Special considerations

While it is important for nurses to be familiar with the family system framework and apply it their practice, families are not static entities. They are, rather, developing and dynamic units. The needs and resources of the family unit, as well as individuals within the unit, change over time. Services to the child with disabilities and his family, therefore, must be flexible and adaptable. Nurses working with the family should expect these changes, respond gracefully and promptly, and reassure family members that this fluidity is normal (and healthy!).

It’s reasonable to expect that families will have intermittent crisis periods, particularly at transition times. Families are often taken aback, for example, when the child with disabilities reaches his third birthday and transitions from the early intervention system to the school system.

Instant Feedback:
When families shift priorities and reverse decisions, this is a warning sign of family instability that should be addressed immediately.

Early intervention systems are family-centered programs with a strong focus on parent education and involvement. The preschool setting in many school districts, on the other hand, is much more in line with a traditional educational model. As the child transitions from one program to the other, it’s not uncommon for parents to feel left out, abandoned, or isolated. Nurses working with the family can intervene effectively to bridge the communication gap between home and school, identify appropriate parental roles to increase their involvement in the child’s development, and ensure carry-over of the child’s learning from school to home.