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Module 2: Having Challenging Conversations: Raising a Concern

1. Describe Observations of the Child’s Behavior

Let’s review the six Relationship-based Practices we use to build and maintain positive relationships with families. Today, we’ll think about these specific strategies in the context of having a challenging conversation about a child’s development.

Erica on screen, “Six Relationship Based Practices”

The first strategy is to describe observations of the child’s behavior. These should start with positive observations that are likely to be reassuring to the parent. Positive observations are different than compliments.

Parents need to know that you recognize and appreciate their child’s unique strengths. It’s easier to face challenges together when the child’s strengths have also been carefully observed together. Even more importantly, sharing your neutral observations helps engage parents in observation and reflection, so that we get to hear what they think of the behavior before we offer any idea of our meaning; positive or otherwise.

An example of an observation that is both neutral and positive is “I noticed Ben goes straight to his cubby when you two come in—he knows exactly where it is.” This kind of statement invites parents to observe their children with you and over time, open up to us about their hopes and dreams for their child. The parent’s response to our neutral comments guides us as to what to say next.

Character/sprite (of Diana) pops up and has a speech bubble saying:
“I noticed Ben goes straight to his cubby when you two come in. He knows exactly where it is.”

2. Focus on the Family-Child Relationship

Next, it is essential to focus on the family-child relationship. Especially as we prepare to have challenging conversations with families, we want to be extra careful to recognize and highlight that the family-child relationship is the primary one in the child’s life.

These conversations are only challenging in the first place because families care so much! When a family has an emotional reaction to a concern, it shows the depth of their emotional connection and dedication. Rather than fighting against a parent’s strong emotional response to your concerns, you can work with it to help the family get through a hard time together.

The power of their emotional connection is a protective factor for the family as they cope with a challenging conversation. For instance, you might say, “And when he finds his cubby, he always brings you over by the hand; you two seem so close.”

Dialogue bubble shows Max saying: “I hope so; we pretty much just have each other right now.”

3. Value a Family’s Passion

Next, try to value a family’s passion. When we bring a concern to parents, their reaction is rooted in their powerful drive to protect their child, as well as their passionate hopes for their child.

It can be easy for us to forget this when they direct their strong feelings at us in ways that make us uncomfortable. For example, any time we start to feel like, “Hmm, maybe the parent is in denial,” that’s a good time to step back and reflect.

You might think about how any parent would feel worried when a concern is raised about their child, and that might make it difficult for them to hear us. We might feel like we want to talk the parent out of their perceptions when they don’t agree with us.

For these first conversations about developmental concerns or behavior to be successful, we have to be patient with parents as they process and react to the information. It’s our own passion for the child’s well-being that can make us to want them to agree with us immediately.

Instead, we can help the conversation flow more smoothly by joining with the parents’ passion and trying to understand their point of view. You might respond to what seems like a parent’s “resistance” or even disagreement with you by deepening the conversation towards understanding. Listen so that they are seeing and thinking, valuing their input rather than trying to explain or justify your own perspective.

For example, we could say, “So right now, you’re really able to understand what he needs and wants.” Using parents’ own observations and expertise to further the conversation is a great way to value their passion and build collaboration.

4. Support Parental Competence

Next, support parental competence. Parents’ perceptions about their child’s development should always be taken seriously. Often they might suspect a concern before the professional does.

Supporting a parent’s competence means listening for the observations and concerns before you tell them about your understanding of the challenges. This reinforces the parent's expertise and makes it more likely that you can share your observations effectively.

It means celebrating the parents’ critical role and appreciating their unique understanding of their child. When we support parents’ competence we honor their unique ways of addressing the child’s challenges – whether they see these as challenges or not. For example, you might say, “Ben shows us things here at school, too. It looks like you’ve helped him learn that that’s a way of communicating.”

Diana’s speech bubble saying:
“Ben shows us things here at school, too. It looks like you’ve helped him learn that that’s a way of communicating.”

Dialogue bubble shows Max saying:
“Thanks. I know I work hard to make sure he feels like he can come to me when he needs something.”

5. Actively Reflect on the Family’s Perspective

When there’s a developmental concern, it’s critical that we actively reflect on the family’s perspective. Invite parents to share their own observations and goals about their child and the family.

You might say, “While we’re talking about Ben’s communication skills, what would you like for him? How would you like to see him be able to express himself when he is older?” Although you are always there to support them, it is necessary to hear and consider the family’s views before coming up with a collaborative plan of action. It is also critical to reflect back to parents what you have heard, and to say it in a way that shows you value their perspective.

Dialogue bubble shows Max saying: “I want him to be able to really be in the mix—you know, able to talk with me, but also with his friends and teachers.”

6. Reflect on your own perspective

It’s also important to reflect on your own perspective as you talk with parents about your concerns. Your expertise, of course, is valuable too. But while your role is to provide support and guidance, you aren’t there to promote your own vision of how you think the family should operate, even if you feel like you know better than the parent about some things.

Again, when we’re worried about a child, it’s easy to slip into the role of telling a parent what we think they should do in their child’s best interest. Our determination to help can easily backfire and be off-putting to a parent, disrupting the collaborative process.

Reflecting on your own perspective helps you identify your own emotions so you can set aside any unhelpful judgments and biases, and better manage any feelings of discomfort. Try looking for common ground between you and the family to strengthen your partnership.

Something I’ve noticed is that starting a discussion about a developmental challenge too directly often isn’t very effective. Instead, I’ve had much more success by first talking about the child in general: the child’s strengths and things I see the child do that I know the parents have seen too. Then I can begin the conversation using the strategies we discussed while also applying the Strengths-based Attitudes.

The strength of our relationship with parents is key to providing the best care for the child. When you have this kind of partnership, discussions often feel easier and less stressful.

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