Making decisions together on health, school and activities

The short answer

Separate the big decisions (health care, school, significant activities, faith) from day-to-day ones, which the parent with the child usually makes. For big decisions, agree a simple process in advance: one parent proposes in writing with the facts and a deadline, the other replies, and if you cannot agree you use mediation or a parenting coordinator, never the child. Both parents should get school and medical information directly.

A new medication. A school that suits one parent's work schedule better than the other's. A hockey program that costs a fortune and eats every weekend. These decisions are hard enough in one home. Across two homes, with feelings still raw, they can become the main battleground of a separation.

They do not have to. If you are dreading the next decision because the last one went badly, you are not failing. You are missing a system. Much of the conflict around shared decisions comes from three gaps: no agreement on which decisions are shared, no process for making them, and no plan for when you disagree. This guide closes those gaps. For what the legal terms mean in your country, see our explainer on custody and parenting time.

Which decisions are made together?

In Canada, the federal Divorce Act uses the term decision-making responsibility. Justice Canada's guide Making Plans says it covers significant decisions about health care, education, culture, language, religion or spirituality, and significant extracurricular activities. It can be joint (both parents decide together), sole (one parent decides), or "divided (parallel)" (each parent decides different areas). Provincial laws apply to unmarried parents and vary.

In the US, the equivalent is usually called legal custody, which can be joint or sole. What it covers, and how disagreements are handled, varies from state to state and depends on the wording of your order or agreement. Check yours, and ask a family lawyer in your state if it is unclear.

In both countries, your order or agreement is what governs your family. The table below reflects common professional guidance, including the Ontario chapter of the Association of Family and Conciliation Courts (AFCC-Ontario), not the law where you live.

Type of decision	Examples	Who usually decides
Major	Choice of school, special education, non-emergency medical treatment, mental health care, significant activities, faith and cultural heritage	Whoever holds decision-making responsibility or legal custody: both parents if joint
Day-to-day	Bedtime, meals, homework routines, play dates, haircuts	The parent the child is with at the time
Emergency	Urgent medical care, an injury at school	The parent the child is with, who contacts the other parent immediately

Set up a decision process before you need one

The time to agree how you will decide is when nothing needs deciding. Write this into your parenting plan or agree it in writing.

Agree the list. Which decisions are "major" for your family? Be specific. Is a second sport major? Braces? A school trip abroad?
One parent proposes, in writing. One topic per message, with the facts, the options, any costs, and a suggested deadline for a reply.
The other parent responds by the deadline. Yes, no, or "I need more information about X".
If you agree, one parent confirms in a single line. That is your record.
If you do not agree, you follow your dispute route (see below). The child is not consulted as a tiebreaker.

AFCC-Ontario describes another option some families choose: "consult, with one parent having final say". One parent must genuinely consult the other, in good time, but decides if there is no agreement. Some families divide it by area (one parent has final say on health, the other on school).

"Subject: Sam, speech therapy. The school has recommended an assessment. Options: (1) the school board's waitlist, about 6 months, free; (2) a private clinic, available next month, partly covered by my benefits; I'll confirm the fee. I'd suggest option 2. Could you let me know by Friday the 12th?"

"I've booked Sam into speech therapy. You'll get half the bill."

"I'm not comfortable with that yet. Could you send me the coach's information on time commitment? I'll reply by Sunday."

"Absolutely not. You always do this."

Keep proposals and replies in one place, whether that is one email thread per topic or a shared co-parenting app, so either of you can find what was agreed months later without asking the children. If you are considering an app, our side-by-side comparison of co-parenting apps lists what each one offers, such as shared calendars and message records that cannot be edited. Where there has been family violence, check any shared tool with a safety advisor first.

Health care

An AFCC guide for joint parenting recommends that both parents are told about check-ups, that the doctor's instructions and any medication go to both homes, and that each parent tells the other about any emergency care. AFCC-Ontario adds that in a medical emergency the parent with the child should contact the other parent immediately.

The Arizona chapter of the AFCC tells the story of a child who was immunised twice because neither parent told the other. It is a small example of a big point: shared information is a safety issue, not a courtesy.

Keep a shared, up-to-date list of the child's doctors, dentist, medications, allergies and health card or insurance details.
After every appointment, send a short summary: what happened, any new instructions, the next date.
For mental health care, such as counselling for your child, agree on it together where you share decision-making, and ask the provider what consent they need from each parent. Check your order or agreement.

In Canada, the Divorce Act (section 16.4) says that, unless a court orders otherwise, a person with parenting time or decision-making responsibility is entitled to ask for and receive information about the child's well-being, including health and education, from the other parent and from others likely to have it, such as schools and doctors, subject to other applicable laws.

School

The AFCC guide recommends that parents agree on the school, make sure both can take part in conferences, events and activities, and "arrange for both parents to receive report cards and progress reports directly from the school." Getting information directly means neither parent depends on the other, and neither depends on the child.

In the US, federal regulations under the Family Educational Rights and Privacy Act (FERPA) say schools that receive US Department of Education funding must give full rights under the Act to either parent, unless the school has been given evidence of a court order, state statute or legally binding document that specifically revokes those rights.
In Canada, the Divorce Act information right above applies to education. Provincial rules and school board policies also apply.
Tell the school office both parents should receive notices, and give them both sets of contact details.
For a child with additional needs, the ADHD organisation CHADD advises talking to teachers early and putting requests for supports (in the US, a 504 plan or IEP) in writing and keeping copies. AFCC-Ontario adds that "the child is not the messenger regarding his or her treatment and diagnosis".

Parent-teacher meetings: AFCC-Ontario suggests attending together if you can be civil, and taking turns if not. Our guide to school during separation covers telling teachers and report cards in more detail.

Activities

Activities cause more friction than you might expect, because they cross into both parents' time and both parents' budgets. The AFCC guide suggests considering the child's interests and agreeing how costs are shared.

Questions to settle before saying yes:

Does it fall on both parents' time? If so, does each parent agree to take the child during their time?
What does it cost, including equipment, travel and tournaments? How is that split?
Who is the contact for the coach or teacher? (Ideally both parents get the information.)
What happens if the child wants to quit halfway through?

Justice Canada notes that even divided decision-making can lead to conflict, because areas overlap: a demanding school program can affect a child's health, for example. Plan how you will settle disagreements where one parent's area touches the other's.

Your child's voice

Children deserve to be heard on decisions that affect them, in a way that fits their age. They should not be made to decide between their parents.

Young children can choose between options you have already agreed: swimming or gymnastics, the blue backpack or the red one.
Preteens and teenagers often want a real say. An AFCC guide notes early adolescents may want a voice, but parents make the final decision. See our guide on how much say teenagers should have.

"Dad and I are both going to think about which school is best. We want to hear what you think, and then the two of us will decide."

"It's up to you. Do you want the school near my place or the one near your mother's?"

"That's something Mom and I need to talk about. I'll let you know when we've decided."

"Ask your mother. If she says no, you know who to blame."

Other decisions to plan for

Justice Canada suggests your plan also covers:

passports and consent for travel, especially outside the country;
introducing new partners;
social media and sharing the children's images online.

When you cannot agree

AFCC-Ontario says joint decision-making needs a dispute mechanism, such as mediation. In order of escalation:

Pause and gather information. Many disagreements shrink when both parents speak to the same doctor or teacher.
Use your check-in rather than a stream of messages.
Mediation, for one-off disagreements.
A parenting coordinator, where disputes keep recurring.
Legal advice or court, for decisions that genuinely cannot wait or be settled otherwise.

Throughout, keep the disagreement away from the child. A 2016 evidence review for the UK government found that "frequent, intense, and poorly resolved" conflict between parents puts "children's mental health and long-term life chances at risk". A classic 1991 US study of 522 adolescents found that conflict harmed teenagers mainly by making them feel caught between their parents. The Ontario AFCC chapter calls children's exposure to parental conflict "one of the most consistent findings" in the research, and the American Academy of Child and Adolescent Psychiatry says "children do better when parents can minimize conflict and cooperate on behalf of the child."

Signs that more help is needed

Important decisions for your child (a needed treatment, a school placement) are stalled for weeks.
One parent regularly makes major decisions alone.
Your child knows about, or is drawn into, your disagreements.
Your child shows signs of distress the Canadian Paediatric Society suggests raising with a doctor if they continue: anxiety, sadness, changes in eating or sleep, trouble at school or aggressive behaviour.

If there is family violence: joint decision-making may not be safe. Justice Canada says joint decision-making "generally isn't appropriate" where there are ongoing safety concerns due to violence between parents, because arrangements needing regular contact can create opportunities for further harm. Get legal advice before agreeing to shared decisions. Read our guide to separation and safety planning. Press Shift+Esc to leave this site quickly.

Sources

Department of Justice Canada. Making Plans: A guide to parenting arrangements after separation or divorce. 2026. https://www.justice.gc.ca/eng/fl-df/parent/mp-fdp/index.html
Government of Canada. Divorce Act, RSC 1985, c 3 (2nd Supp), s 16.4. https://laws-lois.justice.gc.ca/eng/acts/d-3.4/FullText.html
US Code of Federal Regulations. 34 CFR 99.4, What are the rights of parents? (FERPA regulations). https://www.ecfr.gov/current/title-34/subtitle-A/part-99/subpart-A/section-99.4
AFCC-Ontario. Parenting Plan Guide. 2020. https://www.afccnet.org/Portals/0/PDF/AFCC-O-Parenting-Plan-Guide%20(Jan%202020)1.pdf
Association of Family and Conciliation Courts. A Guide for Joint Custody and Shared Parenting. Revised 2003. https://www.afccnet.org/Resource-Center/Family-Resources/A-Guide-for-Joint-Custody-and-Shared-Parenting
Association of Family and Conciliation Courts. Making Your Parenting Plan Work. Revised 2003. https://www.afccnet.org/Resource-Center/Family-Resources/Making-your-Parenting-Plan-Work
Arizona Chapter of the Association of Family and Conciliation Courts. Co-Parenting Communication Guide. 2011. https://www.afccnet.org/Portals/0/PDF/AzAFCC%20Coparenting%20Communication%20Guide-web.pdf
CHADD. Quick Facts: School and Home Communication Plan. Undated. https://chadd.org/for-parents/quick-facts-school-and-home-communication-plan/
American Academy of Child and Adolescent Psychiatry. Children and Divorce, Facts for Families No. 1. Updated 2026. https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Children-and-Divorce-001.aspx
Harold G, Acquah D, Sellers R, Chowdry H, Feinstein L. What works to enhance inter-parental relationships and improve outcomes for children. Early Intervention Foundation. 2016. https://www.gov.uk/government/publications/what-works-to-enhance-inter-parental-relationships-and-improve-outcomes-for-children
Buchanan CM, Maccoby EE, Dornbusch SM. Caught between parents: adolescents' experience in divorced homes. Child Development. 1991. https://doi.org/10.1111/j.1467-8624.1991.tb01586.x
Canadian Paediatric Society. Helping children cope with separation and divorce. Caring for Kids. 2018. https://caringforkids.cps.ca/handouts/mentalhealth/separation_and_divorce

This guide is general information, not medical, psychological or legal advice. If you are worried about your child's safety or mental health, contact a professional or one of the services listed above.

If someone is in immediate danger, call 911. In Canada, call or text 9-8-8 (Suicide Crisis Helpline), or reach Kids Help Phone at 1-800-668-6868 or text CONNECT to 686868. In the US, call, text or chat 988 (Suicide and Crisis Lifeline).

Common questions

Which decisions do separated parents make together?

Usually the significant ones: health care, education, faith and culture, and significant activities. In Canada this is called decision-making responsibility; in the US it is usually legal custody. Day-to-day decisions are generally made by the parent the child is with. Your order or agreement is what governs your family.

Can my co-parent make a medical decision without me?

In an emergency, the parent with the child acts and should tell the other parent immediately. For non-emergency decisions, it depends on your order or agreement. If you share decision-making, major treatment is generally a joint decision. Get legal advice for your situation.

Can the school give me my child's report card if my ex has primary residence?

Usually, yes. In Canada, the Divorce Act gives a parent with parenting time or decision-making responsibility a right to request information about the child's education unless a court orders otherwise. In the US, FERPA regulations give either parent rights unless a legal document specifically revokes them.

Should our child decide which parent is right?

No. Children should be heard in a way that fits their age, but asking them to break a tie between parents puts them in the middle. Use mediation or a parenting coordinator instead.

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This guide is general information for parents, not medical, psychological or legal advice. It draws on published research and guidance from recognised health and family justice bodies, listed under Sources. Every child and family is different. If you are worried about your child or yourself, talk to your family doctor or a qualified professional. FairWell can help you find one through the professional directory.