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A Qualitative Study of Parental Experiences of Participation and Partnership in an Early Intervention Service
Abstract
Family-centered practice encompasses a philosophy and a method of service delivery that underpins early intervention services and is considered “best practice” in fields concerned with optimal child development. The aim of this study was to gain a critical understanding of parental experiences of an early intervention service that professionals believed was based on the principles of family-centered practice. Using qualitative inquiry, in-depth interviews were carried out with parents of 7 children with primary physical disabilities who attended a preschool program. Overall findings revealed that parents were relatively satisfied with the nature of the services they received but identified specific process elements that warranted further attention. These included lack of support at critical times, lack of information, and continuity of care not being adequately developed. Parents in this study felt that there was meaningful collaboration and partnership with individual professionals, but indicated that this was less likely at team level. They also believed that collaboration at a higher organizational level was limited. Parents clearly feel that relationships with professionals are important and perceive that they are in partnership with professionals, but in varying capacities over time. Parent expertise, knowledge, and support were identified as the valuable resources for other parents, professionals, and the organization as a whole, but were not effectively utilized by the service.
... Although some studies emphasize satisfaction with care focused on child development (Alotaibi & Almalki, 2016;Coogle et al., 2013;Kelly et al., 2012;Noyes-Grosser et al., 2018;Summers et al., 2007), most of them highlight as positive the relationship of partnership between the professionals and the family, which is perceived as one of their most beneficial outcomes (Adams et al., 2019;Brown & Remine, 2008;Favez et al., 2008;Fordham et al., 2011;Gràcia et al., 2019;HughesScholes & GavidiaPayne, 2019;Jinnah & Walters, 2008;Leite & Pereira, 2013;McManus et al., 2020;Pighini et al., 2014;Thompson & Bruns, 2013;Trute & Hiebert-Murphy, 2007), through an active listening and a close and collaborative behavior (Fitzgerald et al., 2015;Gavidia-Payne et al., 2015;Gibbs et al., 2019;James & Chard, 2010;Khetani et al., 2011;Pighini et al., 2014). The focus on family priorities and their concerns were also highlighted (Brown & Remine, 2008;Coogle et al., 2013;Kyarkanaye et al., 2017), enabling families to participate in the processes of decision-making in the EI interventions (Fiss et al., 2012;Pighini et al., 2014;Popp & You, 2014;Ziegler et al., 2020). ...
... Professional competence was positively perceived (Coogle et al., 2013;James & Chard, 2010), as well as individualized intervention plans (Alotaibi & Almalki, 2016). Families also mentioned the greater support received, the flexibility, and the communication conveyed when attended by a single reference professional (Fitzgerald et al., 2015). ...
... Family Benefits of Early Intervention situations, or as the control they have over their lives and decisions (Leite & Pereira, 2013). Empowerment is portrayed as an important benefit provided by EI support (Fordham et al., 2011;Gràcia et al., 2019;James & Chard, 2010;Leite & Pereira, 2013;Pérez et al., 2016;Trute & Hiebert-Murphy, 2007). Among these actions, families emphasize the support that allows them to understand the individual characteristics, needs, and abilities of their children (Adams et al., 2019;Epley et al., 2011;Gascon-Ramos et al., 2010;Gavidia-Payne et al., 2015;Leite & Pereira, 2013;Swafford et al., 2015;Zheng et al., 2016), that gives them access to and sharing of information, as well as the exchange of strategies to cope with stress (Brown & Remine, 2008;Coogle et al., 2013;Edwards & Gallagher, 2014;Kelly et al., 2012;Pighini et al., 2014;Thompson & Bruns, 2013;Wilkins et al, 2010;Ziegler et al., 2020) to support their development (Behl et al., 2017;DuBay et al., 2018;HughesScholes & GavidiaPayne, 2019;Noyes-Grosser et al., 2018;Störbeck & Pittman, 2008). ...
Early Intervention (EI) is aimed at children with developmental delays through actions that include families and their context. The objective of this study was to conduct a scoping review based on The Protocols of the Joanna Briggs Institute and PRISMA-Scr, answering the question: How do families of children with special needs understand the benefits (support or assistance received) of Early Intervention Services? 54 articles were found and analyzed, and four different nuclei were organized: EI team, skills, and collaborative practices; Family empowerment and self-efficacy; Participation, personal needs, and Quality of Family Life; Access to information and services. We concluded that family benefits are indicators of the effectiveness of early intervention.
KEYWORDS:
early intervention; family; scoping review
... over of intervention out of sessions, this implies higher levels of parental engagement (Forsingdal, St John, Miller, Harvey, & Wearne, 2013;James & Chard, 2010). The literature alludes that, within the intervention context, parents may assume different types of roles that influence their level of engagement (Davies et al., 2017;Forsingdal et al., 2013). ...
... Four of the included articles described parents as Informers, although other studies named this role the information liaison (Hurtubise & Carpenter, 2011) and informant (James & Chard, 2010). This role is considered a passive information management role. ...
... In terms of the tasks assigned to this role, parents gather, organize, and are responsible for sharing information with and between professionals and organizations (Hurtubise & Carpenter, 2011). Parents are, therefore, responsible for providing professionals with information i.e. their child's likes, dislikes, family needs, parental concerns, their child's behavior at home (Bowen & Cupples, 2004;Burrell & Borrego, 2012;James & Chard, 2010). Within sessions, parents are also tasked with identifying child and family needs. ...
The importance of parental roles in rehabilitation interventions (i.e. the tasks and responsibilities assigned to parents in intervention) is widely reported but there is a paucity of information regarding the tasks linked with specific parental roles. A rigorous scoping review was conducted to understand the various roles that parents of children with developmental delays, disabilities, and long-term health conditions perform in intervention and the tasks and responsibilities associated with each role. The results confirm that parents take on distinct intervention roles which can be placed on a continuum from passive to active responsibility. Some parental roles are clearly associated with tasks completed in-session, some are linked with out-of-session tasks while others entail a combination of in-and out-of-session tasks. The in-session tasks linked with the Learner role emerged as central to enabling parents to assume other in-and out-of-session roles. The results also highlight the influence of the parent-professional relationship on the type of roles parents take on in their child’s intervention. The findings of the scoping review serve as the initial step in generating items for a tool to measure the type of roles that parents assume in intervention to empirically test the relationship between these roles and parental engagement.
... Although a single definition of family-centered orientation has not been agreed on, DEC's recommended practices related to family-based services emphasized that families and professionals should share responsibilities and work collaboratively to strengthen family functioning through individualized services that are flexible and based on the families' strengths and assets (Trivette & Dunst, 2005). Although a family-centered orientation should be reflected across EI practices from the initial entry into EI through a family's transition out of EI, implementation of a family-centered orientation is more complicated to accomplish, especially when working with families living in poverty (James & Chard, 2010). ...
... However, families in this study also identified issues they encountered, including a lack of (a) support at critical times despite receiving EI services, (b) shared information regarding services received, and (c) continuity in the EI services provided. Using a family-centered orientation for EI services requires an evolutionary, responsive partnership on multiple levels: (a) at the parent and EI professional level, (b) at the EI team level, and (c) within organizational levels (James & Chard, 2010). ...
... Understanding how EI professionals are able to develop skills that will enable responsive relationship-based interventions with families who are living in poverty is essential. Families living in poverty are regularly faced with less than ideal circumstances (James & Chard, 2010;Janko-Summers & Joseph, 1998). For example, families living in poverty oftentimes must juggle working a fixed amount of hours each week to receive their state or federal assistance. ...
The Individuals With Disabilities Education Act mandates that very young children with disabilities be served through Part C services. Families of young children with disabilities who are also living in poverty are often the primary recipients of these services. To better understand the experiences of families, particularly those living in poverty, within the early intervention (EI) system, we reviewed four EI components: (a) family-centered orientation, (b) natural learning environments, (c) collaborative team processes, and (d) service integration. We discuss the implications of these components for the preparation and training of EI providers to work with families, including those living in poverty.
... While commenting favourably on many aspects of EI, families also raised concerns, including frequency of therapy sessions. Amount of therapy is central to satisfaction with EI; often parents feel that their child requires more (Hiebert-Murphy, Trute & Wright, 2011;James & Chard, 2010). As with these previous reports, our parents attributed a lack of therapy to organisational constraints, for example, staff shortages, large caseloads and insufficient funds/resources. ...
... The importance of building strong, collaborative partnerships with health professionals has been highlighted for children with chronic health conditions by Kratz, Uding, Trahms, Villareale and Kieckhefer (2009). In addition to issues of lost time, staff turnover can be concerning for parents when high-quality relationships have been forged with previous staff members (James & Chard, 2010). ...
... Parents often felt that various agencies with which they were involved communicated and coordinated services poorly, consistent with our broader study where parents reported relatively less satisfaction with service coordination and quality/availability of other community services (Ziviani, Cuskelly & Feeney, 2010). Other studies have found that parents are responsible for sourcing and coordinating different services they access for their child (James & Chard, 2010), highlighting the need for family-centred service coordination, which reduces families' requirements for psychosocial support resources (Trute, Hiebert-Murphy & Wright, 2008). ...
To gain insight into the special issues confronting parents when accessing early intervention for children with physical disabilities where child and/or family characteristics indicate complex needs within the unique Australian context.
Qualitative interviews with families receiving early intervention for their children with physical disabilities (N = 10). Families with complex circumstances such as having children with high support needs, those from culturally and linguistically diverse backgrounds, and single-parent families were recruited to the study. Families where parents had mental or health issues, parents/other family members had an identified disability, and/or where families lived in regional or rural locations were also purposively sampled.
Participants highlighted issues around (i) the nature of early intervention services provided; (ii) the ways in which services were structured; and (ii) managing their child's needs/planning into the future. Parents stressed the importance of having access to a variety of early intervention services aside from therapy. They also emphasised the need for greater clarity about what to expect from services, the intensity of therapy, other services they could access and how long they would be able to receive these.
Despite their complex circumstances and needs, participants' experiences of accessing early intervention services were largely consistent with the broader research literature. Of the parents interviewed, those with health problems and single mothers expressed most apprehension about managing their child's needs and planning for the future.
... In the literature, it is a common principle that the early intervention system is built on the notion of interdependence and collaboration among professionals and families (Dinnebeil and Rule, 1994;Gallagher et al. 1994;James and Chard, 2010;Minke and Scott, 1995;Vohs, 1998;Ziviani et al. 2011). For example, Minke and Scott (1995) investigated 12 different early intervention programs to examine how parents and professionals work together using family-centered models. ...
... As Nora recalled, the meeting process was simply documenting than discussing with families' needs and concerns. The interaction between the two parties did not present the qualities the families had expected, thus, a lack of the qualities mentioned in previous studies persisted (see also Dinnebeil et al. 1999;James and Chard, 2010;Kontos and Diamond, 2002;Mahoney and Filer, 1996;McNaughton, 1994;McWilliam et al., 1995;Summers et al., 1990;Wehman and Gilkerson, 1999;Zhang et al. 1999;Ziviani et al. 2011). ...
Introduction Early intervention conceived as a program for young infants and toddlers with developmental needs and their families, how early intervention practice establishes family participation in the service process - from referral, evaluation, Individualized Family Service Plan (IFSP) meeting, to service delivery - was considered in this article. Employing disability studies perspectives, the study contends that although families have gained legal rights for family participation in the law, the requirements do not guarantee the quality of family participation. Using a qualitative case study approach, this study looked at both participation and perceptions of families in the early intervention service process in the metropolitan area of the US. Case description Three families’ experience in the process of early intervention was observed, and how these parents reflect on their participation in the development of early intervention service planning and delivery was examined through in-depth interviews. Discussion and evaluation Findings showed that the families’ participation varied by service providers. The disparity resulted from variable availability, competency levels, and approaches of individual service providers during the service process. In addition, early intervention professionals who are bounded by the requirements in a professional bureaucracy, including the procedural requirements, often impinge on the quality of family participation and limit families’ opportunities for quality service provision. Conclusions The paper suggests rethinking about how the practice can be implemented.
... Interprofessional collaboration among allied health professionals is essential in the provision of holistic, early intervention pediatric practice for best patient outcomes (James & Chard, 2010). ...
... A lack of continuity of care can threaten optimal service provision for the early childhood population. For example, in a study of the parental experience with early intervention services, parents highlighted the negative impact that a lack of cooperation among professionals had on their service delivery experience (James & Chard, 2010). The parents felt that there was meaningful collaboration between themselves and the individual professionals but that this was lacking among the service providers. ...
This mixed methods pilot study investigated the impact of an interprofessional education program on OT student readiness for collaboration with SLP students in a pediatric teaching-clinic practice setting. OT students were randomly assigned to either the treatment group, which received the interprofessional education experience, or the control group, which received the typical educational experience. Students completed pre and post surveys and journaled about the experience. Results pointed to a ceiling effect in the measurement scales in both the treatment and control groups due to positive attitudes at baseline. This positivity was also reflected in journal entries for the treatment group students. Several insights were gained through data analysis about the feasibility of this type of program, the usefulness of available measuring tools for detecting change in small samples, and the developmental progression of interprofessional skills attainment.
... T herapists' responsiveness in a therapeutic relationship is critical to promoting parent engagement in pediatric rehabilitation (D'Arrigo et al., 2017(D'Arrigo et al., , 2019. Families value technical and interpersonal skills in therapists (James & Chard, 2010), and therapists' relational competencies may be more significant determinants of families' perception of the quality of care than their technical competency (Bamm & Rosenbaum, 2008;MacKean et al., 2005). Therapists' communication and interpersonal approaches have been recognized as essential to the delivery of family-centered care (Hodgetts et al., 2013) and integrated into existing measures of family-centeredness, such as the Measure of Processes of Care (MPOC; Cunningham & Rosenbaum, 2014). ...
Importance: Responsive communication is critical to ensuring family-centered care in early intervention (EI). The Intentional Relationship Model (IRM) offers a framework for examining therapist–parent communication and offers strategies for supporting therapist responsiveness.
Objective: To explore family-centered care and therapists’ communication in EI using the IRM.
Design: Prospective descriptive study.
Setting: Illinois EI program.
Participants: Convenience sample of 101 therapists and 19 parents enrolled in an EI program. Therapist disciplines included developmental (n = 24), occupational (n = 32), physical (n = 17), and speech (n = 28) therapy.
Outcomes and Measures: Demographic questionnaire, Early Interventionist Self-Efficacy Scale, Early Intervention Parenting Self-Efficacy Scale, Measure of Processes of Care (MPOC)–Short Form, MPOC–Service Provider, Clinical Assessment of Modes (CAM), and Clinical Assessment of Suboptimal Interaction–Short Form (CASI–SF).
Results: Therapists used family-centered practices specific to relationship building more frequently than information sharing (especially sharing of general information). Therapists used the empathizing, encouraging, and instructing modes most frequently in their interactions with families. Participants’ scores on the MPOC, CAM, and CASI–SF were significantly correlated.
Conclusions and Relevance: Therapist–parent interactions were aligned with family-centered care. Opportunities for practitioners were identified in (1) sharing specific and general information and (2) expanding the use of collaborating, problem-solving, and advocating modes.
What This Article Adds: In this study, we explored how the IRM can inform family-centered practices in EI through examination of therapists’ interpersonal competency and therapeutic mode use.
... Family empowerment is a multidimensional construct which has been viewed as important by both professionals and parents, suggesting that empowerment is one of the most important aspects of support. Parental support reflects the strengths that family possess to analyze and respond to children's needs in order to improve their quality of life; maintain social connections and encourage parents to interact with families who share similar problems, as well as to promote their own leadership abilities and implementation of their ideas (James & Chard, 2010;Van Haren & Fiedler, 2008). Modern pediatric care recognizes the vital role that family plays in the delivery of child care. ...
Purpose
To evaluate the extent to which families of children with developmental disabilities, in relation to parents of typically developing children, feel empowered and the way that their empowerment manifests itself.
Design and methods
The comparative research design was used in a quantitative, descriptive analysis of 99 families (57.6% were parents of children with developmental disabilities and 42.4% were parents of typically developing children). With regard to the research instrument, the Family Empowerment Scale was used based on a conceptual framework consisting of two dimensions: the level of empowerment and the way it is expressed.
Results: The highest levels of parental empowerment were observed in the Family domain (M = 3.9; SD = 0.6), while the lowest were in the Community domain (M = 2.9, SD = 0.9). The statistical differences between the comparing groups of parents were most pronounced in the Family domain (Mann-Whitney U = 693.00, p = 0.00). Parents of children with developmental disabilities have demonstrated a lower level of family empowerment associated with attitudes, as well as behaviours and knowledge about specific ways in which they can help their child.
Conclusion
Based on data obtained from this study, it can be concluded that parents of children with developmental disabilities require extra support and empowerment in order to take a more active part in working with their child and making decisions relevant to his/her development in order to utilize all community – based resources available.
... Researchers have explored family-centered coaching strategies used by service providers through interviews and questionnaires with caregivers (e.g., James and Chard 2010;Swafford et al. 2015) and service providers ( Fleming et al. 2011). Additionally, observations of coaching sessions (e.g., Jayaraman et al. 2015), implementation of interventions and professional development to change service providers' practices ( Friedman et al. 2012;Marturana and Woods 2012) have all been used to explore providers' family-centered and coaching practices. ...
Family-centered practices are a hallmark of early intervention (EI). Early intervention service providers are expected to engage in practices that emphasize family strengths, promote family choice and control, and develop collaborative relationships between professionals and families. In 2014 the Division for Early Childhood of the Council for Exceptional Children released a series of revised recommended practices for the field of EI and early childhood special education. The seven topic strands include: assessment, environment, family, instruction, interaction, teaming and collaboration, and transition. This paper addresses practices under multiple topic strands including instruction and family. The purpose of this manuscript is to present strategies that: (a) encourage caregiver reflection—a critical, yet challenging, component of coaching, (b) guide service providers in providing feedback to the caregiver, and (c) enhance service providers use of self-reflection.
... Studies in EI have focused on specific quantitative outcomes of children who have received services (e.g., Epley, Summers, & Turnbull, 2011;Raspa, Hebbler, Bailey, & Scarborough, 2010), parent expectations of family-centered practices (e.g., James & Chard, 2010), or their expectations with EI support and services (e.g., Khetani, Cohn, Orsmond, Law, & Coster, 2013). In addition, studies have examined partnerships between the SLP and family (e.g., Lyons, O'Malley, O'Conner, & Monaghan, 2010) or how parents and children participate in EI to support learning (e.g., Paige-Smith & Rix, 2006). ...
Purpose
Positive experiences in early intervention are vital for families to feel supported when addressing the speech and language needs of their children. However, when a speech-language pathologist (SLP) provides home-based services, Latino families may either embrace them or find them intrusive. How families view these services may differ based on their own knowledge and participation with the SLP. This study explored 5 Latina mothers' perspectives and experiences of their home-based speech and language services during early intervention. During this exploratory qualitative study, the mothers participated in 2 interviews that examined their experiences with receiving home-based early intervention speech and language services.
Conclusion
Findings revealed 4 themes that influenced each family's experiences: (a) bilingual support provided by a monolingual or bilingual SLP or interpreter during sessions, (b) insightful strategies taught by the SLP to interact at home with their child after sessions, (c) clear explanations about the paperwork and purpose of services provided, and (d) respect for family wishes when offering advice or feedback.
... Family-centred, multidisciplinary collaboration has been advocated as a means of administering services such as these because it allows the family greater control over the type and quality of care provided (Dempsey & Keen, 2008;Dunst, 2002;NDHSA, 2017). Although parents often report positive experiences with specific professionals or agencies, research suggests that families are often unsatisfied with the coordination of support across different services (James & Chard, 2010;Wodehouse & McGill, 2009). Moreover, research in this area has largely focused on the perceived barriers to collaboration, rather than the aspects of collaboration that are the most promising or successful. ...
The purpose of this study was to identify features of successful collaboration among professionals and parents involved in supporting children with disabilities in early childhood education and care. The study employed a multiple-case study design comprising 6 cases and 30 adult participants, who were interviewed regarding their collaboration on behalf of 6 children with significant disabilities ranging in age from 3 to 5 years. Applying a system-theoretical approach, analysis led to the development of a framework based on the concepts of ‘internal’ and ‘external’ features of collaboration. Whereas internal aspects refer primarily to the interpersonal interactions of parents and professionals, external features are linked to conditions that occur at a greater ‘distance’ from these interactions, yet nonetheless appear to have a substantial impact on participants’ beliefs about whether the collaboration is successful. We argue that external influences have too often been overlooked in the literature on multidisciplinary collaboration in this context.
... Summary of scores for all reviewed models based on underlying assumptions. partnership may be something that evolves and changes with time (James & Chard 2010). To support accuracy, it is important that models of partnership keep pace with broader changes in how partnership is perceived and enacted. ...
Aims:
A discussion of partnership in the context of family-centred care in the acute paediatric setting, through a critical analysis of partnership models.
Background:
Paediatric healthcare practitioners understand the importance of family-centred care, but struggle with how to translate the core tenets into action and are confused by several rival terms. Partnering relationships are included in definitions of family-centred care, yet less is known about strategies to fully engage or support parents in these partnerships. A rigorous examination of concepts embedded in family-centred care such as partnership may provide a better understanding of how to implement the broader concept and support exemplary care in today's clinical practice environment.
Design:
Discussion paper.
Data sources:
Electronic search (January 2000 - December 2014) performed on CINAHL, Medline, EMBASE, Sociological Abstracts and PsychINFO using keywords partnership, family-centred care and conceptual framework. Eligible references were drawn from the databases, reference lists and expert sources. Eight models met inclusion criteria and had currency and relevance to the acute paediatric setting.
Implications for nursing:
Nurses should continue exploring partnership in various paediatric contexts given the wide-ranging definitions, lack of operational indicators and need for stronger relational statements in current models. An examination of key strategies, barriers and facilitators of partnership is recommended.
Conclusion:
One partnership model had both high overall maturity and best fit with family-centred care principles. All models originate from Western and developed countries, indicating that future partnership models should be more geographically, culturally and economically diverse.
... The literature review revealed main outcomes of parent participation for EI/ECSE practitioners. According to the research studies practitioners: (a) are more likely to develop an understanding of parental experiences regarding intervention services, when parents actively participated (James & Chard, 2010), (b) tend to become more familiar with how emotional needs are met in partnership interactions between parents and practitioners (Brotherson, Summers, Naig, Kyzar, et al., 2010), and (c) appear to increase skills to work with diverse families (Watson & Gatti, 2012). These findings and novel insights into the EI/ECSE principles governing positive child and parent outcomes lead to the supporting functional and meaningful parent participation in the field of EI/ECSE. ...
The authors examined the extent to which practices for parent participation in early intervention/ early childhood special education (EI/ECSE) programs. The role of parents in the EI/ECSE is important and supported through the literature. The changing traditional family picture in the classrooms, the importance of evolving laws and regulations and recommended practices regarding parent participation are highlighted. The conceptual framework is based on the children, parents, and practitioners' outcomes. Strategies to promote family involvement provided a direct way to understand how early childhood education programs influence family participation. Practices to promote family participation are discussed.
... The meeting process was documenting rather than discussing parental needs and concerns. The interaction between the two parties did not present the qualities the family had expected, therefore, a lack of the qualities mentioned in previous studies, such as trust (Vohs, 1998), respect (Zhang, Bennett, & Dahl, 1999;Ziviani et al., 2013), open communication (Coogle & Hanline, 2014;James & Chard, 2010;Wehman & Gilkerson, 1999), equality (Gallagher et al., 2004;Ziviani et al., 2013), etc., persisted. Then again, Lily added other qualities, such as emotional and psychological support from the officials, to the existing qualities listed in previous studies. ...
The purpose of this study is to describe how a parent's partnership with professionals progresses and evolves throughout the service provisioning process. Using a phenomenological ethnographic approach, the lived reality of a family is depicted as the parent walks through different stages of the Individualized Family Service Plan process over a 6-month period. Data concerning parent-professional interactions were obtained via observation notes and document reviews whereas data regarding parent perceptions were collected through multiple individual interviews. Overall, the parent conveyed her satisfaction with actual services especially regarding the professionals' knowledge and parental advocacy. However, the parent also indicated frustration with the early intervention planning process and ''obligated'' partnerships with providers. In particular, the providers' lack of sensitivity was noted, and greater emotional and psychological support was suggested. The overall process of developing partnerships with professionals can be excessively intrusive to the family's lives. Future research directions are offered as a contribution for the development of improved policies for early intervention programs regarding family-centered practice, utilizing the perspectives of families.
... To date, little has been published regarding parents' experiences of models operating in EI services; thus, the current study aimed to address this gap in the literature. Furthermore, few studies have focused on specific characteristics of the models in practice, such as the key working model (e.g., Mullins, 2008) or family-centered approach (e.g., James & Chard, 2010). Given that this model of working represents a significant change over existing models, this research sought to evaluate the multidisciplinary and transdisciplinary model of EI, both from the perspective of assessment and intervention in the field of EI. ...
The authors report on a study addressing gaps in the literature regarding parents' experiences of team-based approaches for their children with disabilities in practice in early intervention services. Specifically, this study examined the facilitators and barriers of the multidisciplinary and transdisciplinary models through a qualitative, grounded theory approach employed in which semi-structured interviews and focus group discussions were conducted with 19 parents (15 mothers and four fathers from 18 families) of children with disabilities from two early intervention services in Ireland. The results revealed that both models contained client-centered values for parents, such as enabling a child/family-centered model and facilitating parent empowerment. Also, parents reported a range of obstacles, which included misuse of time, inefficient delivery of services, lack of support, and their sense of confusion shifting from one model to another. The delivery of a key working system was also seen as worthwhile by parents. The authors concluded that parents placed the highest value on team guidance and teams' ability to promote optimal development for children. The authors note that their findings suggest that considerable gaps remain between policy and service provision in early intervention services in the Republic of Ireland regarding implementation of best practice team models for children with disabilities and their families.
... L'intervention précoce auprès des enfants a été à l'origine du développement de l'éducation familiale comme domaine d'intervention et de recherche. Mais c'est la reconnaissance de la participation active des parents comme facteur d'efficacité de l'intervention précoce qui a fait ressortir la nécessité de faire participer tous les acteurs susceptibles de pouvoir contribuer au mieux-être de l'enfant (Atkins-Burnett et Allen-Meares, 2000 ;Beaudoin et al., 2000 ;Brousseau, 1999 ;Campbell, 2002 ;Hurth et Goff, 2002 ;Leung, Monit Cheung et Stevenson, 1994 ;Whittaker, Kinney, Tracy et Booth, 1990 ;Caruso-Whitney, 1997 ;James et Chard, 2010 ;Mahoney et Wiggers, 2007 ;Pandit, 2008 ;Terrisse et Brynczka, 1990). Dès lors, le champ de l'éducation familiale s'est élargi en intégrant plusieurs activités, développées en réponse à un problème spécifique ou en fonction d'une clientèle cible et en diversifiant ses assisses théoriques qui peuvent aussi bien se référer à des cadres d'inspiration behavioriste, humaniste, écosystémique, neurobiologique ou psycho-développementale. Malgré l'importance des services offerts aux familles dans le cadre des activités d'éducation familiale des OCF, il existe encore peu de connaissances sur la nature des pratiques mises en place. ...
A Survey of the Practices of Family and Community Services Agencies in Quebec
Child-training requires a combining various resources and competences. The challenges sometimes exceed what parents can provide. In this case they can call upon two types of resources : public institutions funded by the State or community-based non-governmental organizations (NGOs). This article describes the services provided to families by 19 such NGOs, which are collectively referred to as “family and community services agencies”. They are autonomous with the self-defined goal of providing, within their community, activities to empower families, to prevent problems arising to assist parents when needed and to support parents. These are destined to support parenting at all its stages : from pregnancy to the achievement of adulthood. These objectives are wide-ranging and result in great diversity both in the services offered, in intervention methods and the outreach of the different groups.
... As has been previously described, the coachee participants viewed the quality of the coach-coachee relationship as fundamental to the success of the coaching experience (Heller et al., 2011;Lanigan, 2011;McWilliam et al., 1998). Partnership has been viewed in other studies as an essential element of coaching (James & Chard, 2010;Knight, 2007). In coaching, or consulting, the process is driven by the relationship; effective coaching focuses on the relationship as a mechanism for supporting change in the coachee (Hanft et al., 2004;Johnston & Brinamen, 2012;Wesley & Buysse, 2006). ...
Coaching is used in early childhood settings to support positive outcomes for young children and families. Although some research shows the effectiveness of coaching on practice and outcomes, little information is available on the experiences and perspectives of “coachees” as recipients of coaching support. The purpose of this in-depth, qualitative study was to understand, from the coachees' point of view, the benefits and challenges of participating in an early childhood coaching relationship. Twenty-one parents, preschool teachers, and child care providers who had engaged in coaching relationships participated in interviews and completed surveys regarding their experiences and perspectives. Data were thematically analyzed. Five overall themes and 16 subthemes emerged as salient to the experiences of these coachees: (a) qualities of the coach, (b) resources provided by the coach, (c) qualities of the coach–coachee relationship, (d) coachee transformation, and (e) challenges to the coaching process. The study identifies strengths and limitations of coaching and contributes to the understanding of essential characteristics and the implementation of coaching as a practice for supporting adult learning. The study has implications for the hiring of early childhood coaches and design of coach professional development activities.
... On the one hand, the advantage of having kindergarten teachers and assistants who are deeply engaged in and knowledgeable about the lives of children seems obvious. On the other hand, it has taken years to explicitly recognize that parents' contribution to collaboration is in large part tied to their intimate knowledge of the child and the family's home conditions (James & Chard, 2010). Participants in this study clearly recognize that kindergarten professionals possess a degree of "insider knowledge" as a result of their familiarity with the child and the time they spend together. ...
The purpose of this study was to examine the role and responsibilities of Norwegian kindergarten (i.e., preschool for ages 0–6 years) from the perspective of participants involved in multidisciplinary collaboration on behalf of children with severe disabilities and their families. The authors employed a multiple-case study approach comprising 26 interviews across six cases. Findings suggest that kindergarten is considered an important partner for families and a major contributor to the provision of services. Kindergartens were valued for their (1) close relationships and intimate knowledge of children as individuals, (2) the sense of security and relief of stress that they provided to parents, and (3) for acting as a “driving force” in multidisciplinary collaboration. Findings are discussed in relation to two contrasting views of the kindergarten professional as an early childhood expert and as a compassionate caregiver who, in many ways, functions as an extension of the parental role. The authors conclude that it is the latter of these two perspectives that dominates perceptions of kindergarten professionals among participants.
... Qualitative studies of parents' experiences of collaboration with healthcare providers and educators tend to focus either on the preschool context or on experiences following the transition into school. In an example of the first, James and Chard (2010) reported the findings of interviews about the experiences of seven parents in Ireland with participation and partnership in an early intervention service for children with physical disabilities. Overall, the parents were " relatively " satisfied but suggested that the program did not meet their needs for support at critical times, and did not provide enough information or adequate continuity of care. ...
Despite recognition of the importance of parent involvement to enable meaningful inclusion of young children with developmental disabilities in education contexts, few Canadian studies have reported how parents experience this collaboration. Recent research suggests that the transition process is critical to the early school experiences of children with developmental disabilities yet challenging for their parents. The purpose of this paper is to report preliminary data from HELPS Inc, a Canadian multi-method research project describing Health, Education, and Learning Partnerships Promoting Social Inclusion of young children with developmental disabilities. In this paper we present parents’ perspectives on inclusion and collaboration with case study findings based on the experiences of three families in one Ontario community. The data demonstrate the unique experiences of and meanings of collaboration held by individual families, and highlight the challenges these differences pose for healthcare providers and educators committed to involving parents in the transition into school and for inclusion of young children with developmental delays and disabilities.
Interprofessional collaboration is vital in the context of service delivery for children with physical disabilities. Despite the established importance of interprofessional collaboration and an increasing focus on research on this topic, there is no overview of the research. A scoping review was conducted to explore current knowledge on interprofessional collaboration for children with physical disabilities from the point of view of the actors involved. The steps of this review included identifying a research question, developing a protocol, identifying relevant research, selecting studies, summarizing and analyzing the data, and reporting and discussing the results. Through databases and studies from hand-searches, 4,688 records were screened. A total of 29 studies were included. We found that four themes: communication, knowledge, roles, and culture in interprofessional collaboration illustrate current knowledge on the topic. Interprofessional collaboration for children with physical disabilities is shown to be composed of these four themes, depending on the actors involved. Interprofessional collaboration is affected by how these four themes appear; they mainly act as barriers and, to a lesser extent, as facilitators for interprofessional collaboration. Whether and how the themes appear as facilitators need further exploration to support innovation of interprofessional collaboration.
This study focused on developing parent–professional partnerships in promoting school readiness skills for children with disabilities entering first grade. A mixed method was used to evaluate the readiness skills of 15 children from two preschools. The development of an intervention plan was the focus of the first phase of evaluation, and several instruments, namely the Vineland Adaptive Behavior Scale, a school adjustment questionnaire, school readiness questionnaire and goal attainment scale, were used during the second phase to evaluate the outcomes of the intervention plan. Both quantitative and qualitative data revealed that all participating children’s attainment of school readiness goals improved, but their specific disabilities and learning environments should be considered. The study emphasizes family involvement and collaboration with transdisciplinary professionals as fundamental to transition practices in promoting children’s learning outcomes.
Purpose:
The primary purpose of this study was to describe the experiences of parents of infants diagnosed with congenital muscular torticollis (CMT). A secondary purpose was to compare the experiences of parents of infants with mild grades versus severe grades of involvement based on the CMT severity classification system.
Methods:
Through semistructured interviews, a qualitative phenomenological approach of inquiry was used to investigate the lived experiences of 12 parents.
Results:
Eight themes common to both groups of parents were identified. Findings indicated having an infant with CMT has a significant effect on the parents and other caregivers. Two themes were unique to parents of the infants with severe CMT.
Conclusions:
Parents are faced with a diagnosis that requires regular therapy visits and a challenging home program. A multimodal approach by clinicians for teaching and supporting parents during the episode of care may best address their unique challenges and stresses.
The goal of interprofessional education (IPE) is to improve outcomes and experience of healthcare services for patients and families through collaborative practice. While patients and families may participate in IPE experiences as recipients of healthcare services, their perspective on students’ emerging collaborative skills is rarely sought. We describe a pediatric IPE activity in which participating families rated students’ performance of the targeted interprofessional collaborative competencies. We asked whether family ratings would be consistent with student self-ratings and independent observer ratings. Participants were 40 interprofessional pre-licensure student teams representing physical therapy, occupational therapy, nursing, and speech-language pathology. Each team developed a joint assessment plan, conducted a 1-h play-based observation of a child, 30 months of age or under, and interviewed an accompanying parent/caregiver. Quantitative rating scale data indicated consistency between family, student and independent observer ratings of interprofessional collaborative skills displayed by the students. Qualitative data suggested that students gained a better understanding of ways in which an interprofessional team can provide effective family-centered care. Our results suggest that patient/family feedback can provide a useful measure of the effectiveness of IPE activities and should be included in such activities targeting interprofessional collaborative competences across settings and patient populations.
A mixed methods design was used to facilitate an understanding of what early interventionists (EIs) experience when working with families living in poverty. EIs working in a large urban area (n = 306) completed an online survey and participated in a follow-up focus group (n = 7). EIs reported that logistical challenges and family/EIs stressors (e.g. domestic violence, personal safety concerns) impacted and often interrupted EI service delivery to families living in poverty. Implications for policy and professional development are described.
Home visiting is a primary service delivery approach to promote young children’s development and support families. Early Intervention professionals are expected to partner with families to create effective learning experiences in the daily context of routine family life. Concerns about early childhood (special) educators’ readiness to take on this partnership role have been voiced, suggesting explicit learning opportunities are needed within preservice preparation programs. This study explored the impact of an introductory assignment analyzing a videotaped home visit on preservice Early Childhood Education/Early Childhood Special Education students’ learning about home visiting practices. Implications for scaffolding home visiting experiences in preservice preparation are discussed.
As the prevalence of Autism Spectrum Disorders (ASD) increases, teachers and special education service providers are experiencing increased contact with not only children with ASD, but also with their parents and families. Partnerships between families and teachers have become more commonplace in the last 20 years in response to mandates related to parent involvement by federal law. The present study examined the relationship between parent–teacher partnership satisfaction and child progress and family quality of life among children (n = 313) receiving autism waiver services (Waiver—Home and Community-Based Services Waivers (42 U.S.C. SS 1915(b) (c)) and those whose families expressed an interest in receiving waiver services (registry). Results indicated family–teacher partnership satisfaction was associated with parent-reported improvement in academic progress and family quality of life. These findings were not dependent on group status (waiver vs. registry) and highlight the importance of the quality of service delivery through family–teacher partnerships for children with ASD.
This paper aims to examine the genealogy of family-centredness in early childhood intervention. In particular, it deconstructs the procedural requirements, such as the completion of the Individualized Family Service Plan (IFSP), which has operated to serve the notion of family-centredness. Employing a poststructuralist lens, the paper contends that the current knowledge/belief is constructed and institutionalized by the dominant groups, such as policymakers and professionals, and their discourse. Families are normalized with discursive practices to believe that their participation perfects the rules set by powered social institutions with knowledge and power; hence, they are at the centre in the practice of services and provisions. Blinded by the normalized discipline, the historically absented position of families in the construction of social structures has perpetuated through the existing practices. Thus, this paper offers a critical reflection on the understanding of multiple discourses. In particular, both service providers and families should be able to question the process of service provisioning, when necessary. By critically viewing the current case, the development of quality early childhood intervention programmes and family-centred practices might be purported across countries.
Objective : The purpose of this study is to understand the significance of experience for parents of children with disabilities in selecting a rehabilitation therapy center and to comprehend the strategies for the selection process.
Methods : This study used a phenomenological approach for a qualitative study. The participants were 7 mothers of children with disabilities, who agreed to participate in this study. They underwent rehabilitation therapy for more than a year after their children were diagnosed with a disability from their doctors.
Results : This study drew 26 units of meaning, 8 central meanings, and 3 themes. The results were analyzed into 3 themes; needs for rehabilitation therapy, difficulty in using rehabilitation therapy centers, and a selection strategy of a rehabilitation therapy center. The needs for rehabilitation therapy include the seriousness of the disability, difficulty in using a rehabilitation therapy center including psychological discomfort, and difficulty of the center’s procedures, and a selection strategy for the rehabilitation therapy center included the therapist’s expertise.
Conclusion : The most important selection strategy for a rehabilitation therapy center for parents of children with disabilities was the therapist’s expertise. This study can provide information on the various experiences of parents of children with disabilities in selecting a therapy.
목적 : 장애아동 부모의 재활치료기관 선택과정에서 겪는 경험의 의미를 파악하고, 선택 과정의 전략을 알 아보는 것이다.
연구방법 : 장애아동 부모의 재활치료기관 선택과정을 알아보기 위해 질적 연구 중 현상학적 연구방법을 사 용하였다. 본 연구의 대상자는 의사로부터 자녀가 장애진단을 받은 후 1년 이상의 재활치료를 경험하였 고, 본 연구에 동의한 장애아동 어머니 7명을 대상으로 하였다. 자료 수집을 위해 일대일 면담방법을 이 용하였고, 녹음한 면담내용을 전사하여 분석하였다.
결과 : 연구결과는 의미단위 26개와 구성요소 8개, 그리고 주제 3개를 도출하였다. 연구결과는 재활치료의 필요성, 재활치료기관 이용 시 어려움, 재활치료기관 선택전략의 주제로 분석하였다. 재활치료의 필요성 은 장애문제의 심각성을 통해 인지하게 되었고, 재활치료기관 이용 시 어려움은 재활치료기관 이용에 따 른 심리적 불편함과 이용 절차의 어려움을 호소하였다. 재활치료기관 선택 전략은 치료사의 전문성을 중 요하게 생각하였다.
결론 : 장애아동 부모의 가장 중요한 재활치료기관 선택전략은 치료사의 전문성이다. 다른 선택전략은 근 거리, 치료비용, 치료시설로 나타났다. 본 연구의 결과는 장애아동 부모들이 겪는 다양한 치료선택과정의 경험에 관한 정보를 제공하고 그 과정 중에 발생하는 어려움을 이해하고자 한다. 이를 통해 기관과 현장 관계자들이 장애아동부모들의 욕구를 이해하고 치료기관을 운영하고 자 하는 치료사에게 도움을 주는 기초 자료가 되고자 한다.
This conceptual paper considers the role of culture in shaping family, professional, and community understanding of developmental
disabilities and their treatments. The meanings of health, illness, and disability vary greatly across cultures and across
time. We use Bronfenbrenner’s ecological model to provide a theoretical framework for examining disability, with special attention
to autism spectrum disorders. Cultural beliefs about the cause of a disorder influence families’ decision-making about what
treatments to use and what outcomes to expect. Autism provides an example that is especially challenging, as there is no agreed-upon
cause. Also, an overwhelming array of treatments is available in the West for autism, including behavioral, cognitive, pharmaceutical,
sensory, relational, vitamin, and diet therapies. Other cultures contribute additional views on cause (e.g., Karma, Allah’s will) and treatments (e.g., acupuncture, herbal medicines, Ayurveda). We suggest how a broad cultural view can help us understand treatments and the treatment delivery system of a nation and
a culture. For the best course of care, professionals need to understand and respect families’ views of autism and work toward
mutually agreeable treatments that may involve a combination of biomedical and cultural practices. Although a family-focused,
open teamwork model that aims to acknowledge the context of the child, take into consideration the strengths and limitations
of the child and the family, and introduce appropriate, sustainable, and sensitive interventions is regarded as best practice
in the United States, it will take sensitive work to find out whether it will suit other cultural groups across the world.
Professional occupational therapy (OT) and physical therapy (PT) programs traditionally instruct students using volunteers, including children who have disabilities. Presenting a child before a classroom of students may deprive the child of dignity and may limit students' understanding of the child's disability and the importance of family-centered service delivery. An alternative approach that respects the child's privacy and promotes dignity is student observation in the context of the child's daily living. The Family Practicum Intervention Plan assignment (FPIP), part of the professional Neuro Rehab course, was created to facilitate students' understanding of a child with a disability while maintaining child dignity and family-centered values. This descriptive study explored, through two online surveys, the experiences of the OT and PT students and the families of children who participated in the FPIP. Additionally, the study investigated the influences of this participation on students' perceptions of family life and views of childhood disability. Overall, students and families perceived this assignment to be a good learning experience because it allowed the student to work within a real-life scenario and it gave the families an expert "voice" in the education of OT and PT students. The positive comments provided by the families and students and the desire of families to recommend the FPIP experience to other families suggest the value of the learning assignment. When developing OT and PT professional pediatric coursework, instructors should include assignments that take place in the child's natural environment to offer meaningful learning that maintains the dignity of the child.
Phenomenological Analysis (IPA) has become a popular methodological framework in qualitative psychology. Studies based in IPA focus on examining how individuals make meaning of their life experiences. A detailed analysis of personal accounts followed by presenting and discussing the generic experiential themes is typically paired with the researcher's own interpretation, which is an expression of double hermeneutics in practice. IPA draws upon phenomenology, hermeneutics, and idiography. This paper presents fundamental principles behind IPA and offers guidelines for doing a study based on this framework. For many decades, the mainstream experimental psy-chology relied on quantitative methodology based on a model which involved testing theories by deriving hypotheses from them, which could then be checked in practice via an experiment or observation. The researcher looked for disconfirmation (falsification) of theory and, by eliminating claims which were not true, he or she was believed to move closer to the truth. In contrast to this approach, we have observed a growing development of qualitative research methodologies.
Little is known about the elements of service delivery that underlie parents' satisfaction with the pediatric rehabilitation services their children receive. Determining the most important elements of satisfaction and dissatisfaction will inform health care managers about what should be done in delivering services. In this study, 130 highly satisfied and 101 relatively dissatisfied parents were identified based on their scores on a standardized satisfaction measure (from a pool of 645 parents). Parents' comments (the 3 things they liked most and least about the services received from a children's rehabilitation center or program) were coded using a comprehensive coding scheme based on the medical and rehabilitation literatures. Coding agreement was ensured through a consensus procedure. Highly satisfied parents most often mentioned elements of the service delivery process, particularly respectful and supportive care (i.e., feeling listened to and having a sense of rapport with service providers). Relatively dissatisfied parents most often mentioned structural elements (particularly lack of access to existing services) and process elements (respectful and supportive care, as well as lack of continuity and coordination of care). To ensure parents' satisfaction and prevent dissatisfaction, managers and service providers should reduce waiting lists, provide respectful and supportive care, and ensure services are coordinated across locations and over time. Measures of satisfaction should contain items tapping elements of both process and structure, because structural elements are particularly important in terms of parents' dissatisfaction.
Objective: This study examined the strength of the relationship between parents' perceptions of family- centered, professionally provided caregiving and their emotional well-being (feelings of distress and depres- sion). This was done in the context of other factors that might affect well-being (child behavior problems, coping strategies of parents, protective factors in the social environment, child factors related to disability, and family factors). Method: We asked 164 parents of children with nonprogressive neurodevelopmental disorders (primarily ce- rebral palsy, spina bifida, or hydrocephalus) to complete a series of instruments measuring the constructs of interest. Results: Structural equation modeling showed that more family-centered caregiving was a significant pre- dictor of parents' well-being. The most important predictors of well-being were child behavior problems and protective factors in the social environment. Conclusions: Services are most beneficial when they are delivered in a family-centered manner and address parent-identified issues such as the availability of social support, family functioning, and child behavior problems.
Occupational therapy is currently experiencing a professional refocusing on occupation and its intrinsic relationship with health and wellbeing (Molineux 2004). However, in order to keep this momentum going and to enhance the confidence of therapists in their practice, it is vital that research is undertaken that enables the development of an understanding of how occupation is experienced and ascribed meaning by individuals. This opinion piece suggests that interpretative phenomenological analysis (IPA) is a useful methodology for therapists to develop such an understanding. It introduces the reader to IPA, including a brief overview of its theoretical underpinnings, highlights factors to consider when planning an IPA study, and discusses how it may provide a useful approach for occupational therapy researchers.
This article reports the development and validation of a Measure of Beliefs about Participation in Family-Centered Service that consists of 5 scales measuring beliefs about family-centered philosophy and principles, positive and negative outcomes, personal competencies, and barriers. The measure is applicable to both parents and service providers, displays good internal consistency, and has good preliminary evidence of construct validity. The measure shows promise for use in the university preparation of service providers, professional development, clinical practice, and the evaluation of family-centered training programs and materials. It also can be used in research on the attributes, antecedents, and consequences of family-centered service delivery.
This article describes the development of a shorter and improved version of the 56-item Measure of Processes of Care (MPOC) to create MPOC−20. MPOC is a measure of parents' perceptions of the extent to which specific behaviors of health care professionals occur. MPOC−20 is a self-administered, parent-completed questionnaire that was derived from the original MPOC, using both conceptual and empirical approaches. Further refinements to MPOC−20 were made in its formatting and clarity of response options. MPOC−20 retains the same conceptual structure of five scales that reflect the essential features of family-centered service. We provide evidence of good internal consistency, reliability, and validity using pre-existing data sets and a new independent sample from a province-wide survey. MPOC−20 offers users a measurement option that is useful for program evaluation and quality assurance activities as well as for research purposes.
Results from a study investigating the factors associated with variations in the reported use of service coordinator practices are presented. The study participants were parents and other primary caregivers of infants and toddlers with identified disabilities or developmental delays in Individuals with Disabilities Education Act Part C early intervention programs. Finding showed that different service coordination structural and process variables, but not child, parent, or family background variables, accounted for differences in the reported use of service coordinator practices. Among 3 sets of service coordination measures, the use of family-centered helpgiving practices accounted for the largest percentage of variance in the dependent measures. Key words: early intervention, infants and toddlers, service coordination S ERVICE COORDINATION is a mandated service that must be provided to infants and toddlers and their families as part of their participation in Individuals with Disabilities Education Act (IDEA) Part C early interven-tion programs. The practice encompasses "ac-tivities carried out by a service coordinator to assist and enable a child eligible under [IDEA] and the child's family to receive the rights, procedural safeguards, and services au-thorized by the State's early intervention pro-gram" (34 C.F.R. 303.22 (A) (1)). According to Bruder (2005), this includes "coordinating Author Affiliations: University of Connecticut, A.J. Pappanikou Center for Excellence in Developmental Disabilities, Research, Education, and Service, Farmington, Connecticut (Dr Bruder); and Orelena Hawks Puckett Institute, Asheville, North Carolina (Dr Dunst).
The development of collaborative partnerships between parents and professionals is too often unsuccessful. One reason for this failure may be the lack of empirical understanding of the components of interpersonal partnerships. Using qualitative inquiry, 33 focus groups were conducted with adult family members of children with and without disabilities and service providers and administrators. In addition, 32 individual interviews were conducted with non-English-speaking parents and their service providers. Indicators of professional behavior facilitative of collaborative partnerships were identified. These indicators were organized into six broad themes: (a) Communication, (b) Commitment, (c) Equality, (d) Skills, (e) Trust, and (f) Respect. The specific meaning of each theme is described, including similarities and differences between professionals and family members. Policy, practice, and future research implications are discussed.
The situation of early childhood intervention in Austria is described from its beginning in the 1970s up to the present situation and future challenges. Children with disability or at risk of being disabled qualify for early childhood intervention as well as partly and to some extent also children in the context of socially disadvantaged families. Based on nine provincial laws, the structure of early childhood intervention in Austria is heterogeneous. A consensus regarding key terms, the age of the child (0 – 3 or 6), and home-based services exists. Future challenges focus on early identification of vulnerable target groups by increased communication with community based networks (social worker, mental health specialists) as the number of children with unspecific developmental delays or vulnerability will increase. The training programmes for early intervention professionals, as proposed for example in the project PRECIOUS (www.precious.at), must include the need for professionals to work with vulnerable families in general to a greater extent.
The importance of being 'family-centered' when providing services to children with a disability and their families has gained currency in the research and practice literature. A growing body of evidence has validated many of the theoretical links between the help-giving practices of staff and desirable outcomes for families with a child with a disability. However, it is clear from the research to date that the relationship between the provision of family-centered services and the achievement of positive outcomes for children and their parents is complex and is yet to be fully understood. The present article reviews the research in this area and discusses the links between help-giving practices and child and family outcomes for families who have a member with a disability. The review summarises the extant research in an accessible format and identifies areas for future research. Yes Yes
Raising a child with disabilities impacts the ability of parents to participate in life situations. This paper describes the development of a new instrument, Life Participation for Parents, to measure outcomes of pediatric therapy on parental participation. Items were reviewed by six occupational therapists with experience in pediatrics and instrument development. The number of items was reduced to 23. The resultant instrument was completed by 29 parents of children with disabilities. Their scores were reviewed by the nine occupational therapists working with the children. Parent and therapist respondents were interviewed regarding item content. Instrument responses were evaluated for internal consistency. The respondents confirmed the face and content validity of the construct, variability in responses, and readability of the items. Good internal consistency for items was demonstrated (Cronbach's alpha .85). The preliminary results indicate that the Life Participation for Parents is a promising tool for evaluating parental issues and measuring parent outcomes in family-centered practice.
The provision of family-centred services (FCS) emphasizes a partnership between parents and service providers so that families are involved in every aspect of services for their child. There is evidence that providing FCS is associated with improvements in parents' satisfaction with services, decreased parental stress, and positive child outcomes.
The purpose of this study was to examine factors that are most important in determining parent perceptions of the family centredness of care and parent satisfaction with service. A cross-sectional survey was completed by 494 parents, 324 service providers, and 15 CEOs from 16 organizations delivering children's rehabilitation services. Analyses were completed using a structural equation modelling approach.
Survey return rates ranged from 77 to 94%. Findings indicate that the principal determinants of parent satisfaction with services are the family-centred culture at the organization and parent perceptions of FCS. Parent satisfaction with services was also influenced by the number of places where services were received and the number of health and development problems experienced by their child.
Parent satisfaction with services is strongly influenced by the perception that services are more family centred, fewer places where services were received and fewer health and development problems for their child. Ways in which organizations can improve satisfaction through carrying out family-centred behaviours are discussed.
This article presents a life needs model of pediatric service delivery that is based on the values of the intrinsic worth, dignity, and strengths of individuals. This developmental, socio-ecological model outlines the major types of service delivery needs of children and youth with disabilities, their families, and their communities within three spheres of life (the personal, interpersonal, and external spheres). The model legitimizes the concept of need, emphasizes the values of family-centered services, and recognizes child and family strengths and capacities. We discuss the utility of this transdisciplinary model in guiding pediatric service delivery to meet the long-range goals of community participation and quality of life of children and youth with disabilities.
Bobath Scotland is a tertiary referral centre providing therapy for children with cerebral palsy. The staff wanted to find a standardised tool that could assess parents' views regarding the care that their children had received. The aim of this study was to conduct a trial using a recently developed tool, the Measure of Processes of Care (MPOC) (King et al 1995), to investigate families' perceptions of the care received at Bobath Scotland and the extent to which they considered it ‘family friendly’.
The MPOC questionnaire was sent to the families who attended Bobath Scotland during a 12-month period. The MPOC consists of five scales: enabling and partnership; general information; specific information; coordinated and comprehensive care; and respectful and supportive care. Items are scored on a 7-point scale, from the behaviour ‘never’ occurs (1) to ‘occurs to a great extent’ (7). Mean scores are calculated for each scale.
Questionnaires were sent to 114 families and 72 were returned completed (63%). The mean scale scores were as follows: enabling and partnership, 6.3 (SD 0.64); general information, 4.3 (SD 1.69); specific information, 6.5 (SD 0.75); coordinated and comprehensive care, 6.3 (SD 0.75); and respectful and supportive care, 6.5 (SD 0.60).
The overall mean scale scores were high, demonstrating that families were satisfied with their care. The MPOC proved an appropriate tool to investigate the perceptions of care of families attending a paediatric centre.
This article describes the use and utility of the Life Needs Model of Pediatric Service Delivery at a regional children's rehabilitation center. The model is a transdisciplinary, evidence-based model that guides pediatric service delivery to meet the long-range goals of community participation and quality of life for children and youth with disabilities. The article describes the use of the model as a tool to assist with the development of organizational culture, strategic and operational planning, the development of therapists' expertise, and the development of community partnerships. The model also has influenced human resources practices, community relations activities, and research. The model provides needed direction to service planners about the types of services that are important to provide in a geographical region, and fills a gap in outlining the nature of services that can be encompassed in pediatric rehabilitation.
Book synopsis: Undertaking qualitative research in psychology can seem like a daunting and complex process, especially when it comes to selecting the most appropriate approach for your project or assignment. This book, written and edited by a world-leading group of academics and researchers, offers an accessible, critical and practical way into qualitative research in psychology. Each chapter provides a detailed, step-by-step guide to using a qualitative research method – from Conversation Analysis or Focus Groups to Interpretative Phenomenological Analysis or Narrative Psychology. Whatever approach you choose to take, this book will ensure you get it right from the start.
In occupational therapy, theorising is an integral part of practice and theory is shaped by practice. This paper suggests that we do theory by developing collaborative models of thoughtful practice that work within specific contexts. It begins by looking at how the nature of professionalism is changing in response to social and political changes. It argues that any claim to professional status is based on the ability to make informed and authoritative judgements. Professional judgements are described as complex and morally purposeful and as being made within a social context. The paper then addresses how thoughtfulness relates to professional practice. Three dimensions of thoughtfulness are discussed: the deliberative, the public and the reflexive. The final section of the paper considers what theory means for professional practitioners; that is, how occupational therapists use theory in order to theorise our own practice.
"Research Methods in Clinical and Counselling Psychology" presents a practical description of the research process, taking readers sequentially through the basic steps of a project: groundwork, measurement, design, analysis and interpretation. It also addresses essential background issues, such as the underlying philosophy of the various research methods and the sociopolitical issues that arise in doing research in service settings.
The authors present a balanced appraisal of both traditional and emergent methods. They re-affirm the scientist-practitioner model: that clinical and counselling psychologists have a dual role as both clinicians and researchers. The authors argue that research embraces a broad range of activities which can be incorporated into everyday professional practice.
The book is aimed at students and professionals who want to conduct their own research and those who simply want to understand published research better. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Discusses the development of comprehensive and coordinated services to young children with disabilities. The chapter presents a description of the major changes in service delivery required by federal legislation. It also provides a portrait of several current, complex, service delivery models. Data are presented regarding the factors that shaped these service models, as well as the nature of service delivery for children and families resulting from these models. An ecological cluster of interacting factors that appear to influence service delivery helps explain the complexities of service delivery. The chapter concludes with a discussion of future challenges for improving services to young children with disabilities and their families. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Family-centered care is critical to successful experiences for infants and their families in the neonatal intensive care unit (NICU). This article describes a retrospective evaluation survey of family-centered practices in an urban, Level III NICU. Evaluation questions focused on parent satisfaction with unit practices in 4 areas: (a) NICU environment, (b) caregiving practices, (c) communication opportunities, and (d) relationships with nursing staff. Quantitative and qualitative data indicated overall parent satisfaction along with suggestions for improvement of unit practices. Specifically, the need for redesign of the NICU environment (eg, increased space at infant's bedside), caregiving practices (eg, increased hands-on practice), communication opportunities (eg, convenient times for care conferences), and relationships with nursing staff (eg, development of parent-professional relationships) are highlighted as avenues for improving NICU practices. Recommendations for family-centered practices are provided.
This article reviews the literature on the transdisciplinary approach to early intervention services and identifies the essential elements of this approach. A practice model describing the implementation of the approach is then presented, based on the experiences of staff members in a home visiting program for infants that has been in existence for over 30 years. The benefits and challenges experienced by therapists and managers of the program are considered, along with the unique aspects of the program and implications for program management. The managerial and team resources required to successfully implement a transdisciplinary model are high, but the potential payoffs for children, families, and therapists' development of expertise are considerable.
The exchange of information between family members and service providers is a central feature of early intervention services and is integral to the development of an individual family service plan. Early intervention professionals pressured by timelines and documentation requirements either may resort to a directive style of communication that is not matched to the interaction or learning style of the family members or may ask general interview questions that do not provide sufficient information for effective intervention planning. Neither approach offers the family members a clear depiction of their role on the team. A framework and 5 strategies that support a reciprocal process for providing and receiving information while promoting family members' understanding of intervention in their everyday routines and activities are described. These strategies, developed and tested in the field within 5 federally funded research, demonstration, and outreach training projects, offer tools for service providers to gather and give information cognizant of different adult learning preferences. A N ESSENTIAL PRACTICE for assessment and intervention in natural environments is the identification of the routines, activi-ties, and events that occur regularly for chil-dren and families at home and in the com-munity. Gathering information about where families go, what they do, when they do it, and how they engage in the tasks of ev-eryday life is pivotal to the identification of authentic outcomes and the initiation of in-tervention that has the likelihood of mak-ing a difference (Bernheimer & Keogh, 1995; Bernheimer & Weismer, 2007; McWilliam & Scott, 2001). However, service providers are Author Affiliations: Department of Communication Disorders, Florida State University, Tallahassee (Dr Woods); and Life Span Institute/ Parsons, University of Kansas, Parsons (Dr Lindeman).
The authors compared mothers' and fathers' perceptions of professional caregiving, using the MPOC, a self‐administered questionnaire for parents. The authors looked at the aspects of caregiving 128 couples judged to be important, their perceptions of the actual caregiving received from health professionals and their stress. The data, from a relatively large sample of intact families, indicated that there were more similarities than differences between the mothers' and fathers' replies. Both valued the enabling and partnership aspect of caregiving most highly. Only one difference in reported experience was found: mothers reported experiencing significantly more coordinated and comprehensive care than did their spouses. The clinical implications of the findings are discussed, particularly with respect to the involvement of fathers in clinical intervention, and the belief that fathers are uninterested in their children's care.
RÉSUMÉ
Comment les pères et les mères voient le tivraison des soins à leurs enfants porteurs d'incapacités.
A partir du MPOC, un auto‐qucstionnairc présente à des parents, les auteurs ont étudié les aspects des soins professionnels jugés par les méres et les péres être iraportants, leurs perceptions respectives des soins donnés en réalité et le stress manifesté par ces parents. Les données, provenant de ce groupe relativement important de families toujours ensembles, ont montré qu'il y avait plus de ressemblances que de différences entre les réponses des méres et des péres. Tous évaluaient trés positivement la capacité et la collaboration des professionnels de soins. Une seule différence fut notée: les mères faisaient part d'une expérience. significativement plus élevée des soins coordonnés et globaux que leurs maris. Les implications cliniques de ces données sont discutées, particuliérement en regard de l'implication des péres dans les approches cliniques, et la croyance que les péres ne s'intéressaient pas aux soins donnés à leurs enfants.
ZUSAMMENFASSUNG
Wie beurteilen Mütter und Väter die professionelle Pflege vonKindern mil Behinderungen
Die Autoren haben Beurteilungen der professionellen Pflege von Müttern und Vätern anhand des MPOC, eines Fragebogens für Eltern, verglichen. Die Autoren haben die Aspekte der Pflege untersucht, die 128 Ehepaare für wichtig hielten, ihre Beurteilungen der aktuellen Pflegeleistungen, die medizinisch geschultes Personal erbrachtc, und ihre Belastungen. Die Daten einer relativ großen Gruppe von intakten Familien zeigten, daß es mehr. Übereinstimmungen als Unterschiede bei den Antworten der Väter und Mütter gab. Beide stuften die unterstutzenden und partnerschaftlichen Aspekte der Pflege besonders hoch ein. Es fand sich nur ein Unterschied: die Mütter berichteten, eine signifikant coordiniertere und ganzheitlichere Pflege erfahren zu habcn als ihre Ehemänner. Die klinische Bedeutung dieser Befunde wird diskutiert, besonders im Hinblick auf die Einbeziehung der Väter bei der klinischen Behandlung und auf die Annahme, Väter seien an der Pflege ihrer Kinder nicht interessiert.
RESUMEN
Como ven las madres y los padres los cuidados dados por profesionales a sits hijos con minusvalias.
Los autores comparan las opiniones de madres y padres sobre los cuidados dados por profesionales, utilizando el MPOC, un cuestionario autoadministrado para los padres. Los autores observaron los aspectos de los cuidados dados por 128 parejas, sus percepciones de los cuidados actuates proporcionados por profesionales y su stress. Los datos a partir de una muestra relativamente grande de familias intactas indicaban que habían más semejanzas que diferencias en las respuestas de madres y padres. Ambos evaluaban altamente los aspectos de eficacia y compañerismo en la administracion de cuidados. Sólo se halló una diferencia en la experiencia: las madres afirmaban que la experiencia era significativamente más coordinada y global que sus esposos. Se discuten las implicaciones clínicas de los hallazgos, particularmente con respecto a la intervención de padres y madres y a la idea que los padres no estan interesados en el cuidado de sus niñes.
This article discusses the challenges and implications for pediatric practice in the home. Pediatric occupational therapists are moving the treatment setting from the clinic to the home. Working within the home environment requires occupational therapists to adapt their roles, functions, and treatment styles. Intervention frequently involves practical and relevant treatment, using activities and objects from the child's world. Thus, functional goals may be more realistically achieved in the child's living environment. Involvement with family members also offers opportunities to develop collaborative relationships with parents and, therefore, to integrate the intervention program into the child's home life.
Interpretative phenomenological analysis (IPA) is a research method gaining in popularity, particularly in health psychology and related fields. Derived from phenomenology, as the name suggests, it has potential for occupational therapy as an underpinning framework for research. This method was developed to enable researchers to provide participants with the opportunity to describe their perceptions of their lived experiences, which are subsequently interpreted by the researcher. A two-stage data process allows participants to make sense of their own world while the researcher attempts to make sense of participants' lived experiences.
IPA acknowledges that researchers cannot gain complete access to the participant's world and that each participant is an expert in his or her field. However, it does recognise that the researcher's analysis of this world is a dynamic and interpretative process. During the research analysis process, themes are identified and connected and followed by higher-order interpretation. Data can be collected using a variety of methods, including interviews, case studies and focus groups.
This paper describes the potential of IPA as an appropriate and worthy methodology for occupational therapists and, therefore, an important adjunct to the occupational therapy evidence base.
The importance of parent involvement in intervention with children has always been recognised by occupational therapists. Current trends in paediatric service delivery have been towards family-centred care, with a central component of this approach being parent-therapist collaboration in planning and evaluating intervention. This paper reviews issues and provides suggestions for clinical practice from the literature on parent-therapist collaboration, including consideration of parents' diversity and unique perspectives, development of effective parent-therapist relationships, establishment of shared goals and priorities when planning intervention, and development of services that support parent-therapist collaboration. Further research is needed in Australian settings to explore the nature of parent-therapist partnerships, the impact of parent participation throughout the intervention process and the extent to which collaboration with parents results in better therapy outcomes for the child and their family.
Families of young children with disabilities are faced with ongoing challenges that impact various aspects of family life. Given the increasing emphasis on promoting positive outcomes in these families, the overall aim of the current study was to examine the contribution of child, family, and support characteristics to the quality of life in families of young children with disabilities.
The sample was recruited from several early childhood intervention programs within metropolitan Melbourne, Australia, and consisted of 64 families of children aged between 3 and 5 years with a developmental delay or disability.
As a whole, parental perceptions and experiences of family-centred professional support was one of the strongest predictors of family quality of life. The perceived intensity of child behavioural problems as well as support from extended family members also accounted for a significant proportion of unique variance in predicting quality of family life.
The current findings provide further evidence for the importance of a family-focused approach to intervention that acknowledges and provides support that is tailored to the unique needs of each individual family. The practical implications of these results as well as directions for future research are discussed.
To investigate factors predicting parenting stress in mothers of pre-school children with cerebral palsy.
Eighty mothers and children participated. Mothers completed the Parenting Stress Index (PSI) and the following measures of family functioning: family support, family cohesion and adaptability, coping strategies, family needs and locus of control. Children were assessed using the Griffiths Scales and the Gross Motor Function measure. The child's home environment was assessed using Home Observation for Measuring the Environment.
Mothers had higher mean total PSI scores than the means for the typical sample; 43% had total PSI scores above the threshold for clinical assessment. Cluster analysis demonstrated five distinct clusters of families, more than half of whom were coping well. High stress items were role restriction, isolation and poor spouse support, and having a child who was perceived as less adaptable and more demanding. Lower stress items indicated that this sample of mothers found their children emotionally reinforcing and had close emotional bonds. Regression analysis showed that the factors most strongly related to parenting stress levels were high family needs, low family adaptability and cognitive impairment in the child.
The results confirmed the individuality of families, and that individual characteristics of coping and feeling in control, together with family support and cohesion, are associated with variation in amount of stress experienced in parenting a child with cerebral palsy.
Improving practices with families of pediatric patients is most likely to occur when nurses and other health care professionals more fully understand the characteristics and consequences of different approaches to their work. A review of relevant literature in the empowerment, helpgiving, and family-centered care fields suggests the kinds of beliefs, attitudes, and behaviors that will optimize benefits to families in different domains of functioning. Family-centered care is a special case of effective helpgiving, and effective helpgiving is a special case of an empowerment approach to working with people seeking professional advice and expertise.
Research carried out over a number of years provides a consistent picture of the experiences and needs of parents of disabled children. Recent studies, based on models of stress and coping, have identified factors which relate to high or low levels of parental distress. Whilst this research can provide useful information for service development, there appears to have been little change over the years in parents' reports of unmet need. It is clear that parental need covers a wide range of aspects of family life and holistic models of service support are required. Although evaluation studies which identify models of services that can change this situation are few, there are positive examples of models of support. The paper reviews the findings of such evaluation and identifies a number of important characteristics of effective service models.
The value of family-centred principles in paediatric professional caregiving services is widely acknowledged. However, the degree to which such services adhere to these principles is not well documented.
To examine the perceptions of both families and service providers of the extent to which family-centred services were being implemented by a paediatric disability service provider and to pinpoint areas for improvement.
A sample of 158 families receiving services from the Cerebral Palsy Association of Western Australia completed the Measure of Processes of Care for families (MPOC-56) and 43 clinicians (most of them physiotherapists, speech pathologists and occupational therapists) completed the Measure of Processes of Care for service providers (MPOC-SP).
As in previous studies, the families rated 'respectful and supportive care' highest and 'providing general information' lowest. Clinicians rated 'showing interpersonal sensitivity' highest and 'providing general information' lowest. Analysis of individual items revealed that the following areas of family-centred services were in need of improvement: provision of general written information to families on a range of issues, continuity of care, greater involvement of the family in therapy and provision of more detailed information about therapy issues and provision of more general support to whole families.
The MPOC tools have been found useful in enabling disability service providers to identify areas for improvement and move towards providing services that are more family centred.
This article clarifies the nature of 'service integration' and 'service co-ordination' and discusses how these aspects relate to the fundamental goal of providing co-ordinated care for children with disabilities and their families. Based on a review of the service delivery literatures in the fields of health, social services and rehabilitation, a framework is presented that outlines the scope of the co-ordination-related functions and activities encompassed in three common types of approaches to the delivery of co-ordinated care. These are a system/sector-based service integration approach, an agency-based service integration approach and a client/family-based service co-ordination approach. The functions outlined in the framework include aggregate-level planning of services (designed to map out the scope and plan for service provision in a community or geographical area), administrative functions (designed to ensure wise and equitable access to resources) and client-specific service delivery functions (designed to link clients/families to needed services). The framework is a tool that can be used to support policy making and decision making with respect to the design of efforts to provide co-ordinated care. It provides information about commonly used approaches and the essential elements of these approaches, which can be used in making choices about the scope and nature of an approach towards service integration/co-ordination.
This article describes the use and utility of the Life Needs Model of Pediatric Service Delivery at a regional children's rehabilitation center. The model is a transdisciplinary, evidence-based model that guides pediatric service delivery to meet the long-range goals of community participation and quality of life for children and youth with disabilities. The article describes the use of the model as a tool to assist with the development of organizational culture, strategic and operational planning, the development of therapists' expertise, and the development of community partnerships. The model also has influenced human resources practices, community relations activities, and research. The model provides needed direction to service planners about the types of services that are important to provide in a geographical region, and fills a gap in outlining the nature of services that can be encompassed in pediatric rehabilitation.
For children who have physical disabilities and their families, involvement with a variety of providers of rehabilitation services is the norm rather than the exception. Despite family-centred practice (FCP) being recognized as the 'best practice' model, families experience models of service provision that range from 'expert' to 'collaborative'. After adopting FCP at Novita Children's Services in South Australia, it was imperative to determine the effectiveness of the implementation of FCP. Aim To investigate parents' and staff's perceptions of FCP at Novita as part of ongoing quality assurance activity, and to identify any gaps in the services provided.
The Measures of Processes of Care (MPOC) for parents/caregivers and service providers were utilized. A total of 189 families stratified by the three age groups of clients (<6, 6-12 and 13-18 years) and home location (metropolitan and rural) completed the MPOC-20 questionnaire. A total of 145 staff, allied health therapists, rehabilitation engineers, managers and other staff who have direct contact with clients and their families completed the MPOC - service providers (MPOC-SP) questionnaire.
Parents generally rated the family-centred behaviours of staff as positive. Respectful and supportive care received the highest rating, while providing general information received the lowest. There were significant differences in scores for all five scales of the MPOC between metropolitan and rural families and the age of the child. Service providers also generally rated their family-centred behaviours as positive. There were significant differences among the professions in areas of showing interpersonal sensitivity and providing general information.
The findings suggest that parents and service providers perceive FCP as positive at Novita, with some areas for improvement. The MPOC-20 and MPOC-SP can be used to measure FCP and to identify service delivery gaps, which warrant further exploration.
Best practice occupational therapy: In community service with children and families. NJ: Slack Incorporated Thorofare
- W Dunn
Dunn, W. (2000). Best practice occupational therapy: In
community service with children and families. NJ:
Slack Incorporated Thorofare.
[AQ7]
Qualitative research in occupational therapy: Strategies and experiences. Canada: Del- mar
- J V Cook
Cook, J. V. (2001). Qualitative research in occupational
therapy: Strategies and experiences. Canada: Del-
mar.
[AQ5]
Client-centred practice in a changing health care system
- C Baum
Baum, C. (1998). Client-centred practice in a changing
health care system. In M. Law (Ed.), Client-centred
occupational therapy (pp. 29–46). NJ: Slack.
[AQ4]
Family-centred service in Ontario: A " Best Practice " approach for children with disabilities and their families
- G King
- S King
- M Law
- M Kertoy
- P Rosenbaum
- P Hurley
King, G., King, S., Law, M., Kertoy, M., Rosenbaum, P., &
Hurley, P. (2002). Family-centred service in Ontario:
A " Best Practice " approach for children with disabilities and their families. Hamilton, Ontario, Canada:
Can Child Centre for Childhood Disability Research,
McMaster University.
Towards family-centred
- K Hanna
- S Rodger
Hanna, K., & Rodger, S. (2002). Towards family-centred
July 27, 2010
14:56
Char Count= 0
Community health and related services for children: Early intervention services for children with a disability or developmental delay
- Uk Cambridge
Cambridge, UK: Cambridge University Press.
Health Services Executive South. (2007). Community
health and related services for children: Early intervention services for children with a disability
or developmental delay. Cork, Ireland: Abbeycourt
House.
Young children with special needs. Delmar
- R M Gargiulo
- J Kilgo
Gargiulo, R. M., & Kilgo, J. (2000). Young children with
special needs. Delmar.
[AQ8]
Low back pain: Exploring the meaning of exercise management through interpretative phenomenological analysis (IPA)
- S G Dean
- J A Smith
- S Payne
Dean, S. G., Smith, J. A., & Payne, S. (2006). Low back
pain: Exploring the meaning of exercise management through interpretative phenomenological analysis (IPA). In L. Finlay & C. Ballinger (Eds.), Qualitative research for allied health professionals: Challenging choices (pp. 139–155). West Sussex, UK:
Wiley.
Family-centred practice: How changes in thinking about working with families affect our practice. Paper presented at Interdisciplinary Seminar Series
- G Brown
Brown, G. (2003, December 4). Family-centred practice:
How changes in thinking about working with families affect our practice. Paper presented at Interdisciplinary Seminar Series, University College Cork, Ire-
land.
The measure of the processes of care, MPOC: a means to assess family-centred behaviours of health care providers
- S King
- P Rosenbaum
- G King
King, S., Rosenbaum, P., & King, G. (1995). The measure of the processes of care, MPOC: a means to
assess family-centred behaviours of health care
providers. Hamilton, Ontario, Canada: Neurodevelopmental Clinical Research Unit, Chedoke-McMaster
Hospitals.
Family-centred services: A conceptual framework and research review. Physical and Occupational Therapy in Pediatrics
- P Rosenbaum
- S King
- M Law
- G King
- J Evans
Rosenbaum, P., King, S., Law, M., King, G., & Evans, J.
(1998). Family-centred services: A conceptual framework and research review. Physical and Occupational Therapy in Pediatrics, 18, 1–20.
Within a family-centred practice. How can family outcomes be identified? Physical & Occupational Therapy in Pediatrics
- L Jeffries
Jeffries, L. (2009). Within a family-centred practice. How
can family outcomes be identified? Physical & Occupational Therapy in Pediatrics, 29, 129–132.