Siblings, Who Invited Them to the Party? – A Table Talk Wednesday Recap

Written by Julie Higginbotham, Senior Case Coordinator, Mecklenburg County CDSA

Well, folks, we have officially completed the last of our Table Talk Wednesday events for the first year of EI Excellence, and what a year it has been!  We have rounded out our topics with a rich discussion about how to include siblings when working with families.  Amy Dunn, Speech-Language Pathologist with Pediatric Theraplay, opened up the room by asking why we should or should not incorporate siblings into our sessions.  She and Shannon Winsjensen, Service Coordinator with the Mecklenburg County CDSA, let it take off from there.  Funny, there weren’t any ‘should nots,’ but there were plenty of ‘shoulds!’  Here are a few that stuck out from the list….

• Siblings are there and part of the natural learning environment.
• Siblings are often ready and waiting for their brother or sister to succeed and play with them.
• It’s good for siblings’ mental health because the child enrolled in our program tends to get a lot of attention – it helps them feel included.
• There are great opportunities for teachable moments, especially when siblings may be talking for the younger ones, so we can facilitate better communication within the family as a whole.
• We can make a bigger impact when we are engaging the whole family.

How impressive is that list?  Seeing as how IFSP stands for Individualized Family Service Plan, it makes sense that we are talking about routines and priorities for the family as a whole.  We talked some about scenarios that we might find because, let’s face it, so many things can be going on when we arrive at families’ homes, especially now that we’re into summertime.  Some interesting ones included….

• Organized (or Disorganized) Chaos – The more siblings there are, the more chaotic it might seem.  While our goal is certainly to incorporate siblings into our supports, there may be challenges involved with that.  It’s not uncommon for families to feel extra pressure to balance everything and keep control of the environment, but that can take away from the coaching experience because we may not see the things that can be most helpful to families.  Working in that chaos could be just what the family needs to achieve their outcomes, and we need to remember that chaos could just be their reality.  Since we sometimes add to the chaos just because we’re there, some questions you can ask include, “What does this usually look like when I’m not here?” or “How is the child usually interacting with the other family members?”  These can help us get a clearer picture to lead us in the right direction, even in the chaos.
• The other siblings have needs, too – There are certainly times when parents need to tend to other siblings during our visits, and that is perfectly fine.  That’s what happens when we’re not there, right?  Siblings need snacks, potty breaks, boo-boo kisses, or just a minute of their parent’s attention since we have more of it during visits.  One person talked about a child who had an older sibling with special needs, and it was time to talk about bath time.  Rather than taking one child while the parent takes the other, what can we do to help facilitate that process so the parent can manage both children safely and still get them bathed?  In the moment, some of us are good at thinking on our feet and finding ways to turn this into a coaching moment without being too involved in the process.  Sometimes, though, we need to reflect back with the parent and talk about how that can happen differently if we were a bit too involved.  Parent may even come up with their own solutions, which really puts it all back into their hands.
• Families don’t want siblings to interfere with the work – Sometimes, when we come into the house, parents want the other siblings to occupy themselves so the child can get their “therapy” done.  While we want to be respectful of the family, take a moment to explain that having siblings involved is okay.  You can say, “I would love to have big brother help us out here.  How is he usually involved during this routine?” This is another great opportunity to get to know the family and meet them where they are so we can provide the best supports possible.  If those siblings are always there, what opportunities are we missing if we don’t ever see them interact together?
• Maybe we’re part of the issue – We all have the best intentions when we go out into the field to work with families, and we want to make the most of our time during visits so we can move toward achieving those outcomes on the IFSP.  One person mentioned that, when we feel like siblings are “interfering,” it could be because we’ve fallen into more of a provider-child therapy session, rather than a coaching interaction with the parent-child duo as the focus.  When parents are in that position, we automatically have to take into account that other kids need their attention, too – if there are four children in the home, we can’t exactly pull one out with the parent and work on speech, right?  On the other hand, how about the opportunity to help an older sibling communicate her needs if her baby brother keeps knocking over her blocks?  One person even said, “My child doesn’t operate in a box.”  Good point.
• Parents and siblings are used to over-helping the child – Families are used to anticipating their children’s needs, but sometimes, children then have fewer opportunities to try things for themselves and learn what to do next.  Parents and siblings make great teachers, and since they’re the experts on that child, and coaching them through ways to model daily activities, like dressing, feeding, or asking for things, really make a difference.  Sometimes, just asking, “Do you think the child can do this on her own?” is enough to prompt families to see it a different way.

So, here are a few quick tips to keep in mind when working with families to help include siblings in the process:

• Be intentional from the beginning and set up the expectation that we want to be addressing the family as a whole.
• Write outcomes from a family perspective, not just focused on the child in the program.
• Be patient, and take time to reflect with families to see how things could work better during visits.
• Family dynamics might not be what we have in mind, but each family has its own culture for us to respect.
• Siblings provide great opportunities for carryover into daily routines when we aren’t there.

Sometimes, visits feel like a big ol’ party with everyone there, and since we want to be part of whatever is happening when we get there, we need to be able to include the whole family in our supports because that’s what life is like for them.  There are so many learning opportunities that happen every minute of the day, and they don’t happen in isolated events for the child in the program.  When you give families information about how much more natural and helpful our information can be when we include everyone involved with the child, you may just find that they share more and trust more, and we all know how much better things can be when we all work together.

As we wrap up our first (and very wonderful) first year of EI Excellence, we’re taking July off from the Table Talk Wednesday events so we can head into the next year ready to bring more interesting topics and engage more of the big team of EI professionals.  Join us on August 20, 2014, and bring a colleague to discuss what happens when The Service Coordinator Is Coming!!