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Family Matters

It’s a play on words….Get it? “Issues pertaining to the family,” and “The family matters !”
Too often, all attention is focused on the child with ASD, and the family gets pushed aside. Not good! (As one of my colleagues, Ruby Salazar, says: “Your child with disability is a member of the family, but should not become the center of the family.”) And on the flip side of the coin, maladaptive behavior in a child (whether disabled or not) is frequently a symptom of problems elsewhere within the family. Like the canary in the mine shaft that warned coal miners of poison gas buildup, a child’s maladaptive behavior is often a signal of unaddressed issues elsewhere within the family. In both situations, the key to healthy development is to pull the camera back from a narrow focus on the child, to take a family-centered approach.

I speak from personal as well as professional experience. I have a sibling with developmental disabilities. I also grew up in a household that was terribly dysfunctional. It took me a long time to realize that my sister’s disability was not the problem. Her disability was added one more layer to stress – one more log on the fire, so to speak – but the real problems in our family lay elsewhere. No two families are alike, but perhaps I can pass some wisdom on to you that will save you a lot of unnecessary grief. (Notice that I said “unnecessary” grief. A certain amount of grief comes with the territory – especially if you have a child with ASD. But why heap unnecessary suffering on top of that?)
In my practice, the unit of treatment is the family. This is why I insist that both parents attend the initial evaluation, unless one parent is in jail, in the ground, or stationed overseas in the armed forces – even if they are divorced and hate each other’s guts. (In fact, that’s a situation in which it is especially important that both parents attend, for the simple reason that I do not want to become identified as a partisan player in an adversarial proceeding. ) Sadly, however, there is almost no attention paid by healthcare providers, therapists, or educators, to the health of the family. (In fact, it’s even worse than that: Nine times out of ten, it is mom who takes the child to the pediatrician, or to the therapist. By relating primarily with mothers, well-meaning human service providers actually undermine family integrity. Moms begin to “bond” to the healthcare provider or therapist, while dads get pushed further into the periphery.) I am continually amazed at how much progress I can make with both parents present, that would have been impossible with only one of them (and if, for some unavoidable reason, only one spouse can attend, I ask the one who’s present “If the other parent was here, what would he / she have to say?”).

So this column will be a place to sound off about “family matters,” and to underscore the fact that the family matters. Until the next time feel free to look around my website for more information, visit me on Facebook or read more in my book: Making Sense of Autistic Spectrum Disorders: Create the Brightest Future for Your Child with the Best Treatment Options

Family Matters 001 (revised 6/14/13)


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