MENTAL HANDICAP VOL. 13 JUNE 1985

Can all parents teach their own children? SUMMARY. Although over the past few years there has been an increasing trend to help parents of children who are mentally handicapped to work with their own child, there has been very little written on the factors which may determine which parents will work well with their child and which will not. This article considers some of these factors which should be taken into account before asking parents to work with their child.

Introduction It is now quite clear that if developmentally delayed children

are suitably stimulated in their pre-school years, their rate of development can usually be increased. This has led to the development of early intervention programmes.

Many of the early intervention services for pre-school children who are mentally handicapped are based on the Portage Project (Shearer and Shearer, 1972), which uses a precision teaching module and involves a home teacher visiting the child and parents at home to advise parents on how to teach their child. This system has been used in the UK, for example, in South Wales (Barna, Bidder, Gray, Clements, and Gardner, 1980) and Wessex (Smith, Kushlick, and Glossop, 1977), and found to be effective.

The current emphasis on the use of parents in early intervention programmes means that parents are expected to work consistently and systematically with their child, with guidance from the home teacher. It is my experience, after being involved in a Portage-style home advisory service for three years, that some parents are good at this and some are not. This paper considers some of the possible reasons why this is so. It is hoped that it will stimulate research into the problem.

At present there are few, if any, studies in literature which have isolated factors that can be used to predict why some parents will work well with their children and some will not. Callias (1980) for example, in considering the evidence for parental ability to learn from group teaching programmes, points out:

“At present there seems to be no way of forecasting accurately which parents will or will not benefit from group teaching, the suggestions made in the literature being poorly documented and based on little more than impressions.” (p. 184)

Thus, in the absence of direct evidence, it seems reasonable to speculate as to which factors may be playing a part.

Social class and educational level In his comprehensive review of early intervention studies,

Bronfenbrenner (1976) suggests that parents from the lower extreme of the socio-economic distribution will probably not be able to benefit from any programme that involves them working with their child. However, he confined himself to studies done in the USA; studies in this country do not seem to support this finding.

Callias and Carr (1975) reported on the effect of family characteristics, claiming that social class makes no difference but that a good marital relationship seems to be an advantage. Similarly, Cunningham (1975) points out that, although some authors have reported that parents who have received further education are able to learn from literature and reading whilst those who have not need more demonstrations and discussion, the parents’ educational level does not appear to affect their ability to teach their child.

Simon Whitaker

Thus, current evidence suggests that if parents are instructed in an appropriate manner their social class or educational attainment makes very little difference to how they work with their child.

Parents’ mood state It is well documented that a depressed mood is often

accompanied by lack of energy and a general low level of activity. It can be argued that as a group, parents of children with mental handicaps are vulnerable to depression. There is good evidence (for example, Brown and Harris, 1978) that major life events, one of which must be the birth of a child who is handicapped, can cause depression. This may be a major factor in determining how some parents behave with their child.

It may be wise, therefore, before asking parents to begin working with their child, to encourage them to express their feelings, and give them help to accept the handicap and cope with the depression.

Parents’ daily routine It is inevitable that some parents will be more organised than

others. It is my experience that some parents work well with their child, even though they have many other compelling demands on their time; and others, with considerably less demands, will report that they do not have time for this.

Several factors may combine to cause this. As well as the depression and acceptance of handicap already

mentioned, other demands upon parents’ time, such as cooking meals and washing up, have immediate consequences and are obvious when they are not done, whereas working with the child may only produce very slow change. Also, if parents do not organise their day, no time will be set aside for teaching sessions.

A statement from parents that they do not have time to work with their child may reflect these other factors, but some parents do, in fact, need help in organising their days in such a way that there will be time for teaching sessions.

Parents’ knowledge and skills Parents’ knowledge of how to deal with their special child may

be very limited. Most parents will have had little or no experience of children with handicaps before the arrival of their own baby. They are likely to feel that they do not have the necessary skills to cope and will consequently look for and rely on professional advice. It has been suggested by Cowan and Brenton (1975) that feelings of rejection, difficulty in coming to terms with the handicap, and a tendency to overprotect the child, often reported in parents of children who are mentally handicapped, are due to a sense of inadequacy in dealing with them. Even if the service parents receive provides them with full and detailed instructions of what to do with their child, parents’ relative level of knowledge and/or skills may still influence whether they carry out these instructions.

There have recently been several criticisms of the Portage- style home advisory services (for example, Gath, 1979; Berry and Wood, 1981) for not attempting to teach parents the necessary skills to decide for themselves how and what to teach their child. Not doing so may reinforce parents’ views that it is

SIMON WHITAKER, a Clinical Psychologist, wrote this article whilst working for Clwyd Health Authority at Broughton Hospital, Near Chester. He is now at the Department of Clinical Psychology, Harrogate Health Authority.

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MENTAL HANDICAP VOL. 13 JUNE 1985

the professionals’ job to do the work and this can make parents too dependent upon the home teacher. Sandow, Clarke, Cox, and Stewart (1981) found that children whose parents had visits from a home teacher once every two months had developed further after two years than children whose parents had received visits once every two weeks.

It may not be sufficient, therefore, to provide a service in which the home adviser gives parents explicit instructions on how to teach their child. The service may be far more effective in the long term if it sets out to give parents the skills and knowledge which will enable them to take their own decisions about what is taught to their child and how this teaching will be accomplished.

Parents’ self-confidence Even if parents have the approprite knowledge and skills,

they still may not have the confidence to use them. In other fields of study in which people are not using appropriate skills, it has been found that cognitive factors within the individual can play an important part (Meichenbaum, 1977). Schwartz and Gottman (1974) found, when they compared students who obtained dates with girls with those who did not, that there was no difference in the social skills the two groups possessed, but there was a difference in terms of the confidence displayed in using these skills. Similar effects may occur with parents who receive a home advisory service; for example, they may feel they cannot make their child sit at a table for a few minutes, or that they are unable to carry out the home adviser’s instructions in a systematic way.

Confidence, from a practical point of view, may not be a very useful concept, however, as it is difficult to measure. In a previous study (Whitaker, 1982) parents who were receiving a Portage-style home advisory service attended a course of five seminars on the behavioural principles behind the service. It was hypothesised that these seminars would increase parents’ knowledge of the principles and their confidence to apply this knowledge. Confidence was measured on the Judson SelfRating Scale (Judson and Burden, 1980), which allowed parents to rate their confidence on a seven point scale, before and after the seminars. It was found, however, that 10 out ofthe 18 parents rated their confidence at maximum on the first administration of the scale; consequently, there was little chance of later administrations showing up either parents who really were not confident or any subsequent change in confidence.

In assessing parents’ cognitive factors Bandura’s (1977) concept of “self-efficacy’’ is probably more useful.

Self-efficacy Perceived self-efficacy is the perception an individual has that

he will be able to complete a specific task or deal effectively with a specific situation. Bandura claims that it is a major factor in determining whether an individual will attempt a particular task; how long he will continue it in the face of failure; and how much effort he will put in.

In work with parents involved in teaching their child this measurement would differ from the above-mentioned measurement of confidence in that they would be asked to indicate the specific teaching and management tasks they felt able to perform, indicating how sure they were for each one. This form of measurement has been found to be a better predictor of future behaviour than is past behaviour (Bandura and Adams, 1977). It could, therefore, be potentially very useful for predicting parents who will not work with their child.

Bandura points out, however, that self-efficacy is not the only determinant of a person’s behaviour. He draws attention to the person’s “outcome expectancy”, that is, the outcome or result an individual expects from behaving in a given way. For example, the parents of a child who is mentally handicapped may have the necessary skills to carry out teaching programmes with their child in a regular and systematic manner. However, they may consider that the nature of the child’s condition is such that their teaching programmes will have little effect and they

may consider working with them a waste of time. It may well be important, therefore, to try to find out what

parents really feel about the probable effects of a service upon their child before asking them to work with the child.

Conclusions Although the factors mentioned by no means constitute all the

possible variables in determining whether parents will work well with their child, they do provide some idea of how to prepare parents of children who are mentally handicapped to work with their child.

If parents are thought to be suffering from depression it is wise to help them deal with this before trying to get them to work with their child, as any consequent failure with the child may aggravate the depression. Similarly, it is wise first to see how the parents view their own abilities to cope with the teaching situation, and whether they regard home teaching as an effective method of increasing their child’s development. If parents’ views on either of these points are negative, it will probably be necessary to spend extra time demonstrating to them that the child will learn as a result of their teaching. Finally, in the long term it is unwise to operate a home teaching system that does not expressly set out to give parents the necessary knowledge and skills to cope more independently with their child.

References Bandura, A. Self efficacy: toward a unifying theory of behaviour change.

Psychol. Rev., 1977; 84, 191-215. Bandura, A., Adams, N. E. Analysis of self-efficacy theory of behavioural

change. Cognitive Ther. & Res., 1977; 1, 287-310. Barna, S., Bidder, R. T., Gray, 0. P., Clements, J., Gardner, S. The

progress of developmentally delayed pre-school children in a home- training scheme. Child: Care Health and Dev., 1980; 6, 157-164.

Berry, I., Wood, J. The evaluation of parent intervention with young handicapped children. Behav. Psychother., 1981; 9, 358-368.

Bronfenbrenner, U. Is early intervention effective? Facts and principles of early intervention: a summary. In Clarke, A. M., Clarke, A. D. B. Early ExperienceMyth and Evidence. pp 247-256. London: Open Books, 1976.

Brown, G. W., Harris, T. Social Origins of Depression: A Study of Psychiatric Disorder in Women. London: Tavistock Publications, 1978.

Callias, M. Teaching parents, teachers and nurses. In Yule, W., Carr, J. (Eds.). Behaviour Modification for the Mentally Handicapped. London: Croom Helm, 1980.

Callias, M., Carr, J. Behaviour modification programmes in a community setting. In Kiernan, C. C., Woodford, F. P. (Eds.). Behaviour Modification with the Severely Retarded. Amsterdam: Associated Scientific Publishers, 1975.

Cowan, B. N., Brenton, A. Developmental training by parents of the very young child with potential handicap. Child: Care Health and Dev., 1975;

Cunningham, C. C. Parents as therapists and educators. In Kiernan, C., Woodford, F. P. (Eds.). Behaviour Modification with the Severely Retarded. Amsterdam: Associated Scientific Publishers, 1975.

Gath, A. Parents as therapists of mentally handicapped children. 1. Child Psychol. and Psychiat., 1979; 20, 161-165.

Judson, S. L., Burden, R. L. Towards a tailored measure of parental attitudes: An approach to the evaluation of one aspect of intervention projects with parents of handicapped children. Child: Care Health and Dev., 1980; 6, 47-55.

Meichenbaum, D. Cognitive Behaviour Modification. An Integrative Approach. New York: Plenum Press, 1977.

Sandow, S. Clarke, A. D. B., Cox, M. V., Stewart, F. L. Homeintervention with parents of severely subnormal pre-school children: a final report. Child: Care Health and Dev., 1981; 7, 135-144.

Schwartz, R., Gottman, J. A task analysis approach to clinicalproblems: A study of assertive behaviour. Unpublished manuscript, Indiana University, 1974.

Shearer, A,, Shearer, D. E. The portage project: a model for early childhood education. Except. Child., 1972; 39, 210-217.

Smith, J . , Kushlick, A., Glossop, C. The Wessex Portage Project: a home teaching service for families with a pre-school mentally handicapped child. Research Report No 125. Winchester: Health Care Evaluation Research Team, 1977.

Whitaker, J. S. The effect ofknowledge uponparents’fmhgs of being able to cope with their mentally handicapped child. Dissertation submitted to British Psychological Society, 1982.

1, 239-250.

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