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Presentation on theme: "UNDERSTANDING NEURODEVELOPMENTAL DISORDERS (ASD & ADHD) AND THE IMPLICATIONS FOR PARENTING PLANS Segment 3: Parenting Plan Considerations Linda Popielarczyk,"— Presentation transcript:


2 Genetic component involved with neurodevelopmental issues Family law professionals should give pause to the possibility that either parent may present with some of the traits, or any of the co-morbid diagnoses commonly associated with the child’s diagnosis Considerations for Parenting Plans

3 Parents and NDD’s Many adults with high functioning autism (HFA) are not formally diagnosed given the limits of our understanding until added to the DSM-IV in 1994 Intellectual functioning can be advanced, and social- emotional functions more subtly impaired Not uncommon for one or both parents with ‘broader autism phenotype’ or ADHD to finally identify the name for their own difficulties when their child is diagnosed; or to realize other extended family members have these traits

4 Parents and NDD’s Cont’d Certain traits of ADHD and HFA can make it very difficult to focus on the needs of children With HFA: ‘Mind-blindness’, egocentrism, challenges with compassion, empathy and reciprocity, and rigidity Mediation may be ill-suited because “good faith negotiation requires the {HFA} parent to recognize and appreciate another’s needs, a core deficiency in autism” (Jennings, S., FCR, 2005)

5 Parents and NDD’s Cont’d With ADHD: Egocentrism, impulsivity, poor adherence to the schedule and routines, poor conflict-resolution skills sometimes including oppositional and anti-social behaviour Negotiation may require strong mediation and may not work because of poor conflict resolution skills and disregulated emotions Attention to parenting strengths and weaknesses, including consideration to available social support, involvement of extended family, and responsiveness to direction and change

6 Parents and NDD’s Cont’d When a parent may have traits of ASD or ADHD, the parenting plan: Must be comprehensive Requires guidelines for approaching conflict with specific rules that are concrete and reduce ambiguity ADR: Where possible, a parenting coordinator may guide and enforce standards of conduct, issue appropriate penalties for violations and rewards for compliance, and make decisions where not anticipated within the parenting plan (Jennings, S., FCR, 2005)

7 Neurodevelopmental disorders can vary immensely in presentation regarding severity and pervasiveness The “diagnostic approach” versus “functional approach” to understanding the needs of these children (Birnbaum et al., 2012) PARENTING PLAN CONSIDERATIONS

8 Where parents are in dispute: Importance of objective input from the child’s care team (Letter, Assessment Report…) with regard to the severity and pervasiveness of the disorder, recommendations for interventions before contemplating parenting plan or final order “Best Interests of the Child’s Special Needs” (Saposnek, 2005)

9 Considerations Cont’d re Major Decisions… Cases of “high conflict”: Major decision-making authority is essential to determine Many decisions with no room for argumentative, posturing parents 9 considerations re custody of a child with Autistic Spectrum Disorder (Jones, L.R., & D.L. Holmes, 2009)… Consider Connor & Spencer


11 Where sole decision-making is appropriate: Include protocols for notice of upcoming decision and the process by which the other parent may offer input Consider compliance pattern of the other parent Where shared decision-making is considered: ADR: Crucial to appoint a neutral third party to make final decisions in case of impasse, such as the attending physician, pediatrician, parenting coordinator, or arbitrator

12 Considerations Cont’d re Health… Requirement to consult with the same primary care physicians, apart from emergencies, as appropriate

13 Involvement of both parents, together where possible, with professionals To attend specialist appointments to understand diagnosis, medical/psychological needs, and to develop plan for managing child’s care and routines (Birnbaum et al., 2012) Where unable to attend together, expectation that each parent arrange own appointments Protocol for communication of professional updates

14 Medicinal treatment Duplicate prescriptions, wherever possible Each parent responsible for filling the prescriptions on time, and administering them as needed Communication protocols regarding the purpose of medication, any medication changes, last dose, noted side effects

15 Considerations Cont’d Communication… ADHD: Communication protocols need to cover issues such as behaviour, youth follow-through, consequences that may carry to other home ASD: Communication protocols need to extend to issues pertaining to child’s coping and cooperation with home application of autism- specific intervention behaviour strategies A guiding principle: The concept of “Continuity of Care” (Saposnek et al., 2005)

16 Considerations Cont’d re Education… Where possible, jointly participate in formal and informal school processes, to be suitably apprised of their child’s progress, the child’s IEP (individual education plan), any modifications needed, continuity between homes and school

17 Autism Specific Therapies: These educational interventions show strong scientific evidence of improving social communication skills Private: Expensive Publically Funded: Long Waiting-times Each case must be considered on its own merits, triaging the needs of the child, the options, and the financial resources available Considerations Cont’d re Treatment

18 Where clinically indicated, and financially available or publicly funded, parents should be compelled to support the child’s therapies, including as examples, autism specific therapy, speech and language therapy, occupational therapy, enrollment in preschool, behavioural parent training, family therapy. It is in the interests of the child with autism or ADHD for each parent to be involved

19 Considerations Cont’d re Parenting Time… After meeting a child with an ASD, you will have familiarity with one child with an ASD… Same with ADHD No ‘One Size Fits All’ where it comes to residential schedules for children with NDDs Idiosyncratic differences between children re reactions to transitions

20 The toll of parenting a child with a severe disorder The benefits of shared parenting time providing respite to each parent when the child spends time with the other Requires 2 parents capable of encapsulating their feelings about former partner to focus on the needs of the child

21 Considerations Cont’d Raising a child with special needs has a ripple effect throughout the family Sheila Jennings (2005): The needs of the child with special needs balanced against the needs of their neurotypical siblings. For example, the children and the parents will benefit from one-on-one time Beneficial contribution of siblings

22 Saposnek and Perryman (2005)--T he concept of “Least Restrictive Environment” (LRE) In this context, the LRE principle would refer to the “greatest degree of unrestricted access to both parents” A continuum ranging from equal time with each parent to supervised visits or no contact with a parent, where appropriate Restrictions may be incrementally increased to meet the child’s needs, as required

23 Parenting schedule should give due consideration to child’s therapy schedule or programs: Each parents’ ability to manage logistics, implement at home as needed Consider the child’s psychological age, not chronological age

24 Special requirements with regard to space (an ‘island of solitude’), managed external stimuli, allergies, and others less so. Some require access to kinetic expression

25 Need for predictability and routines: Intense for some children and requires cooperation between parents Consider items in Parenting Plan entitled “Routines”, “Sensory Issues”, “Safety”, or “Pets”, providing specificity re parental responsibilities

26 Questions, comments, and discussion


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