Integrating a family-centered approach into social work practice with families of children and adolescents with disabilities

This article identifies a family-centered practice construct for working with children and adolescents with disabilities and their families. The experiences of these families have shifted considerably over the past 30 years. A legislative and historical context provides the basis for an understanding of present policies and practices that influence current approaches to service delivery. Though family-centered practice is emphasized in various practice settings, there is still a need to integrate this philosophy into social work practice with children and adolescents with disabilities and their families. In order to enhance the ability of the social worker to integrate this construct into practice, a framework for exploring the experiences of children, adolescents and families is provided. This framework provides an overview of factors related to the individual child, the family and siblings for the social worker to consider when working with these families. The social worker's role as collaborator, advocate, team member and family resource is highlighted.     

Integrating a Family-Centered Approach into Social Work Practice with Families of Children and Adolescents with Disabilities

Abstract

This article identifies a family-centered practice construct for working with children and adolescents with disabilities and their families. The experiences of these families have shifted considerably over the past 30 years. A legislative and historical context provides the basis for an understanding of present policies and practices that influence current approaches to service delivery. Though family-centered practice is emphasized in various practice settings, there is still a need to integrate this philosophy into social work practice with children and adolescents with disabilities and their families. In order to enhance the ability of the social worker to integrate this construct into practice, a framework for exploring the experiences of children, adolescents and families is provided. This framework provides an overview of factors related to the individual child, the family and siblings for the social worker to consider when working with these families. The social worker's role as collaborator, advocate, team member and family resource is highlighted.     

Leading with racial equity: promoting Black family resilience in early childhood

ABSTRACT

It has been 47 years since Billingsley and Giovannoni penned a pointed analysis of child welfare’s failure of Black children the United States. This conceptual paper asserts that this failure will continue unless we take seriously the role that structural inequality plays in Black families’ lives. It updates Billingsley and Giovannoni’s paper by shifting the focus from children to families, grounding Black family well-being in a developmental model and constructing a racial equity approach to family resilience. The paper begins by establishing an empirical justification for focusing on Black families. This review of data on Black families further reveals early childhood to be a particular priority for intervention. The emerging model centers on Black families’ ability to navigate and negotiate for their needs. The model components are malleable factors that work together to form a “supportive state” and resilient pathway. Implications for the model’s compatibility with clinical family resilience models, two-generation approaches, and family-centered policymaking are discussed.     

Early intervention services for very young children and their families under P.L. 99-457

This article addresses early intervention services for children, birth to kindergarten age, who experience developmental deficits and delays that may later be identified as learning disabilities. P.L. 99-457 is briefly reviewed with a focus on elements that emphasize family-centered practice. Vignettes are presented to illustrate interventive strategies that promote parent empowerment, and parent-professional and interagency collaboration.     

Bespoke program design for school-aged therapy disability service delivery

This article uses the evaluation of a school-aged therapy service for children with disabilities in Western Australia to investigate models of service delivery. The current literature on family-centered practice, multidisciplinary and transdisciplinary approaches, and 4 models of service are reviewed. The models include the life needs model, the relational goal-orientated model of optimal service delivery to children and families, the quality of life model, and the collaborative model of service delivery. Analysis of the data is presented together with a bespoke model of service delivery for children with disabilities, arguing that local contexts benefit from custom-made service design.     

Blue-Ribbon Babies and Labors of Love: Race,Class, and Gender in U.S. Adoption Practice by Christine Ward Gailey

ABSTRACT

We investigated the adjustment of differing sized adoptive families rearing children with developmental disabilities. Families of 5 or more children (large: n = 54) were compared with families of 4 or fewer children (conventional: n = 69) on a variety of demographic and outcome variables measuring family strengths, family disharmony, marital adjustment, and adjustment to the adopted child. Analyses of covariance on the outcome variables demonstrated that parents of large families were functioning as well or better than parents of conventional-sized families. We concluded that adoption placement practice should not exhibit bias against the placement of multiple children with developmental disabilities in the same family.     

Outcomes of family centered meetings for families referred to Child Protective Services

In order to address the number of children entering the foster care system each year and to promote the family's participation in the decision-making process, family-centered meetings have been widely adopted throughout the United States as well as in other countries. Since 1989, Family Group Conferencing, Family Group Decision Making, and Family Team Meetings have all been introduced into public child welfare systems. This paper will refer to all three approaches as family-centered meetings. However, little empirical research has been done to test the impact of these meetings on families referred to Child Protective Services (CPS). This paper examines literature on the impact of family-centered meetings with families referred to CPS on child and family functioning outcomes. The results suggest that more research is needed to examine fidelity models and specific types of interventions being implemented. However, all of these three appear to increase kinship care placements. More research is needed, specifically regarding the contexts where family-centered interventions could be appropriate. Implications for practice are also discussed, with special consideration of integrating family-centered interventions with other interventions to promote both family participation and child safety.     

Post-adoption needs of families adopting children with developmental disabilities

The post-adoption service use and needs of 125 families who had adopted children with developmental disabilities were examined using a structured mail questionnaire. Although satisfaction with services used was generally high, many families did not have access to basic family support services such as respite care, life planning and support groups. Income was the only demographic variable which correlated with service need. Middle income families (mean = $30,000 to $34,999) were more likely to need support groups and babysitting for other children than either lower or higher income groups. Of particular note in this study is the relatively high incidence of transracial adoptions. Thirty-one percent of the sample had adopted children of a different race than the family. The implications of the findings and service recommendations are discussed.     

Comparing Service Use of Early Head Start Families of Children With and Without Disabilities

The current study compared patterns of service utilization reported by Early Head Start (EHS) families of children with and without disabilities by secondary analysis of data from the longitudinal investigation of the effectiveness of EHS. Findings reveal comparable positive trends for both groups of families for receipt of services corresponding to EHS performance standards promoting child and family development, family support, and health care. Service challenges remain in the low use of dental services overall and the higher use of acute health care services for children with disabilities. Future research should examine causes and outcomes of service use.     

Whose responsibility? Resilience in families of children with developmental disabilities

Families with children with disabilities are at higher risk of stress, financial disadvantage and breakdown. In recent decades, research and policy have shifted focus from these problems to a strengths-based approach, using concepts such as family resilience. By definition, resilience is the ability to cope in adverse circumstances, suggesting a reliance on the individual. If this is the case, then to what extent does ‘family resilience’ place another burden of responsibility onto families? Whose responsibility is family resilience? This paper begins to answer this question using interviews with parents of children with developmental disabilities based in New South Wales, Australia.     

Transracial Adoption of Children with Developmental Disabilities

ABSTRACT

This study investigated the transracial adoption of children with developmental disabilities. Thirty-four families who had adopted a child transracially were compared with 63 families who had adopted a child inracially; additionally, we compared adoptions in 13 families who had adopted both transracially and inracially. The adjustment of mothers and fathers was gauged separately at three time points using measures of depression, stress, family strengths, and subjective well-being. Results indicated few differences in functioning between transracial and inracial adoptive parents. Mothers in both conditions maintained low depression scores and comparable means on all other outcome variables. Fathers also revealed similar adjustment patterns despite adoption type. Thus, parents experience both short- and long-term positive outcomes from the transracial adoption of children with developmental disabilities.     

The Postadoption Needs of Adoptive Parents of Children With Disabilities

Adoptions of children with disabilities are considered special needs, due to the higher level of support needed pre- and postadoption by families and children for adoptions to succeed. Despite this fact, very few studies examine the specific postadoption experiences of families with children with disabilities. Using secondary analysis of a national survey of adoptive parents, as well as interviews and a focus group with adoptive parents in one state, this study examines families’ with adopted children with disabilities challenges and unmet needs after adoption, as well as the postadoption needs and experiences of adoptive families with children with developmental and intellectual disabilities and adoptive families of children with emotional, behavioral, and mental health disabilities. Findings indicate that families with children with disabilities do report higher rates of challenges and barriers to service access, and that this is particularly true in families with adopted children with emotional, behavioral, and mental health disabilities. Implications for research and practice are discussed.     

Family Assessment and Intervention Using an Interactive Art Exercise

The authors have developed a family-centered interactive art exercise from a synthesis of clinical tools used by attachment theory and family art therapists. The exercise aims to facilitate assessment and treatment of families with younger children (two to eight years) at a tertiary referral child and family psychiatric facility, by observing how a family collectively as well as individually sets about planning and completing an art task. Art exercises allow for both verbal and non-verbal communication. The exercises are deliberately kept simple in order to span a range of developmental abilities, and allow the therapist/s to observe from behind a one-way screen, so as to be less intrusive in the family dynamics. Although developed for assessment with a specific population, the exercise is likely to be useful in other clinical situations and has been used as a treatment tool by the authors.     

Unmet service needs of families of young children with chronic illnesses and disabilities

Data about health and educational services were collected from 187 families with young children (under two years) who have chronic illnesses and disabilities. The purpose was to assess parents' satisfaction with services their families received and to identify families' unmet service needs as well as the reasons for these unmet needs. Although families' ratings of the adequacy of services are relatively high, 28% of the families report unmet service needs. The unmet needs most often reported are occupational, physical, or speech therapy; respite care/child care; and special education. Lack of funding is the most commonly given reason for unmet needs. Children with multiple impairments are at highest risk for unmet needs. Only 22% of unmet needs reported at the initial interview have been met by the time of the six-month follow-up. Increased coordination and monitoring of services across service sectors are indicated. Her research interests include the effects of disability on family identity and families' responses to minority stress. She received her Ph.D. from the University of Minnesota. She gratefully acknowledges Shelley Blazis and Nadav Casuto for statistical consulting. Her research interests focus on the impact of chronic illness and disability on families. She received her Ph.D. from the University of Minnesota. Her research interests include families and health and chronic illness and disability in children. She received her Ph.D. in Family Social Science at the University of Minnesota. His areas of interest include neurodevelopmental outcomes of low birth weight infants and training in developmental pediatrics. He was graduated from the University of Minnesota Medical School. His areas of interest include adolescents with chronic illness and disabilities, adolescent sexual decision making, and international adolescent health care issues. He was graduated from Howard University College of Medicine was awarded his earned doctorate in Health Policy from the University of Minnesota. Preparation of this article was supported by the National Institute on Disability and Rehabilitation Research Grant #H133890012.     

A qualitative analysis of child protective services practice with children with developmental disabilities

The purpose of this study was to examine Child Protection System (CPS) practice with children with developmental disabilities. This study used an emergent design, ethnographic interviews, purposive sampling, inductive data analysis, and grounded theory building. Ethnographic interviews were conducted with foster families, administrators, intake screeners, special investigators, and workers in one local CPS office. Participants expressed concern about the ability to identify disabilities, placement options, services to meet complex needs of children with disabilities, training and support for families, collaborative arrangements with other agencies, and disability training for CPS workers. Findings suggest strategies for improving CPS practice for children with developmental disabilities.     

Parental Caregivers' Desires for Lifetime Assistance Planning for Future Supports for Their Children with Intellectual and Developmental Disabilities

Future life planning is a growing concern among families with children with disabilities. This article presents a needs assessment evaluating feasibility of a new model for future life planning for family caregivers, Lifetime Assistance, which will provide ongoing planning and monitoring for individuals with intellectual and developmental disabilities. Using surveys informed by a series of focus groups, data were gathered from older and younger parents in one midwestern state regarding the potential program. Study results indicate that respondents did not feel the current system of support was adequate for planning for their child's future, nor sufficient for monitoring the quality of life for their children in the future. Although almost all families had identified a person to support their family members when they were no longer able to do so, parental caregivers overwhelmingly identified the need for the Lifetime Assistance program and many were willing to pay for this service themselves.     

Families' experience of a single session therapy framework in advanced allied health practice for children with neurodevelopmental and behavioural disabilities: A thematic analysis of qualitative data

Single session therapy (SST) has emerging evidence for facilitating meaningful therapeutic change in a small number of consults, rather than more traditional long-term therapies. This study aimed to explore and describe the parent/caregiver and child experience with advanced allied health practitioners (AAHP) using SST for children with developmental disabilities, by understanding key characteristics of the consultation that led to therapeutic change. Eligible families attending an AAHP outpatient clinic for children with developmental and behavioural concerns participated in one to four SST consultations around their identified areas of need. Semi-structured interviews were conducted with 38 parents and 12 children, from 37 different families. Thematic analysis was used to analyse interviews. Demographic information was gathered through parent interviews and by reviewing hospital records. Four key themes emerged relating to the characteristics of the consultation that led to a positive experience for families: (1) the art of mutual presence; (2) the value of time; (3) the power of understanding; and (4) the trust of action. These attributes were influenced by the overarching complexities of the AAHP, the parent's and child's interpersonal skills, and the organisational mechanisms influencing patient care. Parents and children reported clinical change during the consult through increased understanding, and being heard, valued, and respected for their individual decisions on how to manage their child's and family's needs. This study provides preliminary evidence that utilising SST for children and families with developmental and behavioural needs facilitates a positive experience valued by families. SST, with a focus on a family's individual identified areas of concern, was valued and effective when delivered by AAHP. This suggests that SST, when appropriately administered by experienced and trained health practitioners, is useful for families dealing with children with developmental and behavioural challenges.     

BUILDING ON FAMILY STRENGTH: A STUDY OF FAMILIES WITH POSITIVE ADJUSTMENT TO THE BIRTH OF A DEVELOPMENTALLY DISABLED CHILD*

This research was based on the assumption that much could be learned from families that had adapted well to the birth of a child with developmental disabilities. It was of interest to explore what made these families strong and if consistent patterns of coping and adjustment could be observed. Positive adaptation seemed unrelated to degree of the child's disability or level of soothability, and further, did not seem directly linked to family income level. However, it appeared that two-parent families with few children were at a distinct advantage. Positive family adaptation appeared to be tied to functioning of the parental subsystem and the skillful utilization by parents of family and friendship network resources.     

Successful Adoption of Children with Down Syndrome and Other Developmental Disabilities

Abstract

Children with many types of developmental disabilities have been successfully adopted. Nonetheless, there appears to be a belief among both adopters and some adoption workers that children with Down syndrome are especially easy to rear. The current paper uses different methodological strategies, including case-by-case matching and regression techniques, to test hypotheses relating to better outcomes for parents and families who have adopted children with Down syndrome in comparison to children with other developmental disabilities. The results demonstrated successful functioning for parents and families on a variety of measures, regardless of whether the adopted children had Down syndrome or other developmental disabilities. The positive stereotype for Down syndrome was not supported.     

Applying the Developmental Family Therapy Model to Issues of Migrating Families

Migration creates a substantial amount of stress for relocating families. Families lose the predictability of familiar surroundings and they often find themselves without the support systems that existed in their previous homes. Especially, they experience tensions between the primary values of the old and new cultures. This stress and the absence of support can lead to developmental problems for both the adults and children in the family. Developmental family therapy has grown out of individual and family developmental theories (Erickson, 1963; Duvall, 1977; Carter & McGoldrick, 1989; Steinglass, Bennett, Wolin, & Reiss, 1987). This model assumes that problems develop when family patterns block normal development of the family and its members. Family therapy then assists families to make changes in those dysfunctional patterns in order to promote the normal growth of the members. Developmental Family Therapy can help families successfully manage the transition between cultures. This paper first examines the impact of migration on families from a developmental viewpoint. Next, it identifies family therapy strategies helpful to families in that transition.