How to Communicate with Families to Build Trust, Connection, and Engagement

 

The best outcomes for clients and students happen when parents, caregivers, educators, and clinicians collaborate. But cultivating effective partnerships can be difficult. It’s hard to establish trust and foster open communication when people come to the table stressed, rushed, and worried. How can we prepare for parent and caregiver interactions to make it easier for everyone to fully engage in the evaluation and intervention process?  

 

Be aware of the barriers that can get in the way of connection-building 

Researchers point to several factors that can make it harder for parents, families, and caregivers to engage and connect with healthcare providers and educators. Some of these factors are: 

• cultural differences 
• language differences
• mistrust of health care providers or educators
• general life stress
• stigma surrounding the learning problem or health condition
• lack of understanding about how to navigate education or health care systems
• anxiety over the cost, time, and skills involved in helping their child
• power imbalances created by perceived differences in income, education, race, or immigration status

Communication barriers like these can increase health and education inequities (Butler 2021). Shrinking these barriers takes time and patience—people often bring years of negative experiences with them to a meeting. A good starting place is a warm welcome. It may also help to arrange seating so you and your team aren’t on one side of a table with the family on the other, which can feel oppositional. And it’s always a good practice to explicitly invite parents to ask questions and share thoughts when they’re ready.  

 

Explain the why, how, and when for assessments

Whether it’s universal screening or a diagnostic evaluation, understanding the purpose of an assessment helps parents and caregivers get on board. It’s also important to explain the services and benefits that may flow from an accurate diagnosis. When parents and caregivers can clearly see how an evaluation or assessment will help their child, it can decrease resistance and boost buy-in.  

Many parents also want to know exactly how an evaluation will unfold. When roles and responsibilities are clearly defined and parents understand the steps in the process, it can ease anxieties and establish clear expectations.  

A detailed schedule is another trust-builder. If a date needs to be changed, let parents know early. Set new dates that work with everyone’s schedule to minimize inconvenience.  

 

Consider word choices 

You may need to speak with parents about sensitive topics. It’s a good practice to think about how your word choices could shape the experience. Some parents experience shame or guilt around their child’s difficulties. Others may feel that the health system or school system has failed them. It’s especially important, therefore, to use inclusive, non-stigmatizing language to avoid more tension (Sim 2021).  

It’s also important to avoid ableist language (“She suffers from...” “normal vs. abnormal” “high-functioning vs. low functioning”). You can find a primer in the National Center on Disability and Journalism’s Disability Language Style Guide. The American Psychological Association offers a detailed Inclusive Language Guide to help people avoid terms that are harmful to people in marginalized communities.  

 

Build trust with trauma-informed practices  

Early in your relationship with a new family or client, you may not know whether trauma has impacted their lives. You may want to familiarize yourself with trauma-sensitive communication strategies for that reason. Here are a few recommended practices:  

• Protect the privacy of personally identifiable information. 
• Ask parents how they would like to communicate with you, including which methods and which times of day are best. 
• Provide documents and information in the preferred language and in a variety of accessible formats.
• Communicate in a direct, sensitive, and respectful manner. 
• Establish safe feedback methods so families can share what is and isn’t working for them.  
• Build choice into the process for students and families.

 

Practice cultural humility

When you approach parent and caregiver interactions from a learning standpoint, asking questions about individual preferences, backgrounds, and experiences, you’re more likely to create meaningful connections (Stubbe 2020). 

Educate yourself about the culture of your clients—not looking for stereotypes but for social norms that might be part of the dynamic. The knowledge you gain may help you adapt your communication style or be aware of different perspectives on health conditions and interventions (Maul 2106). 

 

When you meet, start with positives 

Studies show that parents want to hear more about what you see as their child’s strengths (Azad 2018). Many assessments now identify abilities as well as deficits, so use these positives to set an uplifting tone. Emphasizing strengths can also help to reduce any stigma associated with learning problems or health conditions.  

One additional benefit: Focusing on positive attributes sends a clear message that you see a person, not a problem or diagnosis. In some studies, involving early childhood educators working with immigrant children, collaboration with parents was problematic when teachers saw differences as deficits instead of focusing on the ways immigrant children enrich the classroom (Licardo 2021).   

 

Use clear, accessible language 

When you explain why a further evaluation is needed or inform parents of a finding, use terms that everyone is likely to understand. The information you’re presenting may be hard for people to fully take in, especially if the diagnosis comes as a shock. You’ll make it easier if you avoid educational or medical jargon, limit acronyms, and emphasize key points.  

Because people respond differently, it’s a good idea to leave some space for people to process their feelings and ask questions if there’s something they haven’t understood. You may want to ask questions to be sure everyone has grasped key points.  

 

Listen actively 

Research shows that healthcare providers spend much more time explaining, asking questions, advocating, and negotiating roles than parents or caregivers do during visits (Giambra 2017). The same dynamic happens in educational settings (Gwernan-Jones 2015).  

Yet research shows that people value health care professionals who genuinely listen to them (Washington 2019). Active listening cultivates empathy, which leads to better care and better outcomes (Haley 2017).  

To create an environment where people feel heard, you can: 

• ask open-ended questions (ones that aren’t answered yes or no)  
• explicitly invite questions, either at the conference or afterward 
• consider working with a medical interpreter, health advocate, or intermediary when there are language differences 
• notice body language and other non-verbal messages 
• ask clarifying questions if you’re not sure what you’re hearing
• avoid thinking about your response while someone is speaking
• repeat in your own words what you believe they’ve said
• be aware of differences in communication brought about by personality, cultural differences, and neurodivergence

 

Include actionable next steps 

Assessments, evaluations, and diagnoses are starting points. One of the most valuable parts of a parent or caregiver conference is the opportunity to plan next steps together—to help people see a path forward and envision their role in creating it. As you collaborate on an intervention or treatment plan, you can: 

• invite parents to help set goals 
• list next steps and make sure it’s clear who’s responsible for each action
• calendar follow-up meetings together
• provide information about support groups and organizations
• make sure parents and caregivers know how to reach you

Many clinicians and educators also give families functional homework focused on developing specific skills. That’s not just because home-based interventions can be highly effective. It’s also because numerous studies have found that when parents collaborate with providers and participate directly in interventions, their own quality of life improves (Musetti 2021). 

 

Take care of yourself, too 

Parent and caregiver conferences aren’t always easy. These interactions can be especially hard if you: 

• are new and building up your experience and confidence 
• have recently experienced hardship, illness, or trauma yourself 
• are advocating for someone with a similar condition in your personal life 
• don’t feel supported in your work environment 
• don’t personally enjoy face-to-face interactions
  

It’s okay to spend some time thinking about what you need to build your comfort and confidence during parent and caregiver communications. Mentorship, shadowing experiences, role-playing, or scripting may help. Sharing responsibilities with other evaluation team members is also a good idea. And training with assessment providers can boost your confidence in your ability to deliver assessments and report results.  

As with any skill, it helps to adopt a growth mentality. With deliberate practice and patience, you can develop the communication skills you need to build effective partnerships. 

WPS welcomes every opportunity to support you in your professional journey.  

 

 

Research and Resources:

 

Azad, G., Wolk, C. B., & Mandell, D. S. (2018). Ideal interactions: Perspectives of parents and teachers of children with autism spectrum disorder. School Community Journal, 28(2), 63–84. 

Butler, S.M., & Sheriff, N. (2021, February). How poor communication exacerbates health inequities—and what to do about it. https://www.brookings.edu/research/how-poor-communication-exacerbates-health-inequities-and-what-to-do-about-it/ 

Giambra, B. K., Haas, S. M., Britto, M. T., & Lipstein, E. A. (2018). Exploration of parent-provider communication during clinic visits for children with chronic conditions. Journal of Pediatric Health Care, 32(1), 21–28. https://doi.org/10.1016/j.pedhc.2017.06.005 

Gwernan-Jones, R., Moore, D.A., Garside, R., Richardson, M., Thompson-Coon, J., Rogers, M., Cooper, P., Stein, K. and Ford, T. (2015), ADHD, parent perspectives and parent–teacher relationships: Grounds for conflict. British Journal of Special Education, 42: 279-300. https://doi.org/10.1111/1467-8578.12087 

Haley, B., Heo, S., Wright, P., Barone, C., Rettiganti, M.R., Anders, M. (2017). Relationships among active listening, self-awareness, empathy, and patient-centered care in associate and baccalaureate degree nursing students. Nursing Plus Open, 6, 11-16. https://www.sciencedirect.com/science/article/pii/S2352900816300231?via%3Dihub 

Licardo, M. & Oliveira Leite, L. (2022) Collaboration with immigrant parents in early childhood education in Slovenia: How important are environmental conditions and skills of teachers? Cogent Education, 9:1, DOI: 10.1080/2331186X.2022.2034392 

Maul, A. & Menschner, C. (2016). Key ingredients for successful trauma-informed care implementation. Center for Healthcare Strategies, Inc. https://www.samhsa.gov/sites/default/files/programs_campaigns/childrens_mental_health/atc-whitepaper-040616.pdf 

McIntyre, L. L., & Brown, M. (2018). Examining the utilization and usefulness of social support for mothers with young children with autism spectrum disorder. Journal of Intellectual & Developmental Disability, 43(1), 93–101. https://doi.org/10.3109/13668250.2016.1262534 

Musetti, A., Manari, T., Dioni, B., Raffin, C., Bravo, G., Mariani, R., Esposito, G., Dimitriou, D., Plazzi, G., Franceschini, C., & Corsano, P. (2021). Parental quality of life and involvement in intervention for children or adolescents with autism spectrum disorders: A systematic review. Journal of Personalized Medicine, 11(9), 894. https://doi.org/10.3390/jpm11090894 

Russell, G., Kapp, S. K., Elliott, D., Elphick, C., Gwernan-Jones, R., & Owens, C. (2019). Mapping the autistic advantage from the accounts of adults diagnosed with autism: A qualitative study. Autism in Adulthood: Challenges and Management, 1(2), 124–133. https://doi.org/10.1089/aut.2018.0035 

Sim, W. H., Toumbourou, J. W., Clancy, E. M., Westrupp, E. M., Benstead, M. L., & Yap, M. (2021). Strategies to increase uptake of parent education programs in preschool and school settings to improve child utcomes: A Delphi study. International Journal of Environmental Research and Public Health, 18(7), 3524. https://doi.org/10.3390/ijerph18073524 

Smith-Young, J., Chafe, R., Audas, R., & Gustafson, D. L. (2022). "I know how to advocate": Parents' experiences in advocating for children and youth diagnosed with autism spectrum disorder. Health Services Insights, 15, 11786329221078803. https://doi.org/10.1177/11786329221078803 

Stahmer, A. C., Vejnoska, S., Iadarola, S., Straiton, D., Segovia, F. R., Luelmo, P., Morgan, E. H., Lee, H. S., Javed, A., Bronstein, B., Hochheimer, S., Cho, E., Aranbarri, A., Mandell, D., Hassrick, E. M., Smith, T., & Kasari, C. (2019). Caregiver voices: Cross-cultural input on improving access to autism services. Journal of Racial and Ethnic Health Disparities, 6(4), 752–773. https://doi.org/10.1007/s40615-019-00575-y 

Stubbe D. E. (2020). Practicing cultural competence and cultural humility in the care of diverse patients. Focus (American Psychiatric Publishing), 18(1), 49–51. https://doi.org/10.1176/appi.focus.20190041 

Warren, N., Eatchel, B., Kirby, A. V., Diener, M., Wright, C., & D'Astous, V. (2021). Parent-identified strengths of autistic youth. Autism: The International Journal of Research and Practice, 25(1), 79–89. https://doi.org/10.1177/1362361320945556 

Washington, K. T., Craig, K. W., Parker Oliver, D., Ruggeri, J. S., Brunk, S. R., Goldstein, A. K., & Demiris, G. (2019). Family caregivers' perspectives on communication with cancer care providers. Journal of Psychosocial Oncology, 37(6), 777–790. https://doi.org/10.1080/07347332.2019.1624674