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Inclusive Parenting: Unveiling the Nuances of Healthcare Support for Parents with IDD

Welcome to �this eLearning module:

This module is part of TASP’s series on Working Effectively with Parents with IDD in Healthcare.

www.achancetoparent.net

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Welcome!

This training module provides a holistic exploration of parenting with Intellectual and Developmental Disabilities (IDD), addressing misconceptions about parenting abilities based on IQ or Adaptive Behavior Scores.

Participants will gain insights into the diverse characteristics, support needs, and life experiences of parents with IDD, while understanding the unique challenges they face in obtaining healthcare.

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Objectives�

In this module, you will:

  • Consider who is a parent with IDD and what needs they have.
  • Be aware that IQ or Adaptive Behavior Scores are not a valid predictor of parenting ability.
  • Identify the characteristics and support needs of parents with IDD.
  • Understand supports that are aligned with successful parenting.
  • Understand how life experiences impact parenting success.
  • Understanding the challenges of obtaining health care as a parent with a IDD.

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Parents with Intellectual and Developmental Disabilities (IDD)

Read these statements. Do you agree with them all?

Parents with Intellectual and Developmental Disabilities (IDD)…

  • Have a right to partner in their own health care and receive individualized supports.

  • Have a right to have their needs met under the Americans with Disabilities Act. Not sure how this pertains to you and your work? Learn more about it in our module “Accessible Healthcare: ADA Compliance and Individualized Support for Parents with IDD.”

  • Often have more difficulty in getting and making sense of health information than the general public.

  • Have often had life experiences that can make it difficult to develop self-confidence in parenting.

  • Have important insights into and a life-long interest in their children.

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What is an intellectual disability?

“An intellectual disability occurs before age 18 and is characterized by significant limitations in intellectual functioning and adaptive behavior as expressed in conceptual, social and practical adaptive skills” (AAIDD, 2011)

Parents with intellectual disabilities may not self-identify as having an intellectual disability.

Some parents, such those on the Autism Spectrum or with a Traumatic Brain Injury may have similar difficulty interpreting and using information.

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Can a person with IDD become a parent?

Being a parent is a fundamental right and many people with IDD choose to become parents!

Current research reveals that there are 4.1 million parents with disabilities in the United States, roughly 6.2 percent of all Americans (Powell, R.M., Parish, S.L., & Akobirshoev, I., 2017).

Research shows that IQ does not impact parenting until it falls below 50. Even then, many parents do well with appropriate supports.

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Understanding Parents with IDD

Parents with IDD may have varying levels of cognitive functioning, communication skills, and adaptive behavior.

They often require support in areas such as decision-making, problem-solving, and managing daily routines.

Support needs may include assistance with parenting tasks, accessing community resources, and navigating social services.

How do you see this in your setting? Where does it potentially impact how parents with IDD obtain healthcare for themselves or their children?

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Challenging Misconceptions

Research has show that IQ or Adaptive Behavior Scores do not accurately reflect an individual's ability to parent effectively. There is no correlation between IQ and adaptive behavior and successful parenting. These scores are not a valid determiner of the ability to parent.

Yet despite this, parents with IDD have their children removed by child welfare at a rate of 40-80% (Rocking the Cradle, 2012), and close to two-thirds of states consider intellectual disabilities a factor for termination of parental rights.

Most parents with IDD live in fear that their child will be removed from their care, or they’ll be investigated, simply because they have a disability.

Focusing on strengths-based approaches rather than deficits is crucial in promoting positive parenting outcomes for individuals with IDD.

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Research on Effective Parenting

Despite the many misconceptions about parents with IDD, research shows that parents with IDD can develop effective parenting skills through education, support, and tailored interventions.

Research findings indicate that parents with IDD benefit from support programs that focus on building parenting skills, enhancing social support networks, and promoting family well-being.

Collaborative efforts between healthcare providers, social workers, and community organizations are essential in delivering comprehensive support to parents with IDD.

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Characteristics of Parents with IDD

Parents with IDD often possess unique strengths such as empathy, creativity, and resilience.

Understanding and respecting their individual characteristics is crucial in providing tailored healthcare support that meets their specific needs.

Recognizing the diversity within the IDD population helps promote inclusivity and equity in parenting support services.

How have your own life experience impacted your strengths and needs as a person? Have you seen particular strengths in the parents with IDD you see in your work?

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Listen to the story of a mom with IDD and her daughter

A Life Defined Not By Disability, But Love

From Story Corp on National Public Radio

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Supports Needs of Parents with IDD�

Support needs of parents with IDD encompass various domains, including emotional support, practical assistance, and access to resources.

Tailored support interventions should address the individual strengths and challenges of parents with IDD to promote positive parenting outcomes.

Collaborative approaches involving healthcare providers, social services, and community organizations are essential in delivering holistic support to parents with IDD.

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Impact of Life Experiences

Life experiences, such as past trauma, stigma, and societal attitudes, can influence parenting success among individuals with IDD.

Scotti et al. (2012) noted that upwards of 70% of people with IDD experienced at least one traumatic event during their lifetime, with multiple experiences most common.

As a healthcare provider, promoting resilience, confidence, and self-advocacy skills helps parents with IDD overcome challenges and thrive in their parenting roles. You can learn more about this in our modules “Building Trust and Effective Communication in Healthcare for Parents with IDD.”

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How Negative Life Experiences Impact Success

  • Limited socialization
  • Poverty and neglect
  • Abuse and trauma
  • Unemployment/lack of job skills
  • Exploitation by others
  • Overwhelming life situations
  • Social isolation and loneliness
  • Low self-esteem
  • Shutting down
  • Confusion and panic
  • Inability to cope/cooperate
  • Lack of trust
  • Self-protective defenses
  • Lack of self-confidence

Think how each of the life experience on the left can lead to the possible responses on the right. How can healthcare providers mitigate the reactions on the right when working with a parent with IDD?

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Challenges in Obtaining Health Care

Parents with IDD face barriers in accessing healthcare services, including past experiences, communication difficulties, lack of accessible information, and stigma.

Navigating complex healthcare systems and understanding medical information can be challenging for individuals with IDD.

Advocacy efforts are needed to address systemic barriers and promote healthcare equity for parents with IDD.

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Challenges in Obtaining Health Care

Self-advocates from across the United States who completed a survey by TASP in 2023 identified these top five challenges in obtaining healthcare:

  1. Past negative experiences with health care providers.
  2. Getting the accommodations needed for learning difficulties.
  3. Feeling like health professionals are judging them.
  4. Difficulty in telling others about their child’s health care needs.
  5. Worry/fear about what will happen during the visit.

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Barriers in Accessing Health Care

Limited access to healthcare information and resources creates barriers for parents with IDD in obtaining timely and appropriate medical care.

Stigma and discrimination in healthcare settings can lead to negative experiences and reluctance to seek healthcare services.

Lack of accommodations and support for communication and decision-making further impede access to healthcare for parents with IDD.

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From our 2023 Survey, parents noted additional barriers to accessing healthcare:

  1. Getting through the automated system to make an appointment.
  2. Having others parent my children without my permission.
  3. Being asked to fill out complex forms I don’t understand well.
  4. Being rushed when it takes me time to describe my child’s needs.
  5. Needing support with multiple children during the visit.
  6. Being in a room without toys or distractions for my child.
  7. Having someone assume that I can’t be a good parent.
  8. Using complex language to describe what I need to do next.

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Strategies for Overcoming Healthcare Challenges

With the noted barriers and challengers, can you think of universal ways to overcome healthcare access challenges for parents with IDD?

Providing accessible healthcare information and resources in formats that cater to diverse learning needs, such as plain language, visual aids, and alternative communication methods.

Offering training and education for healthcare providers on how to effectively communicate with and support parents with IDD.

Establishing partnerships between healthcare providers, disability support services, and advocacy organizations to address systemic barriers and promote healthcare access and equity.

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Individual Modifications

Parents with IDD may not always ask for specific modifications or may not identify as having a disability. In those cases, the provider should make care modifications based on best practices that reflect the ethical code of conduct of their profession.

When possible, link the parent with someone they trust who can attend the appointment with them for support.

Ask the parent how you can provide individual supports to meet their needs before, during and after an appointment.

Build a positive relationship with the parent over time.

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Case Study: Navigating Healthcare

Case Background:

Maria is a 32-year-old parent with an and Developmental Disabilities (IDD) who recently gave birth to her first child. Maria has limited literacy skills and struggles with understanding complex medical information. She relies on support from her spouse, Johan, and her sister, Carmen, who serve as her primary caregivers.

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Case Study: Navigating Healthcare

Based on this information, what challenges may Maria face in accessing healthcare?

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Case Study: Navigating Healthcare

Based on the identified challenges, what strategies could you implement to mitigate them?

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Case Study: Navigating Healthcare

Outcome:

By implementing these strategies, Maria and her support network overcome the barriers encountered in navigating healthcare. Maria feels more empowered and confident in managing her and her child's healthcare needs, leading to improved health outcomes and overall well-being for both herself and her child. Additionally, the collaborative efforts between Maria’s healthcare team, support network, and community organizations contribute to a more inclusive and accessible healthcare experience for parents with IDD.

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Conclusion

  • Parents with IDD have often faced ongoing stigma and barriers in their life, including in healthcare access.
  • Parents with IDD need and deserve individualized support to be successful parents.
  • IQ tests, adaptive behavior tests and risk assessments do not correlate with successful parenting.
  • Providers must recognize the strengths and support needs of parents with IDD.
  • Inclusive healthcare practices and collaborative efforts are key to address the unique challenges faced by parents with IDD in accessing healthcare services.

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Congratulations!! �You’ve finished the course. �Check out the Additional Resources tab�

Author: Chelsea Tighe, Colleen Downes, and Cathy Haarstad –TASP

Reviewers:

Lindsay Brillhart

Ivanova Smith

Quiana Mayo

Jamie Junior

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Additional Resources - Organizations

The Association for Successful Parenting – supports parents with IDD through education, advocacy, and support. TASP conducts training for professionals and supports parents with IDD to advocate and share their stories: https://achancetoparent.net/

National Resource Center for Parents with Disabilities conducts research and provides training and technical assistance to improve the lives of parents with disabilities and their families. https://heller.brandeis.edu/parents-with-disabilities/

Proud Parents Connecticut offers plain language resources chosen by parents with differing abilities to help parents be the best parents they can be. https://www.proudparents.info/

Self Advocates Becoming Empowered (SABE): National self-advocacy organization. https://www.sabeusa.org/

Institute for Exceptional Care (IEC) works to make healthcare better and safer for people with intellectual and/or developmental disabilities. https://www.ie-care.org/

The National Center for Disability, Equity, and Intersectionality’s goal is to lead the nation’s charge to identify and reduce life-limiting inequities in healthcare, community living, and justice for people with disabilities. https://thinkequitable.com/

American Academy on Developmental Medicine and Dentistry is a non-profit, membership organization of interdisciplinary health professionals — including primary physicians, medical specialists, dentists, optometrists, nurses and other clinicians — committed to improving the quality of healthcare for people with intellectual & developmental disabilities (IDD).: https://www.aadmd.org/

National Council on Disabilities, Rocking the Cradle Report on Parents with Disabilities:

https://www.ncd.gov/publications/2012/Sep272012

The Arc of the United States: https://thearc.org/position-statements/parents-with-intellectual-developmental-disabilities/

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Additional Resources - Learning

Inclusive Health: Caring for Patients with Intellectual Disabilities

https://www.youtube.com/watch?v=yCgKfaB0szE

Protecting the Rights of Disabled Parents Involved with the child welfare system

https://www.youtube.com/watch?v=VzNBi23bCBI

Exploring professionals' practices and perspectives on supporting parents with intellectual disabilities: a qualitative study

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10261979/

Mothers with intellectual disabilities: challenges and resilience

Https://www.Youtube.Com/watch?V=swdablinodc

Promising practices to support parents with intellectual disabilities

Https://cascw.Umn.Edu/wp-content/uploads/2019/11/PN34_WEB508.Pdf

Supporting people with disabilities in health care settings

Https://odpc.Ucsf.Edu/clinical/patient-centered-care/supporting-people-with-disabilities-in-health-care-settings

Jack’s Basket Communicating Unexpected News Curriculum: This curriculum will improve healthcare provider communication and enhance patient-provider relationships by equipping them with the knowledge, strategies, and communication techniques required to deliver unexpected news to patients and their families without bias. https://jacksbasket.org/curriculum/

What helps parents with intellectual disability learn parenting skills?

https://www.youtube.com/watch?v=ojQTz9FlNt4

Fathers with learning disabilities

Https://www.Youtube.Com/watch?V=pne133yo5s0