Relationship Stages in Early Intervention Practice for Children with Disabilities

Abstract

Background: While a lot is known about the value of relationships in family-centered care for children infants and preschoolers with disabilities insufficient attention has been paid to this in the context of Early Intervention (EI) service provision and practice. Within EI practice, there is an expectation that parents and professionals collaborate and form partnerships to engage in an integrated way. This study aimed to understand the process constructs that underpin EI practice in Ireland. Methods: The research used a qualitative case study research design to coordinate the data from multiple perspectives from one EI team. Multiple methods were used to understand the phenomenon such as interviews, autophotography and observations. Grounded Theory1 provided clear procedural steps for data collection and analysis. Results: Participants included young children with disabilities (n=5), parents (n=6) and professionals (n=17) from one EI team. This EI team was part of a bigger non-government organisation providing an EI service for children, aged from birth to five years, with intellectual disability. The child and parent participants were from different families. All families were nuclear families. In total, 31 in-depth interviews and two observations were undertaken and data were collected and interpreted in a coherent, systematic and rigorous way. Results: The core category, ‘Synergistic Interdependent Relationships in EI’ emerged from the study. One of the key influences affecting the core category is Relationship Stages. The study links stages of relationship development for personal romantic relationships to EI, thus applying social penetration theory to EI. These are: initiating stage, experimenting stage, integrating stage, and intensifying stage. This study also recognises a new fifth stage, transitioning stage, for EI. Discussion: This research proposes considering the relationship stages as momentous in the EI relationships between partners. The EI relationship is a complex interdependent one which requires a roadmap of explicit stages, which can facilitate all involved in the relationship to work together. This study provides this roadmap in the form of a developmental relationship trajectory. Although each EI programme is unique with different people the common goal exists to facilitate a child to reach their full potential. Conclusion: The trajectory of relationship stages can be used as a tool to provide an enhanced focus to all involved. The model is developmental in nature and it is important that participants go through each stage within their EI relationship. Having explicit awareness of the relationship stages will help children, their parents and professionals understand that it is a developmental journey from initiation to transition. Lessons Learned: Being involved in the study gave the family and professionals an opportunity to reflect and share their understanding of EI practice. Limitations: The case study was based on one team in a particular cultural environment. Suggestions for future research: This study identifies a generic model, with transferability to other EI programmes which could be tested.