This advice-column-style blog for SLPs was authored by Pam Marshalla from 2006 to 2015, the archives of which can be explored here. Use the extensive keywords list found in the right-hand column (on mobile: at the bottom of the page) to browse specific topics, or use the search feature to locate specific words or phrases throughout the entire blog.
Is Parent Involvement Necessary?
By Pam Marshalla
Q: Do you think that clients really can improve when parents never attend therapy as is common in the public schools?
The notion that children only can improve when parents are involved is a modern idea that runs counter to the way therapy has been practiced throughout the past century.
In 38 years I rarely have involved parents all the time. I have parents watch parts of therapy when they are around, and I give them encouraging information about how the child is doing. Some parents ask enough questions to let me know that they want to help, and to those I give advice. But others I specifically tell to let their child do the work on his own, and others I never meet even once.
I found for myself that children actually do much better when parents are out of the room. This applies equally to toddlers and teenagers. Toddlers never interact with us as well when mommy is sitting right there, and older children rarely open up all the way when a parent is overseeing the work too closely.
When we work in the public schools, we tend to say, “Oh rats! This child would do so much better if the parents were here.”
When we work in private practice, we tend to say, “Oh rats! This child would do much better if I only could get the parents out of here!”
5 thoughts on “Is Parent Involvement Necessary?”
I agree that parents should not be involved in therapy sessions. But I do think that in some cases for the little ones, parents must know what’s going on in those sessions. For example, if I have a 3 year old who is communicating primarily by pointing and hand leading and the parents accept this behavior, then my therapy will have little effect. Therefore, I have to let the parent know what we are doing in our sessions so that they will begin to stop responding to pointing and handleading (this can be very tough since often these children are spoiled and stubborn) and encouraging verbal output.
Let me add more thoughts to this discussion to clear it up a little because I get the feeling that some of you are beginning to think that I am cruel for not involving parents all the time. The plan of having parents always involved came out of three areas of literature— infant/toddler, severe/profound, and language. The plan did not evolve out of ARTIC. My own 40 years of personal clinical experience has taught me that having the parents always involved for arctic is a bad idea— for me. I would prefer to have direct 1:1 work with the client, teach him to produce the phonemes with me very successfully, and then have the child SHOW the parents what he has accomplished. That way HE is in control of HIS work. It sets up his own personal pride and carryover very nicely. Kind of like soccer practice. How many of you parents have your kids in some kind of sports practice, and how many of the coaches let you on the field/court to be an active part of the practice sessions? NONE! Why not? Because the coaches know that the kids will do better if the parents are a few steps away and just watch. Think about it. Just saying that some of us could benefit from taking a page out of that book…
The relationship between a young child and their parents is THE most important thing in the world to that child. We need to support it with any work we do as SLPs! They will make a bigger impact then we ever will. Please include them and teach them to support their child. You could make a life long impact on the family by helping the parent to help their child.
Before anyone out there has a stroke about my comments about keeping parents out, I need to clarify what I said and what I meant. I did not say to KEEP parents out, I said that the notion that kids can ONLY improve when parents are around is a modern notion that runs counter to the experience of thousands of therapists. When you are talking about infants and toddlers and preschoolers, OF COURSE, parents are involved. But I am telling you from 40 years of clinical experience that YOU WILL ESTABLISH A BETTER RELATIONSHIP WITH THE TODDLER, AND YOU WILL GET HIM TO DO MANY MANY MANY MANY MORE THINGS FOR YOU IF YOU SEPARATE HIM FROM HIS PARENT. I am not talking about separating him so he is screaming… Yikes. I am talking about fading the parent out of the picture so he can bond with you and interact only with you. I have watched countless hours of therapists working with kids while their mom is right there and I am telling you that I can get 10-times more verbal responses from the kid if I set up my own verbal routines with the child, and if I then teach the parent to do what I can do afterwards. A THERAPIST CAN NEVER UNDERSTAND THIS UNTIL HE/SHE TRIES IT, and I cannot convince you of it until you do.
I disagree. When working with toddlers and ei populations it is very important to support the parents and help them during therapy to build an enviornment during nontherapeutic times that will bolster a safe, nuturing environment that will encourage language development. A therapist can engage with a child several times a week, but if the child is not engaging with their caregivers during the course of their day s/he will be at a deficit. This is why I often say that the “work is with the parents”. I have seen most success when there has been true interest on the part of the parents. Once they beccome invested in the process I see a marked improvment with their children. I find that the parents who are looking to you to “fix” their children and are very hands off to be very challenging.
Now older kids are a completely different story.