Awkward Conversation #249: Telling a Parent Her Teenager Has Mental Retardation

It never really gets easier. I get better at my schpeal, but telling a parent their child tested in the retarded range is never easy. It can lead to some very awkward and emotional moments, especially when a parent is getting the news for the first time and the child is FOURTEEN years old. I present to you, Awkward Conversation #249 (get a fresh cup of coffee, it’s a long one…)

Scene: Parent’s home (this parent refused to come to a school meeting, as every school meeting for the past, oh 8 years, has been people telling her that her daughter is behind, acting out, and in trouble). Blaring in the background is Jerry Springer-esque show, where every other word is bleeped out. We’re not going to turn that down, just to add to the awkwardness of having to yell the words, “Mental Retardation.” Good times.

Me: Thank you for allowing us in your home today. I look forward to sharing how Julia learns best and developing a school program that works for her. Before we start, how do you think things are going at school for her? (Knowing full well things are NOT going well. She wanders around the class and yells at teachers every day and is currently suspended).

Mom: I think she just needs tutoring.

Me: Hm…okay, so you are concerned about her academics (BTW, she tested in at the 2nd grade level in reading, math, and writing and she’s a 7th grader).

Mom: Mmm.

Jerry Springer Guest (in background): You think my baby mama gonna BLEEEEP BLEEEP BLEEEP BLEEEEEEEEEP

Me: Right. So let’s have a look at some of the possible reasons why Julia may be struggling academically. I tested her on how she solves brand new problems. This is a test that she can’t study for, as it is a set of new problems, both verbal and visual. (Read: IQ test). I give her very little help in solving them, and it is a good way to measure her thinking skills.

Mom:

Me: Okay. So here is a chart of where most students score. If she were just the same as her peers, she would fall here (points to average range). On both visual and verbal problem-solving, Julia scored here (points to 70—cut off for mental retardation). For example, when I asked her how a banana, apple and orange are alike, she said, “pear.” That’s not quite…erm…it’s related to what I said, but she misses the main point, that they are all fruits. Do you ever notice that sometimes she has difficulties expressing herself to you, or when telling you a story?

Mom: (Noncommittal grunt)

Me: Um. Okay. So you can imagine in the class, where she is currently learning about the Mayan empire, she might have a hard time making connections on her own without help. In head: Not to mention she can’t read the 7th grade text at all. She also might start to wander the class and get angry and yell, because most teenagers would rather look dumb than stupid.

Jerry Springer Guest (in background): BLEEEEPidy BLEEEPin’ BLEEEP!

Me: May I ask if this sounds like Julia? Am I describing her accurately?

Mom: (Stony silence).

Me: (In head: Is she getting this? Is it sinking in where I’m going with this?). I know this must be difficult to hear.

Mom: Not really.

Me: Um…erm..so what are your thoughts so far?

Mom: I think she needs tutoring. I’m not into labels. A student can get special education without being labeled.

Me: While tutoring is a good option, we also want to make sure that Julia’s teachers really understand her, and that she struggles so much with her thinking skills on her own. She can learn, but she requires a lot of support, repetition, and presentation of the material in simple ways. I don’t like labels either, but if they get her better services, then we should think about what is best for Julia. Without a label, you will continue to get calls every day and Julia will likely be misunderstood by her teachers and blamed for things she can’t help. Okay, self, time to just spit it out. She qualifies as mentally retarded. Here goes my “13 Doors Schpeal”.

Um, when we think about special education, we think of 13 “doors” into the program. Each “door” is a disability and with each disability there is a program. (To spare you all, I then go into the process of elimination of doors—not learning disability, not physical disability, not emotional disability—until we reach the “door” that in our district is called Mental Retardation)*

DEEP BREATH.

Ms. Parent, I’m going to use a term that is often kind of hard to hear, but I would be doing Julia a disservice if I didn’t use a term that we can all understand. Knowing what is causing her academic difficulties is the first step to giving her what she needs. The only “door” to services that is left is Mental Retardation. Now, there are several kinds of Mental Retardation. Julia is not in the severe range (points to bottom of chart), so we would not put her in a class with students who cannot take care of themselves, have physical challenges, or are learning only basic life skills. Julia has mild mental retardation (points to 70 on chart) and she has some typical life skills, so she would be in a class that would give her practical academic skills, like making change at the store, and reading and writing in the real world.**

Family Feud Guest (blaring in background): The Movies! Teenagers make out at the Movies! Buuuuuzzzzzz.

Mom: (Mumbles) Lover’s Lane.

Me: Excuse me? (Oh dear she is answering the Family Feud game). Right. So this must be difficult to hear that Julia has mild mental retardation, but the good news is we can find her a classroom where her needs can be met. Does this information surprise you? What are your thoughts?

Mom: I’m not surprised. Oh, and we’re probably moving out of the district next month.

End Scene

I don’t know how things will go for Julia in her new district. I know that I did my best to make it clear that Julia will not be able to keep up in a general education class, and that our meeting documents (the famous “IEP” which is an “Individualized Education Plan”) would carry over to anywhere in the country. I just hope she gets a seasoned teacher who understands that Julia’s “defiance” is a largely a defensive avoidant behavior. I hope she gets to experience success. And I hope that there aren’t a bunch of “Julias” out there who could have been getting early intervention services for 8 years had there been a more concerted effort to have the school psychologist have a look at why she continually acted out.

We will return to our regularly scheduled Tomfoolery and funny stories next week. Promise.

*Some districts say “Cognitive Impairment” some “Developmental Disability” and some “Mental Retardation.” I don’t know if one term is better over another. The only benefit I can see of calling it Mental Retardation is that parents know what you are talking about. I have had parents who never really understand that Cognitive Impairment is really MR until their kid is in late middle or high school. Again, sometimes I get to break that news, and usually the reaction is, “Why didn’t someone tell me this earlier?” There is another school of thought that saying MR is not PC.

**And because of No Child Left Behind, some outrageous Algebra goal.

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Comments on Awkward Conversation #249: Telling a Parent Her Teenager Has Mental Retardation

  1. Kristen says:

    Are you sure you didn't come to work with me last week!?! 🙂 It calms my spirit to know that this conversation happens in other cities, counties, and states. Thank you for sharing, I really enjoy reading your posts!

  2. Steve says:

    As an intern this year, this was a really tremendous story to read. Aside from the sadness involved, hearing how you deliver said news was extremely helpful. I doubt I will have this experience in internship and always wondered how I would be able to manage this type of situation. Being able to communicate the truth to parents but maintaining cognizance of the impact of the news seems very difficult.

    Your blog is Rockin'

    -Steve

  3. Steve G. says:

    First, I must note that I feel odd commenting right after a different Steve.

    But, as a substitute teacher and as a reporter talking to different parents, I've experience the scene you've described many times. Normally, in the role of a reporter, it is the same parent complaining about how their child is "just a little slow" or something similar, as opposed to 1) being realistic about the environment they're providing them and 2) about their actual abilities as students.

  4. What struck me was that you didn't mention Intellectual Disability. I haven't had this conversation yet, but I know that in the past people have used the ID term, and then said, "you may know this as its former label, Mental Retardation." I like the humor you inflect in your writing. I'm a fan.

    The Black Briefcase

  5. As a parent I'm horrified by that mother's behavior. I can see how growing up in an environment with a parent in denial who "loves her some Jerry Springer" could lead to having a child float through the system without receiving proper services.

    I think dressing up the name so much so that no one takes it seriously is a bad idea. I think calling it mental retardation is appropriate.

    I would cry…but I'd feel worse if I went around calling it some other fluffy name and didn't realize what was really challenging my child.

    Sometimes scaring a parent to get their attention may be called for.

  6. Mrs. H says:

    Since this child is a 7th grader, I will be expected to teach her algebra I in two years and told I am a failure for her not having success in my class. If only I would have differentiated my instruction more, she would be successful.

    I am already teaching students just like her and it does nothing for them or for their classmates. Thanks NCLB.

  7. OK guys, I'm a parent here, not your students parent thankfully, I ask for testing for my child because I kow he has issues and because we as his parents have worked so hard with him he out tests himself from special education or even assisted services What is a parent to do then? and No, talking to SELPA does not help
    Thank you for listening

  8. sarah says:

    Ugh. This is the worst. I had a parent in complete denial of her child's needs, and a teacher who sugar coated them in the prereferral meetings. Everything turned out to be in the 50's, except for the parent adaptive measure (which we attempted to complete 5-6 times until FINALLY having the parent fill it out, unwllingly, at the results meeting) which was in the average to above average range. "Oh, he just needs to pay attention better." Um, No.

    Luckily, the parent got out of denial before the original testing had expired and was willing to fill out a new adaptive measure, and the kid was placed ID.

    This happened TWICE this year.

  9. Mimi says:

    Um, so you are the Queen of Awkward Conversations (a title I'm not sure you ever really wanted). Dude, snaps to you for tackling that one – and doing it so gracefully.

    That poor girl…I hope her mother does what is best for her and that it's not another few years until her daughter gets the services she needs.

    Heart the Jerry Springer scenes – beautifully written!

  10. dcollins says:

    I can only echo what Kristen said earlier . . .This is an identical conversation I've had many times. I work at an Outreach high school – an alternative for students who have not had success in a traditional classroom. About 1/2 of our students suffer from mental health issues of various forms. I'm always surprised that parents act as if the news I have to give is the first time they've heard it. I never understand the defenses these parents put up. As in your conversation, it seems as if the parent is also experiencing her own issues. Is her defiance a defense mechanism?

  11. Erika says:

    First I want to say – love love LOVE your blog! It has been incredibly insightful, helpful, and entertaining to read since I began following a few months ago. I'm a SP student in my second year at UF and I absolutely love reading about your (mis)adventures and how to handle really difficult situations (that I know I'll be handling shortly, if not as soon as next year during internship) on my own.

    Seconding black briefcase– no InD? This made me realize I'm unsure if it's a state-mandated or nationally mandated thing.. but I know in Florida we have now all converted to the use of InD (intellectually disabled).

    Also, how far along is your district with RtI? Just curious.. I know the county I'm currently placed in for practicum is trying to make the switch and it's tough going.. hopefully it gets moving soon though, so that children like those of mom2priceboys can actually get SOME assistance to keep them on track.

  12. Kristen says:

    In FL we use the term Intellectually Disabled (InD). Just to add another one to the list. Thanks for the blog. I hate breaking that news.

  13. arbomphr says:

    Wonderfully written anecdote. Gets at so many of the complexities of your job.

  14. Christie says:

    My paticular favorite is when I'm doing a re-evaluation of some elementary-aged child, who was previously identified as "DD" or "Developmentaly Delayed" as a 5 or 6 year old, but nobody really explained what that meant to the parent (even though the child had a solid 60 IQ at the time). The word "delay" lends itself to the idea that the child will eventually "catch up," which is misleading when you get those scores. Many times I have mentally cursed the previous psy who did the eval, but didn't really do their job when explaining to the parent what that cognitive score really meant! The child has been in special ed for years, and the parent has no clue that the kid is functioning in the mildly mentally retarded range.

    Sorry, that's just a personal pet peeve of mine.

  15. Sarah says:

    Eligibility meetings where a student scores below a 70 are the worst part of my job. In Illinois we go by Cognitive Delay. I agree with Christie that it sounds like you can catch up or improve the scores. It is tough to deliver the news and then have to say "Well you may be more familiar with the earlier term, MR."

    I've had many a kid like your girl who moves out of the district immediately after an eval or IEP revision. We can only hope someone is looking out for them in their new district.

    (BTW I got my wedding dress – still in Bridechilla mindset but only 6 mos to go!)

  16. Rebecca says:

    Hey everyone,

    Thanks for all the comments! I appreciate the support. The mom DID sign the IEP so hopefully the new school district will help this girl. I feel for the mom too–she seemed limited herself in being able to understand what was going on and what it all meant.

    I am glad that people agree that while the term isn't the best, it is what it is, and parents are better off knowing.

    @christie–um, yeah, I'm totally with you! I work at a middle school so I see that situation more than I'd like to..

    @Mimi- please cross-stitch that title on a pillow for me to cherish forever.

    @Erika- RT-what? Yeah, we're not that advanced. We do the Dibles and then have no resources to address the difficulties we find.
    @sarah: squeeeeeeeal! i want to see!!!!! 🙂

  17. Jimi says:

    Great blog. I completed my internship as a school psychologist this year. I enjoy your writing style and humor. So much of what you say sounds similar to what I've experienced. People in our district treat the "MR" term like ice and I still have never heard the definitive term. I like the "13 doors" analogy. Can I use that?

  18. Connie says:

    Love your blog! One of the good things about being a seasoned Frau School Psychologist is that over the course of having metaphorically hit your head on the wall/poked your eyes out countless times, you develop the gravitas (and the scary facial lines?) to kindly-yet-firmly say things to a parent like, "Let's just turn that TV off now so that we can hear each other". The trade-off may involve a typo here and there in my reports, but trust me, it's a useful trade-off!

  19. Anonymous says:

    Speil, not schpeal. it means game in german.

  20. Anonymous says:

    I don't know how you can handle the parent apathy. You spend all that time assessing her child and clearly care about how the child is learning….and this parent doesn't seem to care.

    And this seems to be a recurring theme in your interactions with parents…

    You must have the patience of a thousand nuns.

  21. MKK says:

    I know I'm commenting on an extremely old post; bad form on my part, but I just found your blog and am reading like a crazy person…

    I had to respond to sarah (the first Sarah who commented above).

    My daughter's school system thinks I am one of those parents that are in denial. She has been labeled ID (MR, whatever), and their evaluation says she has an FSIQ of 48.

    The school staff (en masse) have completely ignored my input regarding my daughter's capabilities, and even though I had an evaluation I had done by an SLP (PhD, professor at Vanderbilt, specializes in late talking children), which diagnosed my daughter with Mixed Expressive Receptive Language Disorder, and showed signifigant subtest scatter (this SLP is qualified to give iQ testing), they firmly believe their IQ number is accurate. (I don't think I need to explain to you why the WISC is an inappropriate measure for a child with a language problem, right? Didn't think so…)

    Anyway… I'm having yet another private evaluation performed, and they're finding the same type of subtest scatter that was found at Vanderbilt. Shocking…

    So maybe, just maybe, those parents aren't in denial. Or maybe I'm just looney.

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