There are some families who are a joy to work with. They show up on time, their children always have their hearing technology on and working, they read to their children, never miss an appointment, and bring you treats for the holidays. There are others who make professionals want to pull their hair out. Chronically late or absent, hearing aids always in disrepair, unmotivated, nonparticipatory, it seems as if these parents just don’t want their children to succeed. Are these just “bad parents”? Would their children be better off spending less time with their parents and more time with us, the professionals, who can help them learn to listen and talk?
My answer? ABSOLUTELY NOT.
Outside of situations of abuse, I don’t think any family wakes up and says, “I don’t want my child to be successful today,” but some may define success differently and/or lack the resources to make their hopes possible. But I believe families do what they can, and if they COULD do better, they WOULD do better. So our job is to find what is getting in the way of their COULD?
And this is HARD. Every time I work with a colleague, mentee, or graduate student dealing with a frustrating family situation, I challenge them do dig. As we discuss each problem or obstacle, I ask them to look beyond the issue on the surface to try and see if they can get to the root of the problem. The family shows up late? What are their transportation needs? What else is going on in that household that makes keeping an appointment in a timely fashion difficult? What is that family’s cultural concept of time? The parent doesn’t seem to care about therapy and never follows through? What other things might be on that parent’s mind? What other needs are more pressing in her life right now? Does she understand what is happening in therapy and why it is important? Have we explained what is happening in a way that she gets it and establishes buy-in? Bring up an objection, and then just keep drilling, drilling, drilling down, reminding yourself, “If they could, they would,” until you reach rock bottom, where blaming ends and problem-solving begins.
It is easy to blame. It is much harder to problem-solve.
Anyone can find fault. A therapist finds SOLUTIONS.
What if the family wants a listening and spoken language outcome but they have many, many practical and logistical roadblocks in their way?
I think we need to first look at this family on a systemic level: what systems are preventing this family from succeeding (e.g. discrimination, food insecurity, unsafe housing, etc.) and what supports are needed to help achieve access (transportation, referrals to counseling, etc.). As AV professionals, it is not our job to be experts in all of these things, but we do need to be aware of who is and what resources are available in our communities for referrals.
Sometimes the support that is necessary for that child to succeed in learning to listen and talk takes the form of a full-day oral school program instead of 1:1:1 therapist : child : family weekly AVT sessions. For families in these situations, this may be the most appropriate option. But I don’t think recognizing that a family needs the support of a school means that we write the family out altogether, as is tempting. (I hear lots of teachers say, “If I could only take this one home with me,” or, “We just have to keep them in school more hours”). Intervention should be seen as a support for the family, not the antidote to family. Even if a child is in school, the family should be an integral part of the school program. Our aim should always be to help the family serve as the child’s first and best teachers, because even the best school in the world cannot take the place of a healthy, functional family system.
My answer for children in these tough situations is two part:
1. Righting dysfunctional systems and providing supports necessary for every family to succeed
AND
2. Providing safe spaces for intervention, perhaps more intensive and professional-driven but still family focused intervention, than we would in cases with healthier families
Elizabeth A. Rosenzweig 
I just wanted to let you know that I love your posts. They are so thoughtful and helpful. You seem like you must be an amazing therapist and person and deaf children and their families are lucky to have you!
How would I get the six students in my moderate/severe classroom at Jefferson Middle School assessed for hearing?
This is an important question, Mark, because we know that approximately 40% of children with hearing loss have additional disabilities, so some of the students in your class may also have hearing loss, which can really affect how well they can understand your teaching. You can contact your school’s Speech Language Pathologist or Educational Audiologist, either of whom can conduct hearing screenings and then refer your students for further testing if they need it.