Developed by the Connecticut Parents With Cognitive Limitations Workgroup

This guide is designed to help practitioners assess whether cognitive limitation is an issue for their clients.  The questions will best be posed after a relationship between the client and the practitioner has been established.  To be most effective, practitioners will incorporate these categories/questions in their current screening tools while they continue to use their own interviewing techniques.
 
Identifying parents with limited cognitive abilities is a critical but difficult task for service providers as the limitation is often, not easily recognizable.  
 
However, there are a few areas that might provide clues to the appropriate identification of people with cognitive limitations (e.g. their own school history).  In addition, people with cognitive limitations may have difficulty with such tasks as planning, organizing, integrating memory and regulating emotion.  In everyday life they may have trouble scheduling and keeping appointments, exhibit poor judgment and have difficulty setting limits and following through. These limitations may present challenges in maintaining a home, a job and benefits.  Isolation, lack of transportation and few community supports tailored to meet their needs are persistent problems for these families. 
 
Service providers may identify these families as mentally ill or as substance abusers or conversely, parents whose native language is one other than English may be misidentified as having cognitive limitations. When services designed for these other populations are not effective for such parents, they are often labeled as noncompliant and blamed for the ongoing difficulties within the family.  The population needs to be recognized as distinctive and in need of specialized services.
 
It is important to remember that families headed by a parent with cognitive limitations may have had and continue to have multiple case managers from different agencies who have focused on their deficiencies.  This process can be exhausting and engender feelings of hopelessness.  Assisting the family will require the ability to help them identify their strengths; i.e. what they do well (e.g. hard worker; gardening; good friend, etc).  The most striking comment that practitioners have used to describe these families is often how much they love their children and how much they value their role as a parent.

The following questions and categories may help workers to assess parents’ cognitive abilities.  If concerns about cognitive limitations are raised by the assessment, then an examination of past school records, and possibly an examination by a psychologist should be considered.

I. School History: Because a major impact of cognitive limitations is on academic performance, inquiry into a parent's school history can be helpful in identifying his/her cognitive needs/limitations. Furthermore, frequently when a child is identified as needing special services in school, the parent becomes more aware of his/her own learning difficulties.

Start the interview with an open-ended question: How was school for you? or  Tell me about your school experience.

Follow up with some more specific questions:

  • What was the last grade that you completed in school?
  • Who was your favorite teacher?  How did that teacher help you?
  • Did you ever repeat a grade in school? (If so, what grade?)
  • Were you ever in a special program or did you receive extra help either during or after school? (Tell me about that.)
  • Did you ever go to a special school or ride a special bus to school? (If yes, explore further.)
  • How did you get to school? What kind of transportation did you use? Car bus, color, large, small.
  • What is your favorite hobby or interest? How did you learn about it or how to do it?
  • Do/Did you have trouble learning or remembering new information?
  • Are your children receiving any special services in school? (If yes, explore further.)
II. Financial Management:  Managing finances requires a level of cognition and memory that many people with cognitive limitations may not have.  Inquiry into managing financial management can be helpful. Remember that people can experience difficulties with finances for a variety of reasons, so it is important to explore further to determine if difficulties are due to a person’s cognitive capability.  
  • Do you have trouble paying your bills on time?  (NOTE: Some of the reasons may be: losing the bills; forgetting to send them in; not having the money to pay the bill.)
  • Does someone help you with paying your bills and keeping track of your money? (If yes, explore further.)
  • Has your phone or electricity been disconnected this year?  Is so, how many times? (If yes, explore further.)
  • Have you ever run out of food before the end of the month? (If yes, explore further.)
  • Have you lent people money even though you cannot always pay your own bills? (If yes, explore further.)
  • Have you ever lost your housing because you were behind in the rent? (If yes, explore further.)
III. Housekeeping:
  • What’s your favorite thing to do around the house?
  • Do people complain about the way you take care of your home?
  • Do you ever feel overwhelmed with all of the tasks of cooking shopping, cleaning and laundry that need to be done for your family?   (NOTE: Consider whether parent knows the basics of housekeeping).
IV.  Childcare Skills:  Parents with cognitive limitations MIGHT lack the judgment to ensure their child’s basic needs and safety.  They also MIGHT have trouble in the area of self-care and housekeeping.
  • Do you plan breakfast, lunch and dinner for your children every day?
  • Do you look at books with your children? Do you read to them? Do they read to you?
  • When was the last time one of your children missed school? (If necessary, explore further.)
  • When was the last time you or your children missed or were late to an appointment?  Has it happened before? (e.g., Dr., Dentist)? (If necessary, explore why.)
  • Do people complain that you do not watch your children carefully enough? (If yes… tell me more about that?)
  • Do your neighbors often yell at your children? (If yes, explore further.)
  • How often does the school call you about your child? (If necessary, explore why.)
V. Work: Parents with cognitive limitations may have a difficult time obtaining and maintaining employment due to the sophisticated demands of the modern workplace.  Much like school history, inquiry into the parents’ work history can be a helpful indicator that cognitive limitations may exist.  
 
Starting with an open-ended question: How is work for you? (You may eliminate the need for further query.)
 
 If not, follow-up with more specific questions:
  • What kind of work have you done? 
  • What’s the longest time you’ve worked at any one job?
  • Is it easier for you to get a job than to keep a job?
  • Have you lost jobs because you didn’t catch on quickly enough or because you didn’t work quickly enough?
Parents should be assessed to determine if further evaluation of their cognitive functioning is needed.