Academic journal article Exceptional Children

Family Outcomes in Early Intervention: A Framework for Program Evaluation and Efficacy Research

Academic journal article Exceptional Children

Family Outcomes in Early Intervention: A Framework for Program Evaluation and Efficacy Research

Article excerpt

Most evaluations of the effectiveness of early intervention have focused on outcomes for children (Bryant & Maxwell, 1997; Spiker & Hopmann, 1997). Child outcomes are an appropriate focus of efficacy research, since concerns about the child's development constitute the essential rationale for early intervention and the focus of most services. Over the past 15 years, however, many have argued that early intervention has a broader purpose. Known by a variety of labels--family-focused, family-centered, family-friendly, family-directed--this expanded purpose acknowledges that early intervention also has a responsibility to support families of children with disabilities (Bailey et al., 1986; Dunst, 1985).

Discussions about the relationship between early intervention programs and families have focused primarily on rationale and processes. Much less attention has been focused on the outcomes expected as a result of working with families. This article proposes a framework around which family outcomes could be assessed. We begin with a brief overview of the rationale for working with families and the processes acknowledged to be associated with a family-centered approach. Following a discussion of the challenges inherent in assessing family outcomes, we suggest eight questions around which program evaluation and efficacy research could be structured. Conceptual and assessment issues associated with each are presented and recommendations regarding implementation and future directions are made.

THE RATIONALE AND PROCESSES FOR WORKING WITH FAMILIES

Working with families has always been a significant part of early intervention. The initial rationale was to enhance child development and support parental caregiving, reducing the need for institutional care. Part H of the Individuals with Disabilities Education Act (IDEA) asserted that a major goal of early intervention is "to enhance the capacity of families to meet the special needs of their infants and toddlers with disabilities" (Education of the Handicapped Act Amendments of 1986, Pub. L. No. 99-457, 100 Stat. 1145). Families and professionals soon realized, however, that working with families often led to activities other than teaching or providing therapy for the child, leading a number of authors to argue that working with families is justifiable on the basis of supporting the family, even if such support does not directly enhance the child's development (Bailey et al., 1986; Brewer, McPherson, Magrab, & Hutchins, 1989; Dunst, 1985; Shelton, Jeppson, & Johnson, 1987). Three themes have emerged in recent years. First, families vary considerably in resources, priorities, concerns, and culture. Thus an individualized approach is needed to accommodate individual family preferences, which for some families may include a desire for services (e.g., family support) that go beyond promoting child development. Second, families should be partners in planning and providing services. Thus a new relationship between parents and professionals needs to be forged, recognizing, valuing, and supporting this partnership in ways that are culturally appropriate and consistent with the roles parents desire. Finally, families are viewed as the ultimate decision makers and long-term caregivers of their children. Thus, enabling families to feel competent as advocates is of paramount importance.

The changing rationale for working with families has consequences in the way professionals interact with families. Federal legislation requires early intervention professionals to develop an individualized family service plan (IFSP) with families. In creating the plan, professionals need to be prepared, if parents wish, to assess family resources, priorities, and concerns--factors that should be considered in determining goals and activities. The plan may include outcomes for families and a service coordinator who must be assigned to support the family's efforts to gain access to and coordinate services. …

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