Provider Strategies for Working with Parents with Cognitive Disabilities
Q: HOW DO I ASSESS AND MEET THE NEEDS OF A PARENT WITH COGNITIVE DISABILITIES?
- First determine what the parent already knows about the topic at hand. For example, in terms of basic medical care, does the parent know how to properly take a baby’s temperature, read the thermometer, and understand what the reading means?
- Ask and observe how a parent learns best. Does he/she respond best to directions given verbally, with visuals, with role-playing, and/or with practice?
- Prioritize the most important tasks to present to the parent. For example, before referring a parent to a service that will require the parent to take a local bus, you may have to first assess the parent’s ability and comfort level with using public transportation
Q: WHAT ARE THE BEST WAYS TO PROVIDE INFORMATION TO A PARENT WITH COGNITIVE DISABILITIES THAT I AM WORKING WITH?
- Encourage a partnership approach by letting the parent set the pace and help decide when there is “too much” information.
- Break longer or complex tasks into smaller steps.
- Focus on explaining and teaching one task at a time. As an example, when encouraging home safety, you may have to explain and review each childproofing activity separately. Once a parent accomplishes one childproofing activity, then you can move on to the next: (1) the importance of safety gates, (2) the importance of stove locks, and (3) the importance of outlet covers.
- Model or demonstrate new skills and provide concrete examples.
- Use videos, audiotape, and visual aids.
- Use repetition, reminders, and cues. Telling a parent once (at the beginning of the month) that they need to budget for the month is not effective. Some parents with cognitive disabilities may struggle to understand how to plan for money on a weekly basis, especially if they receive their income only once, on a monthly basis. Such parents will require ongoing reminders and cues regarding their spending habits.
- Be mindful that a parent might have reading difficulties. Read written instructions or applications out loud if needed. This is particularly important in terms of written documents such as prescriptions, medication labels, individualized education plans, consents and any applications for housing and benefits. An individual may demonstrate an ability to read a basic permission slip, but many individuals would struggle with reading (and understanding!) an application for food stamps. Even if a parent indicates that they can fill out an application, respectfully ensure their ability to complete the task.
Q: HOW CAN I HELP SUPPORT THE ORGANIZATIONAL SKILLS OF A PARENT WITH COGNITIVE DISABILITIES?
- Help the parent arrange their schedule so that they can feasibly attend all their appointments.
- Help the parent develop a system for documenting their child’s medical and medication history. For example, helping a parent to divide up an accordion file folder into different sections (e.g., medical, dental, and educational) may go a long way towards increasing their ability to produce necessary documentation upon request.
- Assist the parent in writing down information to be shared for appointments with different providers (e.g., school staff, doctors). As an example, it may be helpful for a parent to have one list of all the services that his/her child is involved with, which includes when the child participates in the activity and the contact information for each of the child’s service providers.
- Help the parent identify and write down questions they would like to ask their child’s provider during their next appointment. For example, a parent might want to ask a medical provider what the side effects of a medication are and what to do/whom to call if a dose of the medication is missed.
- Encourage the parent to document information from appointments, such as follow-up appointment dates or medication instructions.
Q: HOW DO I ENSURE THAT A PARENT WITH COGNITIVE DISABILITIES UNDERSTANDS THE INFORMATION I AM PRESENTING?
- Provide opportunities for the parent to practice skills, through role-play and demonstration. For example, if you are working with a parent on the skills of properly feeding a baby, you might request them to show you how to feed the baby after you teach the skill. Remember, even small steps deserve praise!
- Use either/or questions rather than yes/no questions. For example, a caseworker may ask, “Would you like me to go to the housing appointment with you or would you like to go with your service coordinator?”
- Ask the parent to tell you how to complete each step in his or her own words. For example, after teaching a parent steps for giving an age-appropriate time-out, you may request them to repeat the steps in their own words. Remember that an individual nodding their head in response to a question or statement does not necessarily mean that the information was understood!
- Help the parent think of examples from their own experiences that connect to what you are teaching.