This issue was addressed on August 22, 2025 by the North Carolina Supreme Court in the matter of Durban v Durban.  The facts are rather straightforward and, unfortunately, all too typical.

Several years after a divorce, Mom went back to court to modify the original parenting plan.  Father had become increasingly difficult to deal with regarding co-parenting the parties two children.  Most concerning was his resistance to giving the children their mediations and taking them to therapy.  The parties settled the temporary issues by maintaining the terms of the original custody order and retaining a parent coordinator to assist with communication. The parties gave the parenting coordinator the authority to make decisions regarding medicines, counseling and other important custody issues.

In spite of Father's consent to the appointment of the parenting coordinator, he refused to follow her directives regarding medicine, counseling and other parenting decisions.  In fact, Dad "escalated his conflict with the parenting coordinator when he filed a bar grievance against her, noticed her for a deposition, and threatened to file a motion for sanctions against her."  In it's final judgement the trial court found that

...the conflict regarding medical care of the child continues. The trial court also found that the Father continued to refuse to ensure the child was taking the medication consistently in spite of the child’s diagnosed medical condition and a directive from the parenting coordinator to log administration of medication. The trial court also noted ongoing conflicts and" that “amount of conflict between the parties is not in the children’s best interest."

The trial court concluded that the findings “constitute[d] a substantial change in circumstances” warranting modification to the terms of the original custody order.

In reversing the court of appeals, who had overturned the trial courts decision, the Supreme Court stated that

...a substantial change in circumstances is often based upon a series of discrete events or an ongoing pattern of behavior that affects the welfare of the child... The findings in these orders (prior temporary rulings) demonstrate an increasing level of conflict created by the Father about many aspects of the children’s lives but especially the children’s medical needs and therapy appointments.

Father had become unable to communicate with the parent coordinator and Mom in a way that served the best interest of the children, as was noted by many missed therapy appointments and administratiion of medicine.

While Father had "freedom of speech", which is very much in vogue these days, he learned that there are limits to what he can say and do.  His antagonism towards Mom and the parenting coordinator directly negatively affected the children's best interests by way of missed medicine and therapy appointments.  In this way the Supreme Court found that a change in circumstances had in fact occurred, and the change was negatively affecting the best interests of the child.

Guy Vitetta, Charleston