When Grandpa Decides: Map Family Hierarchies Before Writing Goals

Some homes do not run on parent rule. They run on grandfather rule, and if you only talk to the parent on the intake form, you are talking to the wrong person. Mackenzie Sandler said it flat out in her CEU. She has worked with families where the grandfather makes every call about the child, and his vote sits on top of both parents. That is not rare. It is a normal way many families work, in the United States and everywhere else. A Board Certified Behavior Analyst (BCBA) who skips this step writes goals the family will never run, signs consent with the wrong person, and burns trust in week one. This page gives you the workflow to find the real decision-maker before you write a single goal.

Why the parent on the intake form is not always the decision-maker#

Your intake form has a slot for "parent or guardian." Insurance needs a name. Legal needs a name. So a name goes in. That name is who signed the paperwork. It is not always who decides what happens with the child. In many families, the person who picks goals, approves new foods, and tells the BCBA yes or no is not the parent. It might be a grandparent. It might be an aunt. It might be an older sibling. It might be the great-grandmother who lives down the hall.

This is not a story about "other cultures." It happens in homes on every block. Some homes are run by the parent. Some homes are run by an elder. Some homes are run by both at once and disagree all the time. None of those is wrong. They are just the way that family runs.

If you assume parent rule, two things break. One, you write goals the real decision-maker never agreed to, and they get blocked at home. Two, you teach the parent skills they cannot use without the elder's nod. Both look like the family is "not following through." Neither one is the family's fault. It is on you to ask who decides before you write the plan.

The grandfather story: when an elder outranks both parents#

This is the line from the talk that should change how you do intakes.

Individualize and recognize that family structures and decision making hierarchies are often different. I've worked with families where the grandfather is the be all end all. He makes all decisions. It spits right over the parents. So make sure you're talking to the right people. From the talk — Mackenzie Sandler

Picture what that looks like in a real session. You sit down with mom at the first home visit. You walk her through the goals. She nods. She signs. You leave. Two weeks later nothing has changed at home. You think she is not buying in. The truth is the grandfather, who sits at the dinner table every night, never heard about the goals and never agreed to them. The plan was dead the day you handed it over, and you did not know.

Now picture the same case with the hierarchy mapped. You ask mom on day one who else helps decide things for her son. She tells you grandfather. You schedule the next visit when he is home. You walk both of them through the goals. He asks two questions, changes one goal, and signs off on the rest. Now the plan has a real chance, because the person who actually decides has actually decided.

The grandfather story is the easy one. There are quieter versions of the same problem. A great-aunt who controls food. An uncle who controls school choices. A teen older sibling who runs after-school care. The pattern is the same. Find the person who decides. Talk to that person.

How to ask 'who decides' without making it weird#

You cannot walk in and ask "who is in charge here?" That sounds like a power test. You will get a polite, useless answer. The way to ask is to ask about the decision, not the person.

Try these out loud. They are short, they are warm, and they do not put anyone on the spot.

1. "Who else in your family helps make calls about your child's care? I want to be sure they get heard."
2. "When you make a big choice about your son, who do you usually check with first?"
3. "Is there anyone else who lives in the home, or who is here a lot, that I should meet before we lock in goals?"
4. "If we picked a new goal today, who needs to nod before it counts as a yes?"

That last one is the gold one. It maps decision authority for one concrete thing. It also tells the family you respect their setup, and you are not going to bulldoze in with your own idea of who matters.

Use these on day one. Use them again at the six-month plan update. Authority shifts. A grandfather moves in. A grandmother passes away. An older sister takes over weekends. The map is not a one-time job.

Make sure you're talking to the right people and you're including as many people as possible that are those decision makers, set up initial support and understanding for communication barriers, make it standard that it's okay to ask questions, have that opportunity to talk about things that people are not understanding. From the talk — Mackenzie Sandler

Building a stakeholder map at the first home visit#

A stakeholder map is just a sticky-note version of who matters in this child's life. You can keep it in your case notes. Nobody else has to see it. You should look at it every time you write a goal.

Three columns. Name. Role in the home. Decision power on a 1 to 5 scale.

A 5 is the be-all-end-all. Their no is a no. Their yes is a yes. A 4 has to agree for it to stick, but they will follow a 5. A 3 is in the loop and can slow things down if they push back. A 2 hears about it after. A 1 is a name on the consent form and not much else in practice.

Walk through the list with mom or whoever signs the intake. Ask who is a 5 for things like food, sleep, school, screen time, and discipline. The 5 might change by topic. Grandfather is a 5 on food and a 3 on school. That is fine. Write it down.

Now you know who needs to be in the room when you propose goals about food. You know whose nod you need before you change the bedtime routine. You stop wasting parent training time on parents who do not hold the keys to that specific domain.

What to do when a primary decision-maker rejects a goal#

Sometimes you map the hierarchy, you sit down with the right person, and they say no. The fork story from the CEU is the cleanest example. A learner around age eight was being hand-fed. The BCBA asked if a fork could be a goal. The family said no, and gave a real reason: the hand-feeding was meaningful to them.

I said, do we want to start using a fork? And they said, absolutely not. It is their pride and joy and it brings their family great benefit. They found it very valuable to hand feed their oldest child. From the talk — Mackenzie Sandler

So what now? You do not push. You do not write the goal anyway. You also do not delete the topic and pretend it never came up. You leave the door open. Sandler's move is the right one.

I gave, I left it open-ended. When you guys think it's valuable, or I see an opportunity where he could gain access to more least restrictive environments by using a fork, knife, spoon, we'll talk about it. We left it open-ended that either one could come back and offer that again as a goal, but it wasn't being forced. From the talk — Mackenzie Sandler

That is the script. "When you think this is useful, or when I see a moment where this skill would open something up for him, we can come back to it." Either side can reopen the topic. Nobody loses face. The goal is parked, not killed, and the trust stays intact.

A goal that gets a hard no from the real decision-maker is not a goal. It is a fight. Park it.

Documenting decision authority so your RBTs do not get caught off-guard#

This is the step almost nobody does, and it is the one that protects your Registered Behavior Technicians (RBTs) in the home. If you know grandfather is a 5 on food and you do not write it down, your RBT will walk in on a Tuesday, pull out the fork program, and get shut down by grandfather in front of the learner. Now the RBT looks confused. Grandfather looks ignored. The learner watches the whole thing and learns that the team does not have it together.

Write three lines into the program book and the session notes header.

1. Who needs to approve new programs before they run in the home, and how to reach them.
2. Topics that are off-limits without a specific person's nod (food, bedtime, dress, anything the family flagged).
3. The script the RBT uses if a decision-maker pushes back in session. Something like, "Thanks for the heads-up, I will pause that program and check in with your BCBA before we try it again."

Those three lines turn the stakeholder map into something the whole team can use, not just you. They keep your RBTs from running into a wall they had no way of seeing.

Frequently asked questions#

Is it ethical to write a goal a family declined just to keep it on file for later?

No. A goal in the treatment plan is a goal the team will run. If you write it and the family said no, you have lined up your RBTs to run a program the family rejects. That is a consent problem, a trust problem, and a clinical problem. Park the topic in a clinical note instead. Write one line: "Family declined fork-use goal on 5/15. Will revisit if family raises it or if least-restrictive-environment access requires it." That keeps the thinking on file without putting a non-consented goal in motion.

Who signs consent when extended family is the actual decision-maker but not the legal guardian?

The legal guardian signs. That is the law and the insurance rule. But signature is not the same as buy-in. If the grandfather is the real decision-maker, his agreement is what makes the plan work, even though mom's name goes on the page. Walk the goals through with both of them. Have the guardian sign. Note in the clinical record who else was at the table and what they agreed to. That gives you a signed consent and a real plan.

How do I handle disagreement between two parents about a goal?

Slow down and find out what each one wants for the child. Often the fight is not about the goal at all. It is about something older between the two of them. Your job is not to be a marriage counselor. Your job is to find the smallest version of the goal both can live with for the next month, run it, and bring data back. Data settles a lot of arguments that words cannot. If they still disagree after that, refer out. A family therapist or school counselor handles the bigger fight while you keep the clinical work moving on the parts both parents agree on.

Map the hierarchy before you write the plan#

If you only know one name on the case, you only have a piece of the family. Find the real decision-makers. Ask in plain language. Write the map down. Run goals past the right people, in the right order, before they hit the treatment plan. Watch Mackenzie Sandler's full CEU on cultural considerations in ABA clinical practice to see how she handles the harder versions of this in real homes.