Vol. 9, No. 2
January 2004

Identifying Parents with Cognitive Limitations

Identifying parents with cognitive limitations is an essential first step for social workers interested in the safety, permanence, and well-being of their children. Unfortunately, this is not necessarily an easy task.

During an initial encounter, the majority of people with developmental disabilities may seem intellectually normal. Janice Doyle, a family assessment social worker with Alamance County DSS, recalls her surprise when she learned that a parent she had dealt with several times had an IQ of 56. “These parents can be very streetwise,” Doyle says.

People with cognitive limitations have good reason to hide their disability. As explained elsewhere in this issue, there is long-standing and deep-rooted prejudice against people with cognitive limitations. To avoid stigmatization, some people lie about the fact that they attended special education classes while they were in school. Others refuse badly needed services because in order to receive them they must accept a label such as “mentally retarded.”

This can be true even in the midst of a child welfare intervention. As one expert put it, “Most of the mothers with mental retardation I have met over the years would prefer to be called ‘irresponsible’ rather than ‘mentally retarded’” (Keltner, 1998).

Parents with cognitive limitations often behave like other parents involved with the child welfare system. They may be suspicious and resentful of the intrusion of child welfare workers into their lives. Many times these feelings are based on negative personal experiences with schools and other institutions, and on the very real fear that CPS workers will take their children.

Failing to recognize a parent’s intellectual needs can have devastating consequences. If their needs go unidentified, parents may be seen by the system as uncooperative and resistant, fail to receive the supports they require, and lose their children forever.

Only a psychologist or other qualified professional can accurately assess a parent’s level of cognitive function. Pre-diagnostic tools like the one below can help child welfare workers identify the parents who might benefit from such a cognitive evaluation.

The tool on this page was developed by the Families on the Grow Program at Wake County Human Services based on its analysis of more than 30 traits exhibited by cognitively limited parents involved with CPS. Parents identified by the tool as possibly needing formal cognitive assessment are referred to Laura Quinn or another psychologist for one-on-one evaluation. If this evaluation shows that parents have definite intellectual needs they are eligible to participate in a specialized program, Families on the Grow.

Although most child welfare agencies do not have this kind of in-house expertise, this tool may help them identify parents who could benefit from a formal evaluation by a qualified professional.

 

Assessing the Need for Cognitive Evaluation

At Wake County Human Services, this questionnaire is completed during every child welfare assessment or investigation. It helps identify parents who might benefit from a formal cognitive evaluation by a psychologist or other qualified professional. Does this parent have difficulty making and keeping appointments? (e.g., early, late, makes excuses, comes on wrong day) Does the parent appear to lack motivation to care for self or family? Did the parent fail to complete high school (verified)? Grade achieved: _____ Did the parent attend special classes in school? Has the individual’s job history been sketchy (most jobs held three months or less)? Or is the parent chronically unemployed? Does the parent respond inappropriately to routine child management needs, or does he or she seem overwhelmed by family demands? If parent is a mother: Are there two or more fathers of her children without the mother ever having been married? Is one or more of the children in the family disabled or do they appear to be intellectually delayed? Does the parent use public transportation? (Or, for non-urban areas) Does the parent not own a car? Does the parent fail to provide stimulating activities to the children, other than TV? Scoring Refer the parent to a qualified professional for further cognitive evaluation if the answer is “yes” for: Question four Any four items Any three questions, if at least one of them is question 3, 4, or 5 Developed by Families on the Grow, Wake County Human Services

Readers may also find the University of Michigan School of Social Work's Training Program for Child Welfare Supervisors to be a useful resource on this topic. See its "Screening for Mental Retardation/Cognitive Limitations." at <http://www.ssw.umich.edu/tpcws/articles/screening_for_mental_retardation_cognitive_limitations.pdf>.

References for this and other articles in this issue