PARENT COACHING
PARENT COACHING
IN PEDIATRICS
By Laura Goltz , OTR / L , C / NDT – AMSIS Secretary
The role of ‘ parent ’ may very well be the most important role we take upon ourselves . Nobody would argue that this is not a challenging role ! If parenting becomes frustrating or overwhelming , and a parent runs out of tools to effectively participate in this IADL , a pediatric occupational therapy practitioner experienced in parent coaching can help .
Pediatric occupational therapy practitioners with advanced knowledge or experience in parent coaching can make a huge impact on parents and their children by assisting in creating a peaceful home environment . Occupational therapy practitioners ’ expertise in child development , sensory integration , self-regulation , co-regulation , task analysis , and adaptive behaviors allow us to coach parents in a holistic , informed , and action-oriented way .
Parents often seek my parent coaching services when home routines and interactions are causing conflict or discomfort . The parent may feel that the child is not following their rules , or they may not like the actions they feel they must take to encourage compliance ( yelling , threatening , etc .). Most of all , parents come when they feel what they are doing at home is not working and they need more or different parenting tools .
The first and most important step in parent coaching is developing rapport with the parents . I focus on listening without judgment , asking questions , and being curious about the family system . This in-depth conversation is my evaluation and allows me to help parents identify their parenting values and goals . Next comes goal setting . The overarching goal is always to achieve a “ peaceful household ,” but parents ’ concerns and reports of conflict at home guide more specific goals . Helping parents prioritize goals with appropriate expectations is an important part of goal setting .
Example :
Parents ' concern : “ Dinnertime is so stressful . My child won ’ t sit at the table , won ’ t eat what I make , and we can ’ t have a decent family dinner conversation .”
While all those issues can be addressed , we need to isolate them to focus on one issue at a time . I encourage the parents to choose the highest priority first .
Is the goal :
• Increasing sitting time at the table for dinner ?
• Consuming calories ?
• Trying new foods ?
• Communicating about their day ?
Once parents see how complex an enjoyable , peaceful , nutritious , engaging family dinner is , and we ’ ve broken down the goal into achievable parts , we can then talk about appropriate expectations of the child based on the child ’ s developmental age and skill level . Then we are able to focus on how to achieve the goal .
When a parent brings up a conflict scenario at home , among other things , I look at the parents ’ reaction or response . I will always ask if their reaction or response worked to achieve their desired outcome . If the answer is “ yes ,” we move on . But more often the answer is “ no .” That ’ s where I come in as a parent coach . By guiding the parents ’ reactions and responses , helping them create appropriate expectations , and having them respond consistently and calmly , we are able to successfully change the child ’ s behavior , and do it with calm , peace , respect , and love .
I have found that it is rare that insurance covers parent coaching as an individual service . If the OT practitioner is also treating the child , parent coaching might be covered using the new caregiver codes .
No matter what the goals or the family values are , I find myself teaching parents certain fundamentals :
Validate
All people want to be seen , heard , understood , and respected . Teach parents to do that for their children while setting appropriate boundaries . The key to that is validation .
Example : Child : “ I want that toy !”
Parent who has been coached : “ You really want that toy ! I can see that ! ( validation )
We can ask Sally if you can have that toy when she ’ s done .”
Catch them doing good
Teach parents to notice the positives , no matter how small they are .
Example :
Parent who has been coached : “ I noticed you being flexible and sharing your ball with your sister .”
“ Good job using your words when you needed help .”
Illinois Occupational Therapy Association | 2024 ISSUE 3 / 4 8