
Another parent whose child experienced difficulties from a very early age described her sense of relief when a diagnosis was made: “I’d been so frustrated that my suspicions weren’t validated sooner than age three by pediatricians or friends and family. While knowing is a lot of work, it also means I can help my child so much more effectively.” When she notices things about other people’s children, she says, “I’m generous with my own story (hint, hint). Otherwise, I let it be. I’ve learned the hard way that some people want to remain in the dark.”
The takeaway? Children need all kinds of support to get from Point A to Point B – not just from their parents, but from doctors, therapists, and other adults around them. And in a case when parents are burying their heads in the sand about their kids, it’s up to the friends and family – the village – to gently raise the right questions.