The Impact of Services on Family Outcomes

Ann TurnbullDenise Poston

Beach Center on DisabilityUniversity of Kansaswww.beachcenter.org

denisep@ku.edu

With special Thanks to Jean Ann Summers, Hasheem Mannan,Mian Wang,Janet Marquis and Kandace Fleming

What We Say About Early Childhood Services –And Need to Back up with Data

Strengthening families is a way to ensure children have the best outcomes

The type, amount, and quality of services make a difference in meeting families’ needs and their quality of life

Partnerships with professionals influence families’ quality of life

What Do We Mean by Supports and Services for Families?

Largely undefined The Individuals with Disabilities Education

Act (IDEA) Part C (birth to 3) and Part B-619 (3 to 5) provides a start

Family-centered practice is considered best practice in terms of how to deliver services, but not for what to provide

What Do We Mean by Partnerships?

TRUST

Child-Professional Relationship

Family-ProfessionalRelationship

RespectCommitmentSkillsReliability - Safety

RespectCommunicationEqualityReliability - Dependability

What Do We Mean by Family Quality of Life?

Family Quality of Life

ParentingPhysical/Material

Well-Being

Disability-RelatedSupport

EmotionalWell-Being

FamilyInteraction

Service Impact Study

Designed to test the assumption that services and partnerships affect family quality of life

Limited to one life cycle stage – early childhood

Limited to one state - Kansas Encompasses two policy areas (Parts

B and C of IDEA)

The Service Impact Study

13 program partners throughout Kansas4 serve children ages birth to 35 serve children ages 3 to 54 serve children ages birth to 5

180 families of children receiving services in these programs

Family Participants

0102030405060708090

Percent

AfricanAmerican

Asian Hispanic White

Racial Background

Family Participants

0

5

10

15

20

25

30

35

Percent

Urban Suburban Town Rural

Community Size

Family Participants

0

5

10

15

20

25

30

35

Percent

> HighSchool

HighSchool or

GED

SomeCollege

AssociateDegree

BachelorDegree

GraduateDegree

Educational Background

Family Participants

0

10

20

30

40

50

Percent

Mild Moderate Severe VerySevere

Unknown

Severity of Child's Disability

Measures

Services Inventory Beach Center Family Professional

Partnership Scale Beach Center Family Quality of Life

Scale

Services Inventory

14 child-oriented services 14 family-oriented services Parents check whether service is needed

(yes/no) If needed, parents rate how much they are

getting:

None

Some but not enough

Enough

How Families Rate Services for Their Children?

More families report (59%) they are getting enough of the services their child needs – with a few exceptions Of the 163 families whose children need

speech, 60% report getting enough The exceptions

Of the 57 families whose children need behavior support, 40% report getting enough

How Do Families Rate Services for Themselves?

Fewer families report (21%) they are getting enough of family-oriented services they needOf the 73 families reporting they need

information about services, 23% report getting enough

Of the 49 families reporting they need parent training, 20% report getting enough

The Family-Professional Partnership Scale

9 items for Child-Professional Domain 9 items for Family-Professional Domain Parents think of provider who works most

with them and their child Parents rate satisfaction on a scale of 1-5

1 = Very Dissatisfied

5 = Very Satisfied

Child-Professional Relationship:Sample Items

How satisfied are you that your child’s service provider . . .Has the skills to help your child succeedSpeaks up for your child’s best interestsTreats your child with dignityBuilds on your child’s strengths

Family-Professional Relationship:Sample items

How satisfied are you that your child’s service provider . . .Uses words that you understandProtects your family’s privacyShows respect for your family’s values

and beliefsIs a person you can depend on and

trust

How Do Families Rate Partnerships?

Families on average were highly satisfiedChild-Professional Relationship rating = 4.24Family-Professional Relationship rating = 4.43

Highest rated item:Service provider is friendly (4.67)

Lowest rated item:Service provider helps parent gain skills or

information (3.77)

The Beach Center Family Quality of Life Scale

25 items in 5 domainsFamily Interaction (6 items)Parenting (6 items)Emotional well-being (4 items)Physical/Material Well-being (5 items)Disability-related support (4 items)

Families rate satisfaction on a scale of 1 to 5

Family Quality of Life: Sample Items

For my family to have a good life together, how satisfied am I that . . .My family enjoys spending time together.My family members have friends or others

who provide support.My family members have transportation.Adults in my family have time to take care of

needs of every child.My family member with a disability has

support to accomplish goals at school.

How Do Families Rate Their Quality of Life?

On average, participants reported that they were fairly satisfied with their family quality of lifeFamily Interaction – 4.06Parenting – 4.07Emotional Well-being – 3.43Physical/Material Well-Being – 4.21Disability-Related Support – 4.13

Some Limitations and Explanations

Limited Sample High scores

Satisfaction response stemFamilies of young children report more

satisfaction with their partnerships – might this also affect FQOL?

Families may not think they need a service because they think they won't be able to get it anyway

Putting It Together

Service adequacy significantly predicts family quality of life ( t-value = 4.76)

Service adequacy significantly predicts partnership (t-value of 4.39)

Partnership is a partial mediator of the effect of service adequacy and family quality of life (Sobel test = 2.14, p = 0.031)

Partnerships

ServicesFamily Quality of Life

The Support Triangle:Services and Partnerships Make a Difference for Families

Implications For Future Research and Activities

Exploring the issue of family supports and servicesWhy do families report not needing very

many services for themselves (717 vs 425)?Why are they not getting the services they do

need? Exploring the relationship between family

outcomes and child outcomes Exploring how structures in organizations

and best practices facilitate partnerships