The Impact of Services on Family Outcomes Ann Turnbull Denise Poston Beach Center on Disability University of Kansas With special Thanks to Jean Ann Summers, Hasheem Mannan, Mian Wang,Janet Marquis and Kandace Fleming

What We Say About Early Childhood Services – And Need to Back up with Data Strengthening families is a way to ensure children have the best outcomes The type, amount, and quality of services make a difference in meeting families’ needs and their quality of life Partnerships with professionals influence families’ quality of life

What Do We Mean by Supports and Services for Families? Largely undefined The Individuals with Disabilities Education Act (IDEA) Part C (birth to 3) and Part B- 619 (3 to 5) provides a start Family-centered practice is considered best practice in terms of how to deliver services, but not for what to provide

What Do We Mean by Partnerships? TRUST Child-Professional Relationship Family-Professional Relationship Respect Commitment Skills Reliability - Safety Respect Communication Equality Reliability - Dependability

What Do We Mean by Family Quality of Life? Family Quality of Life Parenting Physical/ Material Well-Being Disability- Related Support Emotional Well-Being Family Interaction

Service Impact Study Designed to test the assumption that services and partnerships affect family quality of life Limited to one life cycle stage – early childhood Limited to one state - Kansas Encompasses two policy areas (Parts B and C of IDEA)

The Service Impact Study 13 program partners throughout Kansas 4 serve children ages birth to 3 5 serve children ages 3 to 5 4 serve children ages birth to families of children receiving services in these programs

Family Participants

Measures Services Inventory Beach Center Family Professional Partnership Scale Beach Center Family Quality of Life Scale

Services Inventory 14 child-oriented services 14 family-oriented services Parents check whether service is needed (yes/no) If needed, parents rate how much they are getting: None Some but not enough Enough

How Families Rate Services for Their Children? More families report (59%) they are getting enough of the services their child needs – with a few exceptions Of the 163 families whose children need speech, 60% report getting enough The exceptions Of the 57 families whose children need behavior support, 40% report getting enough

How Do Families Rate Services for Themselves? Fewer families report (21%) they are getting enough of family- oriented services they need Of the 73 families reporting they need information about services, 23% report getting enough Of the 49 families reporting they need parent training, 20% report getting enough

The Family-Professional Partnership Scale 9 items for Child-Professional Domain 9 items for Family-Professional Domain Parents think of provider who works most with them and their child Parents rate satisfaction on a scale of = Very Dissatisfied 5 = Very Satisfied

Child-Professional Relationship: Sample Items How satisfied are you that your child’s service provider... Has the skills to help your child succeed Speaks up for your child’s best interests Treats your child with dignity Builds on your child’s strengths

Family-Professional Relationship: Sample items How satisfied are you that your child’s service provider... Uses words that you understand Protects your family’s privacy Shows respect for your family’s values and beliefs Is a person you can depend on and trust

How Do Families Rate Partnerships? Families on average were highly satisfied Child-Professional Relationship rating = 4.24 Family-Professional Relationship rating = 4.43 Highest rated item: Service provider is friendly (4.67) Lowest rated item: Service provider helps parent gain skills or information (3.77)

The Beach Center Family Quality of Life Scale 25 items in 5 domains Family Interaction (6 items) Parenting (6 items) Emotional well-being (4 items) Physical/Material Well-being (5 items) Disability-related support (4 items) Families rate satisfaction on a scale of 1 to 5

Family Quality of Life: Sample Items For my family to have a good life together, how satisfied am I that... My family enjoys spending time together. My family members have friends or others who provide support. My family members have transportation. Adults in my family have time to take care of needs of every child. My family member with a disability has support to accomplish goals at school.

How Do Families Rate Their Quality of Life? On average, participants reported that they were fairly satisfied with their family quality of life Family Interaction – 4.06 Parenting – 4.07 Emotional Well-being – 3.43 Physical/Material Well-Being – 4.21 Disability-Related Support – 4.13

Some Limitations and Explanations Limited Sample High scores Satisfaction response stem Families of young children report more satisfaction with their partnerships – might this also affect FQOL? Families may not think they need a service because they think they won't be able to get it anyway

Putting It Together Service adequacy significantly predicts family quality of life ( t-value = 4.76) Service adequacy significantly predicts partnership (t-value of 4.39) Partnership is a partial mediator of the effect of service adequacy and family quality of life (Sobel test = 2.14, p = 0.031)

Partnerships Services Family Quality of Life The Support Triangle: Services and Partnerships Make a Difference for Families

Implications For Future Research and Activities Exploring the issue of family supports and services Why do families report not needing very many services for themselves (717 vs 425)? Why are they not getting the services they do need? Exploring the relationship between family outcomes and child outcomes Exploring how structures in organizations and best practices facilitate partnerships