UNDERSTANDING
NEURODEVELOPMENTAL
DISORDERS (ASD & ADHD) AND
THE IMPLICATIONS FOR
PARENTING PLANS
Segment 3: Parenting Plan Considerations
Linda Popielarczyk, MSW, RSW
Considerations for Parenting
Plans
 Genetic component involved with
neurodevelopmental issues
 Family law professionals should give pause to
the possibility that either parent may present with
some of the traits, or any of the co-morbid
diagnoses commonly associated with the child’s
diagnosis
Parents and NDD’s
 Many adults with high functioning autism (HFA) are
not formally diagnosed given the limits of our
understanding until added to the DSM-IV in 1994
 Intellectual functioning can be advanced, and socialemotional functions more subtly impaired
 Not uncommon for one or both parents with ‘broader
autism phenotype’ or ADHD to finally identify the
name for their own difficulties when their child is
diagnosed; or to realize other extended family
members have these traits
Parents and NDD’s Cont’d
 Certain traits of ADHD and HFA can make it very
difficult to focus on the needs of children
 With HFA:
 ‘Mind-blindness’, egocentrism, challenges with
compassion, empathy and reciprocity, and rigidity
 Mediation may be ill-suited because “good faith
negotiation requires the {HFA} parent to recognize
and appreciate another’s needs, a core deficiency
in autism” (Jennings, S., FCR, 2005)
Parents and NDD’s Cont’d
 With ADHD:
 Egocentrism, impulsivity, poor adherence to the
schedule and routines, poor conflict-resolution skills
sometimes including oppositional and anti-social
behaviour
 Negotiation may require strong mediation and may not
work because of poor conflict resolution skills and
disregulated emotions
 Attention to parenting strengths and weaknesses,
including consideration to available social support,
involvement of extended family, and responsiveness
to direction and change
Parents and NDD’s Cont’d
 When a parent may have traits of ASD or ADHD,
the parenting plan:
 Must be comprehensive
 Requires guidelines for approaching conflict with
specific rules that are concrete and reduce
ambiguity
 ADR: Where possible, a parenting coordinator
may guide and enforce standards of conduct,
issue appropriate penalties for violations and
rewards for compliance, and make decisions
where not anticipated within the parenting plan
(Jennings, S., FCR, 2005)
PARENTING PLAN CONSIDERATIONS
 Neurodevelopmental disorders can vary
immensely in presentation regarding severity and
pervasiveness
 The “diagnostic approach” versus “functional
approach” to understanding the needs of these
children (Birnbaum et al., 2012)
 Where parents are in dispute: Importance of
objective input from the child’s care team (Letter,
Assessment Report…) with regard to the severity
and pervasiveness of the disorder,
recommendations for interventions before
contemplating parenting plan or final order
 “Best Interests of the Child’s Special Needs”
(Saposnek et.al., 2005)
Considerations Cont’d
re Major Decisions…
 Cases of “high conflict”: Major decision-making
authority is essential to determine
 Many decisions with no room for
argumentative, posturing parents
 9 considerations re custody of a child with
Autistic Spectrum Disorder (Jones, L.R., & D.L.
Holmes, 2009)… Consider Connor & Spencer
 PLEASE INSERT WMV ‘62House’
 Where sole decision-making is appropriate:
 Include protocols for notice of upcoming
decision and the process by which the other
parent may offer input
 Consider compliance pattern of the other
parent
 Where shared decision-making is considered:
 ADR: Crucial to appoint a neutral third party to
make final decisions in case of impasse, such as
the attending physician, pediatrician, parenting
coordinator, or arbitrator
Considerations Cont’d
re Health…
 Requirement to consult with the same primary
care physicians, apart from emergencies, as
appropriate
 Involvement of both parents, together where
possible, with professionals
 To attend specialist appointments to understand
diagnosis, medical/psychological needs, and to
develop plan for managing child’s care and
routines (Birnbaum et al., 2012)
 Where unable to attend together, expectation
that each parent arrange own appointments
 Protocol for communication of professional
updates
 Medicinal treatment
 Duplicate prescriptions, wherever possible
 Each parent responsible for filling the
prescriptions on time, and administering
them as needed
 Communication protocols regarding the
purpose of medication, any medication
changes, last dose, noted side effects
Considerations Cont’d
Communication…
 ADHD: Communication protocols need to cover
issues such as behaviour, youth follow-through,
consequences that may carry to other home
 ASD: Communication protocols need to extend
to issues pertaining to child’s coping and
cooperation with home application of autismspecific intervention behaviour strategies
 A guiding principle: The concept of “Continuity of
Care” (Saposnek et al., 2005)
Considerations Cont’d
re Education…
 Where possible, jointly participate in formal and
informal school processes, to be suitably
apprised of their child’s progress, the child’s IEP
(individual education plan), any modifications
needed, continuity between homes and school
Considerations Cont’d
re Treatment
 Autism Specific Therapies:
 These educational interventions show strong
scientific evidence of improving social
communication skills
 Private: Expensive
 Publically Funded: Long Waiting-times
 Each case must be considered on its own
merits, triaging the needs of the child, the
options, and the financial resources available
 Where clinically indicated, and financially
available or publicly funded, parents should
be compelled to support the child’s therapies,
including as examples, autism specific
therapy, speech and language therapy,
occupational therapy, enrollment in preschool,
behavioural parent training, family therapy. It
is in the interests of the child with autism or
ADHD for each parent to be involved
Considerations Cont’d
re Parenting Time…
 After meeting a child with an ASD, you will have
familiarity with one child with an ASD… Same
with ADHD
 No ‘One Size Fits All’ where it comes to
residential schedules for children with NDDs
 Idiosyncratic differences between children re
reactions to transitions
 The toll of parenting a child with a severe
disorder
 The benefits of shared parenting time
providing respite to each parent when the child
spends time with the other
 Requires 2 parents capable of encapsulating
their feelings about former partner to focus on
the needs of the child
Considerations Cont’d
 Raising a child with special needs has a
ripple effect throughout the family
 Sheila Jennings (2005): The needs of the
child with special needs balanced against
the needs of their neurotypical siblings. For
example, the children and the parents will
benefit from one-on-one time
 Beneficial contribution of siblings
 Saposnek and Perryman et.al. (2005)--The
concept of “Least Restrictive Environment”
(LRE)
 In this context, the LRE principle would refer
to the “greatest degree of unrestricted access
to both parents”
 A continuum ranging from equal time with
each parent to supervised visits or no contact
with a parent, where appropriate
 Restrictions may be incrementally increased to
meet the child’s needs, as required
 Parenting schedule should give due
consideration to child’s therapy schedule
or programs:
 Each parents’ ability to manage logistics,
implement at home as needed
 Consider the child’s psychological age, not
chronological age
 Special requirements with regard to space
(an ‘island of solitude’), managed external
stimuli, allergies, and others less so.
Some require access to kinetic expression
 Need for predictability and routines:
 Intense for some children and requires
cooperation between parents
 Consider items in Parenting Plan entitled
“Routines”, “Sensory Issues”, “Safety”, or
“Pets”, providing specificity re parental
responsibilities
Questions, comments, and discussion