Family-centered Practice Research Articles

Psychometric properties of the Spanish version of the family-centred practices scale for use with families of young children receiving early childhood intervention.

Early childhood intervention (ECI) centres in Spain recently initiated a process of change towards the adoption of family-centred practices (FCPs). Knowledge about the extent to which practitioners' use FCPs is needed. The psychometric properties of the Spanish version of the FCPs scale were examined. A convenience sample of 105 families of children with developmental delays attending three different ECI centres in Spain completed the FCPs scale and provided information about the ECI centre characteristics and practices, caregiver self-efficacy beliefs, and family and child demographic information. The Spanish version of the FCP scale was found to be both reliable and valid. FCPs were correlated with self-efficacy beliefs, parents' involvement in their child's ECI program and family decision making. The FCP scale provides practitioners with useful information about their practices, but also has capacity-building consequences for families. The study is a first step for examining the use of FCPs in Spain.

Differences between Pre-School Children with and without Special Educational Needs Functioning, Participation, and Environmental Barriers at Home and in Community Settings: An International Classification of Functioning, Disability, and Health for Children and Youth Approach

The International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY; WHO, 2007) provides a framework for child functioning with an emphasis on child participation. Participation is defined as “involvement in life situations” and can be influenced by both child characteristics (health conditions, body functions and structures) and by contextual factors (facilitators or barriers of the physical or social environment) (WHO, 2007). This study aimed at characterizing functioning of pre-school aged children, based on their frequency of participation in home and community activities and on the perception of environmental barriers to their participation by parents, using an ICF-CY approach. Differences between children with Special Educational Needs (SEN) (n = 42) and children without SEN (n = 74) were analyzed. Parents of 116 children from Porto District (Portugal) completed an adapted version of the Young Children's Participation and Environment Measure (YC-PEM; Khetani et al., 2013a). To assess child functioning, pre-school teachers completed 6 items of the Matrix for Assessment of Activities and Participation (MAAP; Castro & Pinto, 2015), corresponding to 6 code sets of the ICF-CY Developmental Code Sets (Ellingsen & Simmeonsson, 2011). Children with SEN showed lower levels of functioning when compared to children without SEN, according to their pre-school teachers. Parents of children with SEN reported that their children participated less frequently in home activities. Specifically, significant differences were found in household chores, at home. Parents of children with SEN perceived more environmental factors as barriers in both settings when compared to parents of children without SEN. Differences between groups in specific environmental factors are presented with reference to the YC-PEM environmental content linked to the ICF-CY environmental domains (Khetani, 2015). Findings highlight the importance of identifying and adjusting environmental barriers, through family centered practices, to promote child participation and overall functioning. The adoption of the ICF-CY (WHO, 2007) is recommended when implementing and monitoring inclusive services and practices. Results are further analyzed and discussed with reference to the biopsychosocial model of the ICF-CY (WHO, 2007)

Facilitated playgroups to promote speech and language skills of young children with communication delays: A pilot study

Family-centered practices that build caregiver capacity are a central focus of early intervention services for young children with disabilities. The purpose of this study was to evaluate the feasibility of adapting the ‘Parents Interacting with Infants’ (PIWI) facilitated playgroup model to target effective communication strategies for parents of young children with communication delays. A concurrent multiple baseline across behaviors design with three parent–child dyads was used to determine the effects of the weekly facilitated playgroup model on parents’ successful implementation of communicative strategies and the effects on the children’s communication behaviors. Visual analysis revealed a functional relationship between the seven-week intervention and an increase in parent and child outcomes. Results support the feasibility of using a facilitated playgroup model to enhance parents’ ability to implement effective communication strategies with their children. Clinical implications and future directions for research are discussed.

Acute care nurses' views on family participation and collaboration in fundamental care.

To understand the beliefs, attitudes and perceptions of nurses regarding family participation and collaboration in the care of their hospitalized adult relative. Family participation in care is known to enhance the quality of patient care. Nurses are uniquely placed to support such participation, including the delivery of fundamental care. However, nurses' attitudes and beliefs may help or hinder participation. A mixed methods approach with an exploratory sequential design was used. A regional referral hospital in Australia. Nurses were eligible to participate in the study if they were permanent staff of the hospital, and who in their day-to-day work had direct contact with adult patients and their families on acute care wards. Observer-as-participant observation data and semi-structured interviews were undertaken. 30hr of observational data were gathered, and 14 nurses were interviewed. Data collection occurred between September and December 2016. Following separate analysis, data were triangulated. Analysis uncovered two contrasting categories: (i) enacting family participation (four themes); and (ii) hindering family participation (five themes). The findings of our study demonstrated that the practices of nurses do not always align with healthcare policies, and strategies to support nurses to enact patient- and family-centred practices are needed. Nurses can use these findings to make informed evidence-based changes to the way they practice and communicate with families to ensure fundamental care is delivered.

A Glass Half Full Not Empty: Strength-Based Practice in Persons with Substance Use Disorders

The strength-based practice highlights the inherent competencies, resources, and values of an individual. While acknowledging underlying problem behaviors, it moves toward identifying potential solutions and meanings an individual holds. It therefore presents an innovative method to working with clients with different mental health concerns, including substance use disorders (SUD) with a focus on building resources. Traditionally, psychosocial interventions in the field of SUD have focused on behavioral management, cognitive approaches and the 12-steps programs. Such approaches have a leaning toward the deficit model and identify underlying pathology seen in addiction. Moving toward a strengths perspective offers possibilities to view one’s self and others in a positive light. In the current report, we present an argument to incorporate strength-based practices such as Motivational Interviewing, Solution-focused family therapy, Family-Centered Practice, Community-Based Participatory Research interventions and Case Management in working with persons with SUD. Specifically, we recommend a therapeutic focus of individual, family and community interventions that intensify movement toward healing by examining variables that instill well-being, while destigmatizing addiction. Secondly, we look at relational research such as social support, social networks and family strengths. Finally, we review aspects of community support groups and access to help that are intertwined within a strengths model.

Child- and Family-Centered Practices in a Post-Bureaucratic Era: Inherent Conflicts Encountered by the New Child Welfare Professional

ABSTRACTVarious child welfare organizations are changing services by adopting child- and family-centered approaches and moving away from redundant bureaucracy, top-down strategies, and fragmented networks. This shift inevitably poses challenges. This article uses the case of intensive family case management in the Netherlands to explore conflicts perceived by professionals and associated coping strategies. Findings are that internal conflicts (leading to a relapse into old routines or to misinterpretation of purpose) and boundary conflicts (leading to a relapse into old collaboration agreements) cause challenges. Pioneering organizations need to provide support for learning and reflection between professionals, seeking alignment between accountability and learning.

Working With Parents and Families to Improve Outcomes for Adolescents With Substance Use Disorders: Incorporating Family-Centered Care Into Your Practice

Working With Parents and Families to Improve Outcomes for Adolescents With Substance Use Disorders: Incorporating Family-Centered Care Into Your Practice

Implementing a collaborative coaching intervention for professionals providing care to children and their families: An exploratory study

The growing complexity of healthcare requires family and interprofessional partnerships to deliver effective care. Interprofessional coaching can enhance family-centred practice and collaboration. The purpose of this study was to explore the acceptability and feasibility of collaborative coaching training to improve family centredness within acute paediatric rehabilitation. Using a participatory action design, service providers (SPs; n = 36) underwent a 6-month coaching programme involving coaching workshops, learning triads, and tailored sessions with a licensed coach. The feasibility and acceptability of coaching on SPs’ family interactions and care was explored. Measure of Processes of Care (MPOC) and MPOC-SP, a coaching skills questionnaire, and focus groups were used to evaluate the acceptability of coaching training. We found that structured coaching training was feasible and SPs reported significant improvements in their coaching skills; however, MPOC and MPOC-SP scores did not reveal significant differences. Qualitative themes indicated that clinicians are developing coaching competencies and applying these skills in clinical practice. Participants perceived that the coaching approach strengthened relationships amongst colleagues, and they valued the opportunity for interprofessional learning. Findings suggest that coaching offers promise as an approach to facilitate successful patient outcomes and improve processes of care. Preliminary findings indicate that interprofessional coaching training is acceptable, feasible, and can significantly improve SP coaching skills and improve team cohesion. Further research to study the effects of coaching on interprofessional care using validated outcome measures and to assess the impact on service delivery is recommended.

Collaborative Leadership, Part 2: The Role of the Nurse Leader in Interprofessional Team-Based Practice - Shifting from Task- to Collaborative Patient-/Family-Focused Care.

This paper presents a discussion on the key role that nurses assume with their patients and also with other health providers. We will argue that a change is needed to provide "space" for nurses to re-engage with their patients and to return to their key coordinating role between their patients, their family members and other health providers in interprofessional patient and family-centred collaborative practice. Furthermore, we will discuss the important role of nurse leaders to present the nurses' unique role and importance to health system administrators and policy makers to improve health outcomes of patients and how their role can concomitantly reduce healthcare costs.

Early Implementation of a Family-Centred Practice Model in Child Welfare: Findings from an Irish Case Study

This article reports on the outcomes of a research study on the early implementation of a strengths-based family-centred model of practice in Ireland known as the Meitheal model. The paper aims to translate the key messages from this research to practice with families involved in the child welfare system. This is done by highlighting the process by which intervention focused on support and prevention using a strengths perspective has begun to occur in practice. Using data collected from stakeholders involved in the implementation of the practice model, the research provides insight into the opportunities and challenges involved at macro and micro-levels of practice. The discussion links this development in Ireland to the wider international context, using three broad frameworks informed by the ecological model; a framework for determining thresholds in children’s services and the continuum of intervention between support and protection to inform system change aimed at enhancing family support and better outcomes for children and families. Underpinning this is an emphasis on how Meitheal as a strengths-based approach can influence the achievement of the principles of early intervention, prevention and family support in the child welfare system in Ireland.

Measuring family-centred practices of professionals in early intervention services in Taiwan.

Family-centred practices emphasize professional supports for forming partnerships with families in early intervention. The Measure of Processes of Care for Service Providers (MPOC-SP) measures the perceptions of paediatric service providers in supporting children and families. This study aimed to establish reliability of the Chinese version of the MPOC-SP (C-MPOC-SP) and to examine professional perceptions of family-centred practices in relation to professional discipline and years of experience. A convenience sample of 94 physical therapists, occupational therapists, speech-language pathologists, social workers and early childhood educators completed the C-MPOC-SP. Thirty-seven professionals completed the measure a second time within 2-4weeks for test-retest reliability. Internal consistency and test-retest reliability were examined by Cronbach's α and intra-class correlation coefficient. Comparisons were made across professional disciplines by multivariate analyses of variance followed by analyses of variance. Relationships between years of experience and ratings of family-centred practices were examined by Pearson's correlation coefficients (r). Cronbach's α for items on each of the four scales of the C-MPOC-SP ranged from 0.80 to 0.92, indicating adequate internal consistency. Intra-class correlation coefficient between the initial and repeat completion of the C-MPOC-SP for each scale ranged from 0.56 to 0.77, indicating adequate to excellent test-retest reliability. Mean ratings for the Communicating Specific Information were significantly higher for physical therapists, occupational therapists and speech-language pathologists than for social workers (P = 0.001). The C-MPOC-SP scores were positively correlated with years of experience for all four scales (r = 0.23-0.38; P < 0.05). This study established adequate internal consistency and adequate to excellent test-retest reliability of the C-MPOC-SP in measuring perceptions of family centeredness of early intervention service providers. Cross-discipline differences were found in communicating specific information about the child. Higher perceptions of family centeredness were associated with more years of experience. The results support the utility of the C-MPOC-SP in professional education and programme evaluation of early intervention services in Taiwan.

Latent subtypes of youth in psychiatric residential care

In current practice, residential care programs in the United States are often more general than specialized with little demonstrated results of effectiveness for different types of youth. Subgroup analyses focused on developing a thorough understanding of the subpopulation of youth served in residential group care have potential to inform targeted program development. Using assessment records of a sample of 447 youth in psychiatric residential treatment, a latent class analysis was performed to identify youth subtypes. The results revealed four classes of youth characterized by severe levels of functional impairment and externalizing behavioral problems. Class distinctions were observed in the areas of psychiatric diagnoses, child behavioral problems and strengths, family characteristics, and maltreatment histories. An examination of class profiles lends support for the applicability of some general approaches across therapeutic residential programs, including the use of trauma-informed care and family-centered practice frameworks. The findings further demonstrate the need to also include program elements that are specified to the types of youth the program is designed to treat. Implications for policy and developing specified treatment protocol matched to the types of youth served in psychiatric residential programs are discussed.

Influence of a Parent–Child Interaction Focused Bookmaking Approach on Maternal Parenting Self-Efficacy

We examined the effects of our parent-child interaction focused bookmaking intervention with 89 families and their toddlers receiving early intervention services. Participating early intervention providers (N = 24) were assigned to either continue providing services as usual or participate in training to implement the bookmaking approach in their home visits. Compared with those receiving services as usual, the mothers in the treatment group showed greater maternal parenting self-efficacy, which in turn, predicted better child language development and fewer behavior problems. A significant interaction of treatment with maternal depression suggests that being in the treatment group reduced the association of depression with parenting self-efficacy. These findings suggest that early intervention approaches focused on parent–child interaction and other family-centered practices may be effective at increasing parenting self-efficacy, buffering against the potential deleterious effects of depression on parenting self-efficacy, and strengthening parents' confidence in their own ability to promote their children's development, resulting in gains in social–emotional and language domains.

Collaboration in Early Childhood Intervention Services in Gauteng

A central tenant of early childhood intervention (ECI) is collaboration between professionals and the caregivers of children receiving these services. There are limited studies on caregiver perceptions of collaboration in ECI teams particularly in resource-limited countries. Sixty-four caregivers participated in this study by completing a questionnaire on their perceptions of collaboration in ECI services in South Africa. The questionnaire survey was administered in a group setting by a trained research assistant who was proficient in the Setswana language. The results revealed that caregivers have a good understanding of collaboration in ECI services. However, collaboration, in relation to family-centered practices, appeared to be undervalued by caregivers. These results are discussed and the limitations of the study as well as future recommendations are outlined.

Parent Training Occupational Therapy Program for Parents of Children with Autism in Korea.

Attitudes and beliefs about parent participation in occupational therapy are shifting toward family-centered practice worldwide. However, adopting a family-centered approach in a society such as Korea, where a Confucian culture of hierarchical roles is reflected in a strong medical model, can prove to be very difficult. A parent training program was developed at the HOPE Center, a pediatric occupational therapy center, to bridge the gap between the traditional medical model and the ideal family-centered model. This study examined the effectiveness of the parent training and gauged parents' perceptions and experiences of a more family-centered approach to therapy. Four parent-child dyads living with autism participated in five months of parent training at the HOPE center. The results on the Canadian Occupational Performance Measure showed that the parent training improved the occupational performance of both children and parents. Six open-ended questions were used to investigate parents' perceptions and experiences of parent training. Two broad themes emerged: improved self-efficacy and the cultural reality of living with autism in Korea. This study demonstrates that building parent training into an occupational therapy program may optimize the effectiveness of any therapy and introduce a more family-centered approach to therapy while maintaining cultural integrity.

Family-centred practice in community physiotherapy: An Indian perspective

Family-centred practice in community physiotherapy: An Indian perspective

Preparing early interventionists to implement family-centered practices

ABSTRACTThe reauthorization of IDEA in 1997 placed greater emphasis on providing early intervention services to the family unit versus solely focusing on children with disabilities or children who are at risk for disabilities. Due to the shift from child-focused services to family-focused services, the need to implement family-centered practices became apparent. This study explored the experiences of graduates of an early intervention/early childhood special education personnel preparation program to gain an understanding of the factors that facilitate implementation of family-centered practices. Results from an online survey and focus groups revealed that the graduates, in general, held positive beliefs about partnering with families, and there were several program components that facilitated the implementation of family-centered practices. Implications are described for advancing the knowledge base about preparing students to work in the field of early intervention.

It takes two: The role of family-centered practices in communication intervention

Based on an ever-growing body of research, family-centered practices are a recommended, evidence-based principle of early childhood intervention provided by speech-language pathologists and audiologists, as well as by all other disciplines involved in providing supports and services to young children with delays and disabilities and their families. Despite this, research also suggests that (1) the concept of family-centered practices is often misunderstood, and (2) a gap continues to exist between recommended and the actual use of family-centered practices across all disciplines. In this article, we describe the evidence behind family-centered practices, how and why family-centered practices have become a key aspect of evidence-based early childhood communication intervention, and the defining characteristics and components of family-centered practices. In order to accomplish this goal the authors did an extensive research review of the literature. As a result of findings from the studies revised, the role of the SLP in early childhood intervention is calling for a shift from direct work with an individual child to teaching, supporting, and building the capacity of the child's communication partners, with the ultimate goal of the child becoming more successful in how he/she participates and communicates in interactions and routines throughout the day and within natural contexts. These recommendations have been incorporated by important scientific and professional organizations such as the American Speech-Language-Hearing Association in their guidelines for providing early evidence-based communication intervention. Concluding we underlined the importance of viewing family centered practices as a capacity-building endeavor required for quality EI practices.

Atención temprana y prácticas centradas en la familia: a propósito de un caso

Scientific evidence demonstrates in Early Intervention the effectiveness and efficiency of family-centered practices and natural environments. Interventions with children who have a disability or are at a risk should allow participation of families and/or teachers. The practices must generate skills in the child's caregivers to promote the development of their usual routines and contexts. This paper presents the analysis of a case that exemplifies how the theoretical aspects can be transferred to the sphere of daily practice.We use de Routines Based Model to shown the intervention. The Individual Family Support Plan describes the service: Initial assessment, functional objectives, intervention plan and monitoring. As a result of the intervention, we can see the improvement in the functional development and we observe the family and the teacher feel more competent, empowered and better family quality of family life. The importance of transdisciplinary work, collaboration between different social agents and the undisputed role of the family throughout the process is reflected.

Perspectiva de las prácticas de atención temprana centradas en la familia desde la logopedia

In Spain, in recent years, early intervention is undergoing a process of transformation. Experiences begin to be known that are making the transition from a model of outpatient intervention, clinical, focused primarily on the child; towards one more social, where the family and the environment are particularly relevant and prominent.In this process of change, speech therapists play an important role. On the one hand, by the mere fact of being an integral part of the intervention teams. On the other, being responsible for ensuring the development of core competencies in the development of the child as is communication, speech and language.It is therefore necessary to carry out a reflection on how this transformation is occurring in services, what it means, and how it should be assumed by speech therapists.This article defines the concept of family-centered in Early Care Practices, outlines the key elements that have driven it since its inception, and it also reviews components that characterize and differentiate it from other practices that may also include family involvement. From all this, the importance of the speech therapist in transdisciplinary early intervention teams, where they must develop family-centered practices, is highlighted.