On the road again. Enabling School Psychologists to work with families of children with ASD

On the road again

Enabling School Psychologists to work with families of children with ASD

This week I was in New Orleans, where I gave a presentation before the National Association of School Psychologists (NASP), on the topic of “Working with families of children with autism spectrum disorder.” You can download a copy of my PDF from that presentation here. Even though my session was scheduled for 8:30 a.m. on Saturday (not a prime slot!), it drew a large audience, and seemed to go over well. (I’ll let you know when I get the audience ratings.)

The short version of my talk can be summarized as follows:

Due to the strongly genetic nature of ASD, every child with ASD has at least a 50% chance of having at least one parent with significant cognitive or mental health issues (we’ll go into these in a future post).

Given this risk, a strong case can be made for proactively performing family function assessment on the families of all children with newly diagnosed ASD.

When assessing a family, Rule #1 is to get both parents involved. (When I was in private practice, I required both parents to attend the evaluation. The only exceptions were if one parent was unknown, completely uninvolved, deceased, in jail, or stationed overseas with the military.) Much of the time, however, schools wind up meeting with only one parent – usually mom, but occasionally dad – and only rarely do schools get into the business of assessing the inner workings of the family, and how that may be impacting the child’s behavior and learning at school.

Common excuses offered by one parent or the other for not both attending school meetings include:

• He/she is too busy to come.

• We agree on everything, so only one of us needs to be there.

Or, the mirror image of the above:

• My spouse (almost always “he,” occasionally “she”) refuses to come. I am the one who has to deal with this.

• My ex-spouse and I have a hostile relationship; I don’t want my ex to be involved.

It’s tempting to meet with the one parent who’s more readily available (usually mom), especially when the issue on the table is family function, but it’s sub-optimal. By agreeing to meet with just one parent, the psychologist limits their ability to get a full picture of what’s going on within the family, and may be perpetuating family dysfunction: Sometimes, one parent has isolated themselves from child-rearing and needs to be pulled back in. Sometimes, however, the absent parent actually has been pushed out of the picture, and the role of the psychologist is to enable the excluded parent to get back into the picture. In either case, getting both parents into the room is the first step towards making progress. (This is true for all families, but especially the case for families of children on the autism spectrum, since there is a strong possibility that one parent or the other has cognitive or mental health issues that can negatively impact on the child’s development.)

Most school psychologists have little or no training in family systems theory or its practical application (i.e., family therapy). In order to meet the needs of children, such training is badly needed. Unfortunately, there are huge institutional barriers to getting there.

More next time.

James Coplan, MD is an Internationally recognized clinician, author, and public speaker in the fields of early child development, early language development and autistic spectrum disorders. Join Dr. Coplan on Facebook and Twitter. Have a question for Dr. Coplan? Ask the doctor.