Published by ASHA Leader, December 12. 2018
Read the blog at ASHA.org
As the new year approaches—potentially along with a new round of referrals—it’s a good time to prepare for new students who have yet to be identified for speech and language issues. Maybe it’s a new transfer student or a student receiving multi-tiered systems of support or one on a “watch” list.
Handling new referrals involves one particularly sensitive task—planning those conversations with parents about their child. We must strike a careful balance of stating facts, giving our clinical opinion and remaining empathetic to the parent and their perspective.
I find the following tips useful in handling these potentially challenging conversations:
Phrase your concerns as questions.
“Ms. Smith, have you noticed Janie has difficulty using the personal pronoun ‘I’ in sentences? She usually says, ‘Me want cookie.’ Have you noticed this at home?” Phrasing concerns as questions provides two benefits: It keeps concerns a two-way conversation and helps parents not get defensive. Nine times out of 10, parents will say, “Oh yeah, I’ve noticed that.”
Let them know you are listening. Use “I hear you. I understand.”
Sometimes people just want to be heard, and sometimes our job is to just listen. Let the caregiver speak. You don’t have to agree with them, but remind them you’re listening and let them know you understand their perspective. Listening often goes farther than speaking.
Clarify the concern/intervention/evaluation/IEP process.
In the schools, we often speak a different language than the rest of the world. IEPs, MTSS, RTI—we have our own private lexicon of acronyms. When parents meet with me the first time—especially when first discussing interventions—I hear some version of “I don’t want him labeled” or “I don’t want him pulled out of class.” I reassure them that referrals, in particular, don’t necessarily mean placement or services. The referral is a process requiring their consent and input for each every step. Clarify, and repeat if needed, steps involved in the referral process and continue this straightforward approach through each phase of working with their child.
Speak up about additional concerns besides speech or language.
Yes, we live in the world of speech and language, but we can detect other challenges a child exhibits. Maybe you suspect cognitive or psychological issues. Whatever your concern, speak up! Even for disorders outside our scope, we can still advocate for each child. Involve other professionals as needed—school psychologists, occupational therapists, physical therapists and teachers—and don’t be afraid to ask parents if they’ve talked to their pediatrician about your concerns.
Don’t take it personally.
This tip can be hard for SLPs in general. We want to help. We joined our profession to help. On occasion, however, we encounter a parent who simply doesn’t want help for any number of reasons. That’s their choice. Your role is to state concerns, educate parents about available services, and, if they decline your help, ask them to do so both verbally and in writing. It’s challenging to not provide services for a child who could benefit from them, but remind yourself all the good you do on a regular basis. The parents’ decision has nothing to do with you.
Some of my tips might seem basic, I know, but we all find ourselves in difficult conversations. What tricks do you use to make things go smoothly? Please share in the comments section below!
Katie Conn Suggs, MS, CCC-SLP, serves as a lead speech-language pathologist in the Charlotte-Mecklenburg, North Carolina, school district. She also founded a private practice, The Speech Carrot, and is an affiliate of ASHA Special Interest Group 16, School-Based Issues. firstname.lastname@example.org