Features of the Parent to Parent Service Coordination Model for Preschool Children with ASD in Hartford* • Families of Children with Autism Spectrum Disorder • Living in a High Poverty Environment • Parent to Parent Service Delivery Model • Service Coordination • Measures of Effectiveness Using a Logic Model Framework * Grant funded by MCHB to UCHC
Household income • Hartford Median Income: $29,107 • Connecticut Median Income: $69,243 Less than Less than Hartford Connecticut $15,000 $15,000 $15,000 to $15,000 to $24,999 $24,999 $25,000 to $25,000 to $34,999 $34,999 $35,000 to $35,000 to $49,999 $49,999 $50,000 to $50,000 to $74,999 $74,999 $75,000 to $75,000 to $99,999 $99,999 $100,000 $100,000 or more or more
Race and Ethnicity White White Race (Hartford) Race (Connecticut) Black Black American Indian and American Indian and Alaska Native Alaska Native Asian Asian Native Hawaiian and Native Hawaiian and Other Pacific Islander Other Pacific Islander Two or more Races Two or more Races Other Other Ethnicity (Hartford) Ethnicity (Connecticut) Hispanic or Latino (of any race) Hispanic or Latino (of any race) Not Hispanic or Latino Not Hispanic or Latino
Evidence Base for Parent to Parent • Parents can train other Parents on Teaching Their Children Skills( Bruder & Bricker 1984; Bruder,1987) • Parent to Parent Programs Serve a Variety of Types of Families and Provide Emotional Support and Informational Support (Santelli, Turnbull, Marquis, & Lerner, 1995;Santelli, Turnbull, Sergeant, et. al, 1996; Santelli, Turnbull, Marquis, & Lerner, 1997). • Random Control Study Found Differences in Families who Received Parent to Parent Support VS Delayed Treatment Group: cognitive adaptation; coping ( Singer et al, 1999)
Program Features of Parent to Parent • Parent of a Child • Veteran Parent of a Child with Similar Needs • Training of Veteran Parent on Skills: Communication Resources Problem Solving Referral • System Of Matching and Supervising Parents
Evidence Base for Service Coordination • No Evidence for Child or Family Outcomes Improved as a Result of Service Coordination as a Program Feature (Bruder & Dunst, 2006; Dunst & Bruder, 2006) • Research and Training Center Examines and Proposes Second Generational Research Model (Bruder, Harbin, Whitbread, Conn-Powers, Roberts, Dunst, Van Buren, Mazzarella, & Gabbard, 2005).
Service Coordination Activities ( Part C) • Coordinate the Performance of Evaluation and Assessments • Coordinate with Health and Medical Providers • Facilitating and Participating in the Development, Review, and Evaluation of IFSPs • Assisting Families in Identifying Available Service Providers • Coordinating and Monitoring the Delivery of Available Services • Informing Families of the Availability of Advocacy Services • Facilitating the Development of a Transition Plan to Preschool Services, if Appropriate (C.F.R. § 303.302(d))
Outcome Comparisons INTERVIEW OUTCOMES DEPHI OUTCOMES SURVEY OUTCOMES SYSTEM Children will have successful Children have successful System Coordination transitions. transitions. Children and Families receive early Children and families receive Family-Centered Practices intervention services that are appropriate supports and service individualized, coordinated and s that meet their individual effective. needs. People work together as a team Teaming Families are involved in decision making. FAMILY Families make informed decisions Families are involved in decision Family Support and Resources about services and opportunities in making. the community for their children Families are informed about Information and Referral with a disability. resources and services. Families acquire and/or maintain a quality of life that enhances their Quality of Life well-being. Family Support and Resources Families are self-sufficient. Quality of Life Families are knowledgeable of their child’s disability. Families are satisfied? Family Satisfaction CHILD Children’s development is enhanced. Ch ildren’s development is enhanced. Children are safe and healthy. Children are healthy.
Service Coordination Practices • Helpgiving • Collaborations • Administrative Tasks
Helpgiving Practices (Dunst &Trivette, 2009) • Relational : behaviors such as active listening, compassion, empathy, etc. and positive practitioner attributions about help- receiver capabilities • Participatory: behaviors that involve help-receiver choice and decision making, and which meaningfully involve participants in actively obtaining desired resources or supports, or achieving desired life goals.
Service Coordination Outcomes IF • Agencies and professionals are coordinated • Families have access to support, information and education to address their individual needs • Families are able to communicate the needs of their child • Families make informed decisions about services, resources and opportunities for their child • Children and families receive quality services THEN • Families acquire and/or maintain a quality of life to enhance their well being • Families meet the special needs of their child • Children ’ s health and development is enhanced in the following areas: social emotional skills and relationships acquiring and using knowledge and skills using appropriate behaviors to meet their needs
Outcomes Inputs Output Activities Immediate Distal Impact Families acquire and/or maintain a quality of life to enhance their well being Children and families Families meet participate in the special supports and needs of their services that are child coordinated, effective and individualized to their needs Children ’ s health and development is enhanced
Resulting Model Comprised Of: • Checklists for Each Service Coordination Activity Which Embeds Practice Categories • Outcomes Which Were Adopted and Refined by OSEP for All Infants, Toddlers and Preschoolers Receiving Early Intervention
Initial Intake Checklist Name: / x Notes The service coordinator will: Share information about: Early intervention philosophy The statewide early intervention system including eligibility criteria for children The difference between assessment for evaluation and ongoing assessment The role of the family in the assessment process Procedural safeguards and family rights Confidentiality policies and practices Gather information from the family about: Family background, ethnicity and language preference Family structure and composition Child health and development status and history Family resources, concerns and priorities Other agencies and professionals involved with the child Their child ’ s reaction to strangers (e.g., the interventionist)
/ x Notes The service coordinator will: Collaborate to: Identify methods of sharing information with others, including the family Perform administrative tasks such as: Get parent permission for the child ’ s evaluation/assessment Complete and submit to system releases for information Complete and submit to system reimbursement information, if needed (insurance, Medicaid, family payment) Get and share with the early intervention evaluators records and past assessments on the child Gather information about the child ’ s disability Get parent permission to store data Send a letter of acknowledgement about the family to the referral sources including the medical home
Parent to Parent Service Coordination for Preschool Children with ASD in Hartford Culturally Compatible Parents who have a Child with ASD, Provide Service Coordination using Checklists of Practices, And Research Team Collect Data on Measures Of Effectiveness Using Logic Model
Intervention (Independent Variable) Identification and Minimal Training Of Veteran Parents Use of Activity Checklists Supervision of Veteran Parent
Service Coordination Process SC searches Toolkit and Family asks SC a Curriculum for question information and /or asks Project staff Project staff and SC search Family and SC IDEA.gov, CT SDE website to review outcome find an answer (SC learns of plan about resources she can then share with families) SC responds to SC and family family with develop a plan to answer, shares address issue resources
Dependent Variables Match Logic Model • Families Acquired and Maintain a Quality of Life Family Professional Partnership Family Quality of Life (Beach Center) • Families Meet the Special Needs of Their Child Family Outcomes Survey IEP Observation Medical Visit Observation • Childrens ’ Health and Development is Enhanced IEP Quality Medical Home Index Services Inventory Battelle Developmental Inventory
Pre-Treatment Child Characteristics • 3- to 5-year old children with ASD • Mean =47 months • 83% male • Battelle Developmental Index • Mean = 32 months • Sub-Scale Age Equivalence • Adult Interaction – M = 18 months • Peer Interaction – M = 26 months • Self Concept – M = 18 months
Enrollment • Completed Time 1 (pre-treatment) • N = 42 • Completed Time 2 (6-month) • N = 28 • Completed Time 3 (12-month post-treatment) • N < 10
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