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Education and Training in Developmental Disabilities, 2009, 44(4), 453-470© Division on Developmental Disabilities

Impacts of Family Support in Early ChildhoodIntervention Research

Anna C. FriendPittsburg State University

Jean Ann Summers andAnn P. TurnbullUniversity of Kansas

Abstract: The purpose of this paper is to review intervention research to determine the types offamily support thatare reported and evaluated in early childhood. This review includes 26 articles evaluating (a) parent trainingprograms; (b) general family-centered practice models which offer comprehensive supports; (c) peer support;(d) two-generation programs; and (e) respite care. In the article, we focus our discussion on: (a) the definitionsor description of family support, (b) the family variables or impacts evaluated and their findings, and (c) thelink between support and impacts to both the ECO outcomes and the family quality of life domains. This reviewindicates a need for specific and consistent terminology in defining family support in the early intervention field.Further, a family support framework to guide future research to investigate both long-term and short-termoutcomes for families is warranted.

Over the past decade, early interventionistshave recognized that working with families ina broader scope by providing supports to fam-ilies and children impacts not only the child'sdevelopment, but the family's ability to helpthe child grow and develop (Bailey et al.,1998; Bailey & Bruder, 2005; Sandall, Hem-meter, Smith, & McLean, 2005). Further, thestatutory underlying premise of early interven-tion services for children with disabilities is "toenhance the capacity of families to meet thespecial needs of their infants and toddlerswith disabilities" (Individuals with DisabilitiesEducation Act Amendments of 2004, Title I,Part C, Sec. 631 (a) (4)), thus strengtheningthe role of the family as the primary caregiver.

Family-centered practice is defined usingtwo primary facets. The first facet is the part-nerships that are developed between profes-sionals and parents that culminate in empow-ering the family to make decisions for theirchild (Allen & Petr, 1996; Bailey et al., 1998;Mahoney et al., 1999; Turnbull, Turbiville, &Turnbull, 2000). The second facet specifiesthat the family itself is a recipient of supportsfor two reasons: because it helps children

Correspondence concerning this article shouldbe addressed to Anna Friend, 2900 West 51st Street,Westwood, KS 66205.

grow and learn and because families are im-pacted by their child's disability and are inneed of supports in their own right (Allen &Petr, 1996; Mahoney et al., 1999; Poston et al.,2003). (We are using the term, family support,to refer to assistance provided through formalsystems (e.g., early intervention programs)and informal networks (e.g., peer support).This article focuses on the nature of familysupport as contrasted to the nature of partner-ships between professionals and parents).This second facet of family-centered services isthe focus of this paper.

The family as a recipient of support hasreceived less emphasis than the relationshipfacet of family-centered practice. In an analy-sis of early intervention literature, familychoice and family strengths perspectives havedominated the literature in comparison withthe delivery of support to the family (Epley,2006). In 25 articles, definitions included thefamily as a unit of attention only 60% of thetime; while 88% of the articles identified howto provide support to families, only 42% iden-tified what types of support should be pro-vided to families in early intervention. Al-though position papers and commentary haveremained strong in advocating the impor-tance of establishing partnerships with fami-lies and maintaining empowering relation-

Impacts of Family Support / 453

ships-the how of early intervention-therehas been relatively less emphasis on the wholefamily as a unit of attention (Epley), and morespecifically, on the delivery of support to fam-ilies to "enhance their capacity", as the lawputs it.

An understanding of the types of support,both formal and informal, families receive isparticularly important due to recent efforts todevelop outcome measures related to chil-dren and families in early intervention* andearly childhood special education. In 2005,the Early Childhood Outcome (ECO) Centerrecommended five family outcomes that ap-ply to early intervention and early childhoodeducation. The ECO Center defines familyoutcome as "a benefit experienced as a resultof services received" (Bailey & Bruder, 2005).The five outcomes are (a) families under-stand their children's strengths, abilities andspecial needs, (b) families know their rightsand advocate effectively for their children,(c) families help their children learn andgrow, (d) families have support systems, and(e) families are able to gain access to desiredservices, programs, and activities in their com-munity (Bailey et al., 2006).

Another more long-term outcome of thesespecific ECO outcomes is family quality oflife (Summers et al., 2005). Family quality oflife is a condition in which family needs arebeing met, family members enjoy their lifetogether and have an opportunity to partici-pate in the activities that are important tothem (Park et al., 2003). Based on psychomet-ric studies, family quality of life is comprisedof five domains: family interaction, parenting,emotional well-being, physical/material well-being, and disability-related support (Hoff-man, Marquis, Poston, Summers, & Turnbull,2006). The Beach Center on Disability definesfamily outcomes as either positive or negativeimpacts that families may experience as a re-sult of supports and services for themselvesand/or their children with disabilities (Man-nan, Summer, Turnbull, & Poston, 2006)which can be measured using the family qual-ity of life domains. However, in addition toassessing family outcomes, it is critical to de-termine what specific support families are re-ceiving in order to link those services to theproposed outcomes.

An understanding of the specific services

that are linked to family outcomes might befound in the Individuals with Disabilities Ed-ucation Act (IDEA). Part C of IDEA governsthe manner in which infants and toddlers withdisabilities and their families receive educa-tional services from public agencies. Early in-tervention services are defined as "develop-mental services that are designed to meet thedevelopmental needs of an infant or toddlerwith a disability, as identified by the indiviclu-alized family service plan team" (Individualswith Disabilities Education Act Amendmentsof 2004, Title 20, Part C, Sec. 1432(4)(C)).The family support included on the IFSPshould promote physical, cognitive, communi-cation, social/emotional, and adaptive devel-opment of the child. Within the statute, thefollowing developmental services are listed:family training, counseling and home visits;special instruction; speech-language pathol-ogy and audiology services and sign languageand cued sign language services; occupationaltherapy; physical therapy; psychological ser-vices; service coordination services; medicalservices only for diagnostic or evaluation putr-poses; early identification, screening, and as-sessment services; health services necessary toenable the infant or toddler to benefit fromthe other early intervention services; socialwork services; vision services; assistive technol-ogy devices and assistive technology services;and transportation and related costs that arenecessary to enable an infant or toddler andthe infant's or toddler's family to receive oneof these services (Individuals with DisabilitiesEducation Act Amendments of 2004, Title I,Part C, Sec. 1432(4)(E)).

However, it is not clear just what this list ofservices means in terms of what specific sup-port is delivered to families, as opposed tochild-oriented services. Further concern israised by a review of data concerning types offamily support on IFSPs. In reviewing datareported by states regarding the number andpercentage of early intervention services re-ported on IFSPs for children ages 0-2 underPart C of IDEA, family support has been on adownward trend over the past decade (Dana-her & Armijo, 2005). For example, familytraining, counseling and home visits; healthservices; medical services; respite care; socialwork services; and transportation are early in-tervention services that have decreased in

454 / Education and Training in Developmental Disabilities-December 2009

numbers as reported by IFSP data (Danaher &Armijo). The exceptions to this appear to beservices that are child-focused, including oc-cUpational therapy, physical therapy, specialinstruction and speech and language pathol-ogy, which are remaining consistent or in-creasing in number (Danaher & Armijo).However, problems with this data set indicatethat states and local programs may be definingthese services differently, and family supportmay be occurring in the context of other de-fined services (J. Hurth, personal communica-tion,JanUary 23, 2006). It is not clear whetherthese findings indicate an actual decline inemphasis or amounts of support provided tofamilies. It is possible that early intervention-ists are serving families in a variety of ways thatare not captured in the data. Also, it may bethat definitions of family support are not con-sistent with the actual types of support families

are receiving.Another possible source of insight into the

types of support families receive in the contextof early intervention might be found in liter-ature describing and evaluating early child-hood service models. Intervention researchmay include descriptions of types of familysupport and related outcomes of this support.The purpose of this paper is to focus on inter-vention research and evaluation to determinethe types of family support that are reportedand evaluated in descriptions of early child-hood intervention research. The specific ques-tions guiding this literature review were:

1. What types of family-related support areincluded in evaluations of early interven-tion programs?

2. How are families impacted by the provi-

sion of family support?3. What specific family outcomes appear to

be related to these family impacts?

Method

We conducted a literature search for interven-tion studies in the field of early interventionand early childhood, including programs de-signed both specifically for families and chil-dren with disabilities and for families and chil-dren considered "at risk" for disabilities (e.g.,programs serving low-income families or ado-lescent parents). "At risk" children and fami-

lies were included in the population for thispaper because there were a limited number ofintervention research articles devoted only tofamilies and children with disabilities in earlyintervention. Therefore, the investigator ex-panded the search to include the "at risk"population to provide insight into more typesof family-oriented services in the early inter-vention field.

The literature search used the following de-scriptors to capture the population of interest:early intervention, early childhood, preschool,infant and toddlers, families and disabilities.The search included the following key words:family outcomes, family services and supports,family centered services, family interaction,parent training, parent to parent, parentalstress, parental depression, parent education,respite care, routines-based intervention,home visiting, family counseling, relationshipintervention, advocacy, social supports, andsupport groups. The search also included spe-cific names of authors known as investigatorsof family issues in the field, e.g., Bailey,Bruder, Dunst, McWilliam, Kaiser, Fewell, Ma-honey, Ramey, and Singer. These key words,author names, and descriptors were used tosearch five primary databases: Psych-INFO,PubMed, ERIC, Educational Abstracts, andWilson Web. Further, we searched websites ofspecific national organizations in the field ofearly intervention to identify interventionstudies. Those websites included Parents asTeachers (PAT), Early Childhood OutcomesConsortium (ECO), Division of Early Child-hood (DEC), Office of Special Education(OSEP), Administration of Children and Fam-ilies (ACF), National Early Childhood Techni-cal Assistance Center (NECTAC), and theNational Association of Councils of Develop-mental Disabilities (NACDD).

Studies selected for this article were limitedto those published within the last decade fromthe date of the first search in 2005. Studiesincluded in this paper used randomized con-trolled designs, meta-analyses, longitudinaldesigns, quasi-experimental designs, pilotstudies, pretest/posttest experimental de-signs, path analysis, and correlation designs.Literature reviews and meta-analyses were in-cluded, especially in the case of research eval-uations with a very large literature base (suchas home visiting programs). Studies that inves-


tigated the effectiveness of commercially avail-able programs and materials were excluded.Articles were collected from literature acrossall disability-related disciplines, but did notinclude those studies narrowly focused on spe-cific services listed in IDEA that are child fo-cused, such as speech, OT, PT, special instruc-tion and assessment or diagnostic testing. Theintervention studies were restricted to familiesand children from the ages of birth to 8, withthe exception of the intervention studies re-garding respite care and peer support whichreflect families and children with develop-mental disabilities of all ages. The reason forthis exception was that we were not able tolocate studies on respite care or peer supportthat were focused on the early childhood agerange. Some of the programs reviewed wereevaluations that were specifically focused onfamily support, e.g., respite care and peer sup-

ports (Parent to Parent); the majority, how-ever, were general early childhood interven-tions that included some family supportcomponent in the context of providing inter-ventions for children. Since the focus of thispaper was to identify and define the types ofsupport to families that are typically includedin such early childhood interventions, thesestudies were of particular interest.

The articles collected based on the abovecriteria were included in the final reviewbased upon three stipulations. First, the articleneeded to have specified a clear interventionor interventions related to the area of earlychildhood that was "tested" through an empir-ical research design. Second, at least one as-pect of the intervention needed to target par-ents or family members. Third, the results ofthe intervention research needed a compo-nent of measurement regarding how the par-ents or family members responded to the in-tervention in question. Based on all, weincluded a total of 26 articles in this review.

Results

Table I presents a synthesis of these 26 arti-cles. The intervention studies reflect inter-vention models including studies of supportfor families that were part of evaluations of:(a) parent training programs; (b) generalfamily-centered practice models which offercomprehensive support, which may include

counseling, parenting skills, respite care,and/or support groups; (c) peer supports;(d) two- generation programs; and (e) respitecare. The following sections sUtmmarize thefinrdings of this review related to each of thesetypes of family support. The columns in Ta-ble 1 describe the type of family support pro-vided, a brief summary of results pertainingto families, our judgment of the specific familyoutcomes represented in the study in termsof both ECO Center and FQOL family out-comes, and the reference. Because of thefocus on family support in this article, weomitted descriptions of specific child mea-surements, results, and outcomes.

In each of the following sections we willdiscuss the three primary questions for thisreview: (a) the definitions or descriptions ofthe types of support families receive, (b) thetypes of family variables or impacts includedin the research or evaluation design and theirfindings, and (c) a categorization of the linkof these types of supports and impacts to boththe ECO outcomes and the family quality oflife (FQOL) domains as indicated by the re-suits of the evaltation.

Parent Training Programs

Parent training programs encompass inter-vention research that is specifically focused onproviding parent training to improve interac-tions between parents and their children. Theintervention studies in Table I were focusedon specific areas of parent education and/or aspecific population: family-infant interactionand home environment (Bakermans-Kranen-burg, van ljzencloorn, & Bradley, 2005); fatherempowerment to improve parenting (Fagan &Stevenson, 2002); home-based parent trainingprogram and support group (Kucuker, 2006);skill-building groups to improve parental well-being and family interaction (Niccols & Mo-hamed, 2000); parent management trainingto reduce behavior problems (Roberts, Maz-zucChelli, Taylor, & Reid, 2003); Parents AsTeachers programs (Wagner & Spiker, June2001); and deaf mentor program for parentsto improve interactions with their childrenwho are deaf (Watkins, Pittman, & Walden,1998). Some of these interventions were of-fered in the context of a home visiting model,while others were provided in group settings.


TABLE 1

Family Support Identified in the Intervention Literature

References/Support Jdentified Results Outcomes

Bakerinans-Kranenburg,M. J., van ljzendoorn,M. H., & Bradley,R. H. (2005)

Meta-analysis of earlychildhood interventionstudies aimed atparenting or parent-child interaction usingthe HOME assessment.(U.S. & international)

Fagan, J., & Stevenson,H. C. (2002)

Parent training forfathers.

Kucuker, S. (2006)Early intervention

program, to enhancethe development ofchildren withdisabilities ages 0-4through a parenttraining program(Turkey)

Niccols, A., & Mohamed, S.(2000)

Parenting skill buildinggroup focused onattachment theory forparents of infants withdevelopmental delays

,tervention mode: Parent trainimng and information prograis1. Interventions with middle-class, non-

adolescent parents reported higher effectsizes than interventions with low-SES oradolescent parents.

2. Five to 16 home-based interventionsessions in a limited period were mosteffective.

3. Interventions starting when the child wasolder than 6 months or started prenatallywere more effective than interventionsstarting in the first 6 months of thechild's life.

1. Resident fathers (those who live at home)in the parent training group reportedsignificantly greater self-esteem at the endof the intervention in comparison toresident fathers in the control group.

2. Resident fathers in the parent traininggroup showed significant improvement inparenting satisfaction in comparison toresident fathers in the control group.

3. All fathers in the parent training groupmade significantly greater gains thanfathers in the control group in theirattitudes about facilitating the teaching-learning process for their child.

1. The severity of depression scores for bothmothers and fathers had decreased afterparticipating in the early interventionprogram with parent training.

2. There were no differences reported inparental stress scores.

1. Parents in the skill-building groupreported statistically significant lowerlevels of parent-child dysfunctionalinteraction, parental distress, anddepression.

2. Parents in the comparison groups showeda trend towards increased depression.

3. Parents in the skill-building groupreported high satisfaction, higheffectiveness of the content, and increasedsupport from others.

4. The majority of parents in the skill-building group (75%) chose consultationas their preferred follow-tip serviceoption.


ECO outcomes* Families help their

child learn and growFQOL Outcomes* Parenting

ECO outcomes"* Families help their

child learn and grow"* Families have support

systemsFQOL Outcomes"* Parenting"* Emotional well-being

EGO outcomes"* Families help their

child learn and grow"* Families have support

systemsFQOL Outcomes"* Parenting"* Emotional well-being

ECO outcomes"* Families understand

their child's strengths,abilities and specialneeds

"* Families help theirchild learn and grow

"* Families have supportsystems

FQOL Outcomes"* Parenting"* Emotional well-being

TABLE l-(Continued)

References/Support Identified Results Outcomes

Roberts, C. et al. (2003)Parent management

training-review ofstudies for parents ofpreschool-agedchildren withdevelopmentaldisabilities (U.S. &international)

Wagner, M., & Spiker, D.(June 2001)

Evaluation of Parents asTeachers (PAT)-home visiting model

Watkins, S. et al. (1998)Parent mentor groups

1. Comprehensive early intervention programsaimed at skill building through AppliedBehavior Analysis, Parent Management

ECO outcomes0 Families help their child

learn and grow

Training, and social learning theory have FQOL Outcomesdemonstrated positive outcomes for building • Parentingcompetencies and reducing behavior problems. * Emotional well-being

2. Studies using a group intervention format ofPMT indicated some positive effects on childbehavior, parental stess, parental self-efficacy,and marital satisfaction.

3. Studies with individual families indicate somesupport for generalization of effects to othersettings and behaviors.

1. The very low income group had more positive ECO outcomeseffects than the moderate income group in the 0 Families help their childarea of language and literacy promoting learn and growbehaviors. FQOL Outcomes

2. PAT families reported being happier taking 0 Parentingcare of their families. * Emotional well-being

3. After three years, PAT teen mothers had moreknowledge, greater literacy promoting behaviorson HOME, less reports of child maltreatment,and increased positive home environmentcompared to the control group.

1. Parents of the children in the deaf mentor ECO outcomesgroup reported that they understood what the • Families understand theirchild was communicating to them a greater child's strengths, abilitiespercentage of the time than parents in the and special needscontrol group. FQOL Outcomes

2. Parents in the deaf mentor group reported that • Parentingtheir children understood them a greater • Disability-related supportpercentage of the time than the parents of thecontrol group.

3. Parents in the deaf mentor group reported lessfrustration and increased number of signs whencommunicating with their child.

4. During the intervention, parents in the deafmentor group were observed in videotapedsessions to use more ASL.

5. Parents in the deaf mentor group reportedperceptions more consistent with the deafculture and deaf community.

ýT)Pe-oiýntei-vention-n-odelC.eiGeral family centered practice models--usually oflering coiprehensive support;n

includes some .proqngiS that focus pimarily oni the child but include evaluations of impacts on familiesDunst, C.J. et al. (2001) 1. Participation in a larger variety of activity ECO outtcomes

Natural learning settings was related to parents reporting that * Families help their childenvironments they engaged their children in more learning learn and grow

activities. FQOL Outcomes2. The greater adoption and use of the responsive • Family interaction

teaching methods by parents, the more the 0 Parentingchildren were observed interacting with adults.

3. Greater adoption and use of the responsiveteaching methods by parents were related toenhanced positive child affect.


TABLE 1-(Continued)


Erickson-Warfield, M. E. etal. (2000)

Parent support groupsIntensity of services

provided to children

Hendriks, A. H. C. et al.(2000)

Family-directedintervention which mayinclude family supportgroups, counseling andrespite care (TheNetherlands)

Kim,J. M. & Mahoney, G.(2003)

Impact of relationship-focused interventionon Korean mothersand their preschool-aged children withdisabilities (Korea)

Mahoney, G., & Bella, J. M.Family-centered practice

model involving anarray of familysupports

Mahoney, G. & Perales, F.(2005)

Relationship-focusedearly intervention-twostudies

1. The greatest change between entry anddischarge of El was increased socialsupport networks, both formal andinformal.

2. More intense service (total hours ofservice) was significantly and positivelycorrelated with increased family cohesion.

3. More intensive parent support groupservices and more intensive child groupservices were significant predictors ofincreased social support.

4. The greater number of different servicesprovided resulted in more parent-reported gains in social supporthelpfulness.

5. Maternal education impacted serviceintensity and comprehensiveness ofservices.

1. On average, both mother and fatherperceived a positive change in well-being10 months after participating in theprogram.

2. Mothers perceived a greater positivechange in well-being than fathers.

1. Mothers in the relationship-focusedintervention group scored significantlyhigher on measures of responsiveness,affect, and achievement orientation.

2. Overall, relationship-focused interventionreduced parental stress.

1. There was no overall change on theFamily Environment Scales.

2. There were marginal changes in maternalstress.

3. Although there was no overall change inmaternal affective styles, enjoyment andexpressiveness significantly decreasedduring intervention.

4. Approximately 45% of families reportedreceiving a comprehensive array of familyservices, which were characterized byextremely high levels of services relatedto their child's development andmoderate levels of services related tofamily-level concerns.

1. Mothers who used responsive teachingmade significant increases inresponsiveness to their children.

ECO outcomes"* Families help their child

learn and grow"* Families have support

systems"* Families are able to gain

access to desired services,programs, and activitiesin their community

FQOL Outcomes"* Family interaction"* Emotional well-being"* Disability-related support

ECO outcomes* Families have support

systemsFQOL Outcomes* Emotional well-being

ECO outcomes* Families help their child

learn and growFQOL Outcomes"* Parenting"* Emotional well-being

ECO outcomes"• Families help their child

learn and grow"* Families have support



FQOL Outcomes"* Family interaction"* Emotional well-being"* Disability-related support

ECO outcomes* Families help their child

learn and growFQOL Outcomes"* Family interaction"* Parenting


TABLE 1-(Cantinued)

References/Suppoit IdenVtifed Results Outcomes

Trivette, C. M., Dunst, C. J.,Boyd, K, & Hamby,D. W. (1995)

Family-centered services,using supports to helpfamilies accessinformal supports.

Ainbider, J. C. et al. (1998)

Qualitative analysis ofParent to Parentprograms throughinterviews with 24parents

Ireys, H. T. et al. (1996)Social support

intervention formothers of childrenwith JuvenileRheumatoid Arthritis(ages 2-11). The socialsupport interventionwas a one-to-onementoring match ofmothers of childrenwith JRA.

Rosenberg, S. A. et al.(2002)

Comparison of nursehome visiting model tohome visiting modelwith trainedparaprofessionals, whoare all mothers ofchildren with specialhealth care needs

1. Helpgivers from more family-centeredprograms who had more frequent contactwith families reported more positiveassessments of helpgiving practices.

2. Participation in family-centered programsin which parents had frequent contact% withhelpgivers using empowering helpgivingpractices was associated with greaterindication of personal control.

_Tpe of intervention model: peer support1. Parent to Parent support is particularly

helpful when reliable allies have the fourcomponents: (a) perceived sameness,(b) comparable situations for learningrelevant skills and gathering usefulinformation, (c) availability of support, and(d) Mutuality of support.

2. Some parents did not find their experiencewith Parent to Parent to be helpfil, butexpressed belief in the value of parentconnections.

3. Barriers to unsuccessful matches includedlogistics in connecting due to business, costfor phone bills, lost numbers, or negligentfollow-up. Barriers also included differencesin preferences and values regardingparenting style, communication style,outlook on disability and future vision forthe children.

1. The mothers receiving 1:1 mentoringreported a decrease in mental healthsymptoms compared to the control group.Mental health symptoms includeddepression, anxiety, anger, and cognitivedisturbance.

2. The mothers receiving 1:1 mentoringreported greater improvements onperceived availability of supports than thosemothers in the control group.

1. Both groups believed the services theyreceived were helpful. The families whoreceived visits from the paraprofessionalswere significantly more positive about theirexperience.

2. Families who received services from aparaprofessional indicated they learnedmore about how to obtain medical andtherapy services than the nurse homevisiting group.

3. Both groups of mothers showed significantimprovement on qualities of care givingand home environment, as well asemployment status.

ECO outcomes"* Families know their

rights and advocateeffectively for theirchildren

"* Families are able to gainaccess to desired services,programs, and activitiesin their community

FQOL Outcomes* Emotignal well-being*0 Disability-related support

ECO outcomes"* Families have support



FQOL Outcomes"* Emotional well-being"* Disability-related support

ECO outcomes"* Families have support



FQOL Outcomes"* Emotional well-being"* Disability-related support

ECO outcomes"* Families understand their

child's strengths, abilitiesand special needs


"* Families are able to gainaccess to desired services,programs, and activitiesin their community

FQOL Outcomes"* Emotional well-being"* Physical/material well-

being"* Disability-related support


TABLE 1-(Continued)


Singer, G. H. S. et al. 1. Parents who participated in Parent to Parent ECO outcomes(1999) had positive perceptions of their child and * Families have support

Peer support his or her impact on the family, systems2. Initial contacts in Parent to Parent were not 0 Families are able to gain

associated with changes in parents' access to desired services,perceptions of empowerment. programs, and activities

3. Parents who participated in Parent to Parent in their communitymade statistically greater progress than the FQOL Outcomescontrol group in getting help with their 0 Emotional well-beinginitial problem. 0 Disability-related support

4. Eighty-nine percent of the parents whoparticipated in Parent to Parent rated it ashelpful.

[ Type of intervention_model. Two-generation programs ____

Gomby, D. S. et al. (1999) 1. Home-visiting programs may be associated ECO OutcomesEvaluation of home with changes in some parent attitudes, 0 Families help their child

visiting programs using though not necessarily their behaviors that learn and growvarious models; most are related to the prevention of abuse and 0 Families have supportfocused on providing neglect. systemsparent information, 2. Home visiting may be beneficial in 9 Families are able to gainbut also providing decreased child maltreatment, though access to desired services,supports to parents evidence was primarily from self-report programs and activities in

measures. their community3. Only Nurse Home Visiting Program found FQOL Outcomes

benefits in altering maternal life course for 0 Family interactionpoor unmarried women. Women who had 0 Parentingbeen home visited had fewer subsequent * Physical/Material well-pregnancies and births, deferred their beingsecond birth, spent fewer months onwelfare, and had fewer problems resultingfrom substance abuse and arrests than thecontrol group.

Love, J. M. et al. (2002) 1. Families in Early Head Start programs ECO OutcomesTwo-generation measured more positive impacts on 0 Families help their child

intervention model parenting behaviors, and support for learn and growproviding parents' emotional well-being. * Families have supportcomprehensive family 2. The programs led to lower levels of systemssupports for self- insensitivity and hostile parenting behavior 0 Families are able to gainsufficiency and mental and the use of less punitive discipline access to desired services,health; parent training strategies. programs and activities inand child-oriented 3. At age 3, there were no overall impacts on their communityservices. Some measures of parent's health or mental health FQOL Outcomesprograms were home and family functioning. * Family interactionvisiting models, others 4. Overall, results showed continued impacts * Parentingwere center-based; on parent training and education activities 0 Emotional well-beingmost were for families in the program compared to * Physical/Material well-combination, control group families, being

St. Pierre, R. G. et al. 1. Two-generation programs increase the rate ECO Outcomes(1995) of participation for both children and 0 Families help their child

Two generation service parents in social and educational services, learn and growprograms focusing 2. Two-generation programs have positive 0 Families are able to gainsimultaneously on effects on parenting, including time spent access to desired services,improving outcomes with child, parent teaching skills, programs and activities infor families and expectations for child's success, attitudes their communityproviding supports about child rearing and parent-child FQOL Outcomes(usually through interactions. * Family interactionparent training) for 3. Two-generation programs have large positive 0 Parentingchildren, effects on attaining a GED. There are no 0 Emotional well-being

effects on mothers' depression levels, self- 0 Physical/Material well-esteem, and social supports. being

4. There was a positive correlation to theamount of participation and GEDattainment.


TABLE 1-(Continued)


Zeece, P. D. & Wang, A. 1. Over a three-year time span, parent-

(1998) centered risk decreased for the participantsTwo-generational in the Head Start +Family Empowerment

program-Head Start Transition Program.

and the Family 2. There were no significant differences

Empowerment Transition between the two groups regarding familyProgram economic risk over time.

.Type •oftervention,model: Respite care

Chan, J. B. & Sigafoos, J. 1. The use of respite care was associated with

(2001) reduced parental stress, especially forRespite care mothers, in the majority of families who

have children with developmentaldisabilities.

Cowen, P. S. & Reed, D. A. 1. Reported parental stress scores (parent-(2002) child relationship) were significantly lower

Respite care following respite care interventions.2. Following respite care intervention, scores

reporting parents' perception of the child'straits were significantly lower.

Herman, S. E. & Marcenko, 1. Respite care use indirectly effected parental

M. 0. (1997) depression. The quality of care and the

Respite care perception of time the parent has forthemselves were mediating variables.

ECO Outcomes"* Families know their

rights and advocateeffectively for theirchildren

"* Families help their childlearn and grow


"* Families are able to gainaccess to desired services,programs and activities intheir community

FQOL Outcomes"* Parenting"* Emotional well-being"* Physical/Material well-

being

EGO Outcomes"* Families have support


access to desired services,programs and activities intheir community

FQOL Outcomes* Emotional well-beingECO Outcomes"* Families have support



FQOL Outcomes"* Family interaction"* Emotional well-beingECO Outcomes"* Families have support



FQOL Outcomes• Emotional well-being

Only half of the articles included in this sec-tion of Table I were specific to families whohave children with disabilities; the remainderof the articles focused on "at-risk" children

and families. Programs aimed at families ofchildren with disabilities tended to use mea-sures of maternal/parental stress or depres-sion and family interaction; the programs for


"at risk" children and families centered moreon the acquisition of parenting skills and in-volvement with their children.

Effectiveness of parent training programswas typically measured in terms of gains inchild outcomes, e.g., in reductions of behaviorproblems or improved child language and lit-eracy behaviors or other cognitive gains. Im-pacts on parents that were measured includedthe acquisition of parenting skills, parentingstress or depression, and parenting satisfac-tion. In the intervention studies that also mea-sured parents in terms of depression or stresslevels, parents reported reductions of thesevariables (Kucuker, 2006; Niccols & Mo-hamed, 2000; Roberts et al., 2003). Last, ameta-analysis by Bakersman-Kranenburg, vanIjzendoorn and Bradley (2005) revealed that(a) middle-class, non-adolescent parents ben-efited more from early childhood interven-tions than adolescent or low income parents,(b) limited (between 5-16), home-based ses-sions were more effective than interventionswith sessions numbering more than 16, and(c) sessions for families with children eitherolder than six months or during the prenatalstage were more effective than during the firstsix months of a child's life.

Based on the ECO Center family outcomedefinitions, we concluded that interventionsthat improve parenting and reduce stress ordepression are consistent with the ECO familyoutcomes of (a) families understand theirchild's strengths, abilities and special needs,(c) families help their children learn andgrow, and (d) families have support systems.We also concluded that the primary area ofBeach Center family quality of life domainsimpacted by these programs was the Parentingand Emotional Well-Being sub-scales.

General Family-Centered Practice Models

A number of investigators have reported re-sults of evaluations of early intervention pro-grams described as "family-centered" services.These programs may or may not provideservice components specifically targeted toparents (e.g., parent support groups), butinvestigators describe the programs as family-centered in the sense of developing empow-ering partnerships with families in decision-

making and delivering services to childrenwith disabilities (i.e., the how of family-centered practice). Evaluations of studies in-cluded in this review include both those thatidentified specific supports provided to fami-lies and those that did not describe familysupport but did include family impact mea-sures in the evaluation design.

General family-centered practice modelsdescribed in this section included home visit-ing or center-based programs that provided acomponent of family support and collabora-tion (see Table 1). Families in these studiesmay have received a variety of types of familysupport depending on their individual needsand preferences. These included counseling,parenting skills, respite care, and/or supportgroups. Although the interventions may havefocused primarily on outcomes for children,the evaluation of these programs also investi-gated the impact on families. The generaltheme from this group of research studiesindicates that early intervention programsthat provide general family-centered practicesthat focused on relationships between the par-ent and child positively impacted parent-childinteraction and improved family communica-tion and cohesion (Dunst, Bruder, & Trivette,2001; Kim & Mahoney, 2003; Mahoney & Pe-rales, 2003; Mahoney & Perales, 2005). Addi-tionally, the parent's use of responsive teach-ing methods (Dunst et al.) and participationin support groups improved parental emo-tional well-being (Erickson-Warfield, Hauser-Cram, Krauss, Shonkoff, & Upshur, 2000; Ma-honey & Bella, 1998). Lastly, the child'sparticipation or enrollment in an interventionprogram with different types of family sup-port, which included parent training andcounseling, positively impacted parental well-being and family cohesion (Hendriks, DeMoor, Oud, & Savelberg, 2000).

In comparisons of the reported outcomesfrom these studies, we concluded that family-centered early intervention programs thatprovided an array of family support achieved anumber of the ECO outcomes for families.These included (c) families help their childgrow and learn; (d) families have support sys-tems; and (e) families have access to desiredservices, programs and activities in their com-munity. With respect to family quality of lifedomains, we concluded that the outcomes re-


ported were most relevant to Emotional Well-being, Parenting, and Family Interaction.

Peer Su4port

Peer support offers a way for people in similarcircumstances to offer each other emotionaland informational supports, as well as otherself-help. For families of young children withdisabilities or at-risk for disabilities, parentsmay be offered one-to-one peer support or

parent support groups as a component of theoverall early intervention program. Supportgroups also may be offered for siblings of achild with a disability or for other extendedfamily members such as grandparents. Wewere unable to find recent specific researchfocusing exclusively on the impact of supportgroups on families, but there were overall eval-uations of the general family-centered pro-grams which included support groups, whichwere discussed above. In this section, we dis-cuss two types of peer support models forwhich there is evaluation research available,the Parent to Parent model (Ainbinder et al.,1998; Singer et al., 1999) and one-to-one peermentoring programs (Ireys, Sills, Kolodner, &Walsh, 1996; Rosenberg, Robinson, & Fryer,2002).

Parent to Parent groups match trained par-ents with parents who request assistance (Ain-binder et al., 1998; Singer et al., 1999). Parentto Parent organizations provide parents withconnection to resources and services in theircommunity, emotional support, and practicalinformation about caring for a child with adisability (Ainbinder et al.; Singer et al.).Singer et al. evaluated Parent to Parent men-toring programs in multiple sites across fivestates. As a smaller component of the largerstudy, Ainbinder et al. conducted a qualitativeevaluation of Parent to Parent programs byinterviewing 24 parents. The majority of thefamilies participating in these two studies wasCaucasian and married. The children with dis-abilities ranged in ages from one to 16, withan average age of seven. The population forthis group of studies was expanded to includechildren beyond the age of eight, as we foundno peer support intervention studies that fo-cused exclusively on the early childhood pop-ulation.

The evaluation studies of one-to-one peer

mentoring programs were similar in that men-toring services were provided by mothers,mothers of children with Juvenile Rheuma-toid Arthritis (Ireys et al., 1996) or mothers of

children with special needs (Rosenberg eL al.,2002). The study by Rosenberg et al. evalu-ated home visiting services delivered to fam-ilies considered to be in an at-risk situationdue to environmental or caregiving factors.The services were delivered by trained para-professionals who were all mothers of chil-

dren with special needs and were recruitedfrom the neighborhoods in which they pro-vided services. The families received two

visits per month and the visits focused on

building family strengths, identifying needs,assisting with accessing services and sup-ports within the community, and providinga parent mentor to guide maternal careand home safety issues (Rosenberg et al.).The mentoring program evaluated by Ireyset al. (1996) focused on enhancing threetypes of social support-informational, affir-mational, and emotional support. Mothersin the intervention group were in contactwith their peer mentor every two weeks viatelephone, through home visits held every 6weeks, and at group events, such as picnicsor group lunches (Ireys et al.).

The multi-site Parent to Parent study re-

ported that peer supports had a significantimpact on attitudes regarding acceptance offamily and disability; however, contacts withthe organization did not change parents' per-

ception of empowerment (Singer et al., 1999).Further, successful matches were contingentupon equality and mutuality in their Parent toParent relationships (Ainbinder et al., 1998).The evaluation of the home visiting model

using peers as paraprofessionals reported im-provement for families in care giving skills,

home environment, and employment status(Rosenberg et al., 2002). One-to-one peer

mentoring also decreased the number of re-

ported mental health symptoms mothers ex-perienced (Ireys et al., 1996). Additionally,families who received support from other par-ents who have children with special needsmade greater progress in getting help with

their disability-related problems than parentsdid on their own (Ireys et al.; Rosenberg et al.;Singer et al.). Overall, participants rated the


programs with peer support as helpful(Rosenberg et al.; Singer et al.).

In comparing these findings to definitionsof the ECO Center family outcomes, we con-cluded that peer support programs typicallyoffer families (a) information to understandtheir children's strengths, abilities and specialneeds, (d) support systems, and (e) informa-tion to gain access to desired services, pro-grams, and activities in their community. Theoutcomes reported in these peer supportstudies also appear to be relevant to thefamily quality of life domains of Emotional andPhysical/Material Well-Being and Disability-Related Support.

Two-Generation Programs

The term "two-generation programs" arisesfrom the theory that long-term improvementsin outcomes for children from families withmultiple challenges requires a comprehensiveand intensive array of services that are focusedsimultaneously on interventions for the childand on supports for the family as a whole(St. Pierre, Layzer, & Barnes, 1995). With re-spect to the family enhancement componentof two-generation programs, these servicesgenerally involve the development of an indi-vidualized family support plan to help parentsreach goals in education (e.g., completing aGED or learning English), self-sufficiency,mental health (e.g., accessing substance abusetreatment or shelter from domestic violence),and health and nutrition. A part of the childenhancement component of two-generationprograms also typically includes parent train-ing and information, using group and/orhome visiting approaches (Love et al., 2002).The desired outcomes of two-generation pro-grams are to produce improved cognitive anddevelopmental functioning in children, aswell as increase family functioning and self-sufficiency (Love et al.), thus negating theeffects of poverty on families.

One article included in Table 1 is a reviewof several two-generation programs, includingAvance, Child Family Resource Program,Comprehensive Child Development Program,Even Start, Head Start Family Service Centersand New Chance (St. Pierre et al., 1995). Thesecond article is a report of a longitudinalstudy of the impacts of Early Head Start on

children and families (Love et al., 2002). Alsoincluded is an evaluation of five nationalhome visiting models, including Nurse HomeVisitation Program, Hawaii's Healthy Start,Home Instruction Program for PreschoolYoungsters, Comprehensive Child Develop-ment Program, and Healthy Families America(Gomby, Culross, & Behrman, 1999). Finally,Table 1 includes a review of an article evalu-ating the effects of Head Start plus a FamilyEmpowerment Transitioning Program for at-risk children and their families (Zeece & Wang,1998). It is important to note that all of thesestudies included populations of at-risk childrenand families; none were specifically designed forfamilies of children with disabilities.

There was some controversy over the effectsof two-generation programs on children sincethe effect sizes of the programs reviewed bySt. Pierre, Layzer, and Barnes (1995) were rela-tively small. The Early Head Start study foundmodest effect sizes for child outcomes that weresustained until the age of three years (Love etal., 2002). Additionally, the Head Start plusFamily Empowerment Transitioning Programdecreased parent-centered risk (emotional/social issues) and improved child develop-mental outcomes over a three-year period(Zeece & Wang, 1998). With respect to im-pacts on families, the results are more consis-tent: These programs appeared to have a pos-itive impact on parenting, including parent-child interactions and reductions in negativediscipline (Gomby et al., 1999; Love et al.;St. Pierre et al.). In addition, two-generationprograms appeared to have an impact onimprovements in parents' educational attain-ments, but did not have significant effect onparents' health or mental health (St. Pierreet al.).

In analyzing the reported family outcomesof two-generation programs in comparison tothe ECO Center family outcomes, we con-clude the results were potentially relevant toall five outcomes. However, given the variablesin these studies, it appears that two-generationprograms most often addressed the ECO out-comes of (b) families know their rights andadvocate effectively for their children, (c) fami-lies help their child learn and grow, (d) familieshave support systems, and (e) families are ableto gain access to desired services, programs,and activities in their community. Further,


comparison of the reported results of thesestudies suggests that two-generation programsmay address family quality of life domains ofFamily Interaction, Parenting, Emotional Well-Being and Physical/Material Well-Being offamilies.

Respite Care

Respite care services provide temporary childcare and support to families with a child witha disability (Cowen & Reed, 2002). The use ofrespite care has been proposed as a way toreduce stress and depression for parents. In2002, respite care was only cited on IFSPs atotal of 135 times for all Part C programs inthe 50 states, including DC and Puerto Rico(Danaher & Armijo, 2005).

Table I includes data on three articles thatevaluated the impact of respite care on fami-lies. All studies focused on measuring families'emotional well-being, including stress and de-pression levels. Unlike the other interventionmodels in this paper, we selected respite carestudies that included families with childrenfriom ages two through 20, because we couldfind no evaluations of respite care focusedspecifically for young children with disabilitiesand their families. The population of thesestudies tended to be Caucasian, low-to-middleclass families.

Themes of restults froom these three articlesindicate that utilizing respite care services re-duced parental stress (Chan & Sigafoos, 2001;Cowen & Reed, 2002). The quality of the childcare and the frequency by which parents' uti-lized the service affected their level of depres-sion; the higher the quality of care, the moreoften the services are tised, which was associ-ated with lower depression levels (Herman &Marcenko, 1997). All of these studies focusedon short-term interventions (18 months orless); more information is needed on the im-pact of long-term use of respite for families(Chan & Sigafoos).

Based on these reported results, we con-clUde that early intervention programs provid-ing or referring families to respite care ser-vices may be relevant to the ECO Centerfamily outcomes of: (d) families have supportsystems, and (e) families are able to gain ac-cess to desired services, programs and activi-ties in their community. With respect to family

quality of life domains, the reported resultsappear to be relevant to improved FamilyEmotional Well-Being.

Discussion

Limitations

There are some limitations to this review ofintervention research for family supports.First, there are evaluations of commercial pro-grains and models that are aimed at improv-ing family outcomes that were excluded fromour review. We chose to exclude commerciallyavailable curriculum or materials for early in-tervention since all Part C programs wouldnot have the opportunity to pursue these pro-grams. Also, the majority of the studies wereaimed at mothers, thus limiting generaliza-tions of the findings to the entire family unit.

Research Implications

There are four research implications to con-sider from the results of this literature review.They include (a) inconsistent and loosely de-fined terminology in intervention research ar-ticles, (b) lack of family outcomnes and mnea-sures tailored to families in interventionresearch, (c) limited intervention researchtargeting families and young children withdisabilities, and (d) few evaluations specifi-cally focused on family emotional supports.

First, the intervention research included inthis review measured outcomes for familiesusing many different variables. Those vari-ables included stress or depression levels,health benefits, abuse and pregnancy rates,home environment, self-esteem, satisfaction,attitudes, frustration levels, acceptance, nega-tivity, parenting behavior, participation, inter-action, income and employment levels, socialsupports, use of teaching practices, family co-hesion, perceptions, affective styles, numberof services received, responsiveness, socializa-tion, helpgiving practices, and control. Thedefinitions and model descriptions to evaluatefamily support and outcomes in interventionliterature are not mutually exclusive; there-fore, it is difficult to parcel out what aspect ofthe support is truly impacting the family. Forexample, in this review the category of generalfamily-centered practices had a variety of dif-


ferent interventions grouped together whichmade it difficult to delineate the specific sup-port that was being offered to families. Eitherthe research or model description was vagueor the field of early intervention has notclearly defined the terminology or definitionsrelated to family support. Therefore, morespecificity is needed in the terminology anddefinitions that the field uses to guide re-search on family support and outcomes.

Secondly, the overlap in variables measuredleads to confusion in interpreting the out-comes for families. In this review, we at-tempted to categorize the results of each studyaccording to the ECO outcomes and BeachCenter family quality of life domains as aframework for discussing family support out-comes. A framework for the field in measuringfamily outcomes, both short-term and long-term, is needed. To meet this goal, measure-ments with psychometric properties tailoredto assess families' outcomes are warranted.Further research on family support is neededthat specifically measures both short-term andlong-term family outcomes.

The third research implication is the lim-ited intervention research targeting familiesand young children with disabilities. Becausea primary purpose of this article was to deter-mine how family support is defined and deliv-ered in early intervention studies, we broad-ened our search beyond programs focused onfamilies of children with disabilities in orderto include more types of family support in thisanalysis. This necessity in itself underscoresthe lack of emphasis on supports for familiesof children with disabilities. Only 18 of the 26articles in this paper evaluated interventionsfor this population. There were more inter-vention studies available that sampled generalearly childhood populations, especially in re-gard to parent training programs and two-generation programs. In this article, only ap-proximately half of the articles included in theparent training programs category measuredparenting aspects in relation to families withchildren having disabilities. None of the stud-ies evaluating two-generation programs sam-pled families and children with disabilities.The intervention in these two areas is promis-ing; however, the research needs to be ex-tended to deliberately include families andchildren with disabilities.

Another research implication from this re-view is the limited number of interventionresearch targeting families and young chil-dren with disabilities evaluating family emo-tional support. One category of interventionmodels, peer support, examined the interven-tion research on emotional supports for fam-ilies. Included were studies evaluating Parentto Parent and peer mentoring programs.There were no studies specifically evaluatingsupport groups as the primary interventionfor families. Support groups were evaluated aspart of more comprehensive interventions inthe category of general family-centered ser-vices, therefore, making it difficult to deter-mine the specific impact group supports hadon families. Family emotional support wouldbe an area for further research.

Policy Implications

There are two policy implications that haveevolved from this literature review. They in-clude (a) policy adoption of an established setof family outcomes using specific definitionsof family support and (b) policy adoption ofevidence-based family support in IDEA.

First, policy must adopt an established set offamily outcomes using specific definitions andterminology for family support. This paperhas attempted to link family support interven-tion research with outcomes defined by theECO Center and the Beach Center familyquality of life domains. The goals developedby the ECO Center reflect short-term out-comes, though long-term impacts also need tobe emphasized. Long-term family outcomesare reflected in the Beach Center's familyquality of life domains. A challenge to devel-oping an established set of family outcomes inpolicy is the overlap or lack of specificity interminology and definitions of family support.As previously recommended in this paper, re-search needs to delineate the specific termi-nology for defining family support. Once de-lineated through research, the family supportdefinitions and terms need to be incorporatedinto a framework for family outcomes. Fur-ther, a family outcome framework should beadopted into federal policy, such as IDEA PartC and the DD Act.

Second, policy must adopt evidence-basedfamily support in the next reauthorization of


IDEA. The intervention research evaluatingoutcomes for families is limited in scope toonly a few types of support outlined in IDEA.There is a gap between the types of supportsstated in IDEA and evidence-based family sup-port reviewed in this article. For example,IDEA does not require agencies to providefamilies with respite care, though the inter-vention research indicates respite care en-hances the emotional well-being of families bydecreasing parents' stress and depression lev-els. Similar positive outcomes for Parent toParent and peer mentoring programs werereported. Families reported receiving emo-tional and informational support from peers.In knowing the positive impacts respite careprograms and peer support have on families,it would seem feasible to include these types offamily support in the available services out-lined in IDEA under Part C in the next reau-thorization. Policy should mandate the typesof family support that are empirically vali-dated.

Summary

We have reviewed intervention studies thatevaluated support for families which includedparent training programs, general family-cen-tered practice models offering comprehensivefamily support, peer support, two-generationprograms, and respite care. The majority ofstudies reviewed did not clearly define thespecific support provided to families and,thus, it is not often clear just what the inter-ventions entailed. However, we are able toidentify impacts on families of this support,both those that were specifically defined (e.g.,respite care, peer supports) and those thatwere broadly comprehensive. Intervention re-search suggests that parent training programsimproved parenting skills and parent satisfac-tion and reduced parental stress (Niccols &Mohamed, 2000; Roberts et al., 2003). Addi-tionally, general family-centered practicemodels offering an array of support improvedoverall family cohesion and parental emo-tional well-being (Dunst et al., 2001; Erickson-Warfield et al., 2000; Hendriks et al., 2000;Mahoney & Bella, 1998). An evaluation ofpeer supports indicated parental attitudes to-wards family and disability improved, but notparental empowerment (Singer et al., 1999).

Two-generation programs positively impactedparenting (Gomby et al., 1999; Love et al.,2002) and improved parents' educational at-tainments, but did not have significant effectson parental health or mental health (St.Pierre et al., 1995). Finally, respite care hasshort-term effects of reducing parental stress(Chan & Sigafoos, 2001; Cowen & Reed,2002). The intervention research reviewed inthis article, overall, reported positive out-comes for families. Most often, the evaluationsfocused on child outcomes and family impactswere incidental in the reporting of the find-ings of the study. The outcomes for familiescould be characterized by the family quality oflife domains of family interaction, parenting,emotional and physical/material well-being,and disability-related supports, as well as bythe categories of family outcomes defined bythe ECO Center. In reviewing the interven-tion research, it is apparent that the implica-tion for the early intervention field is to adoptconsistent terminology defining family sup-port. Research on family support is also neededthat specifically links to family outcomes, thusguiding future policy decisions for families andyoung children with disabilities.

References

The Early Childhood Outcomes Center. (2005). Re-trieved November 1, 2005 from http://www.fpg.unc.edn/-eco/pages/overview.cfm

Ainbinder, J. G., Blanchard, L. W., Singer, G. H. S.,Sullivan, M. E., Powers, L. K, Marquis, J. G. et al.(1998). A qualitative study of Parent to Parentsupport for parents of children with specialneeds. Journal of Pediatric Psychology, 23, 99-109.

Allen, R. I., & Petr, C. G. (1996). Toward developingstandards and measurements for family-centeredpractice in family support programs. In G. Singer,& L. Powers (Eds.) Redefining family supports:Innovations in public-private partnerships (Ist ed.)(pp. 57-85). Baltimore, MD: Brookes.

Bailey, D. & Bruder, M. B. (2005). Family outcomesof early intervention and early childhood specialeducation: Issues and considerations. RetrievedSeptember 5, 2008 firom http://www.fpg.unc.edu/-eco/pdfs/Family-Outcomneslssues_01-17-05.pdf

Bailey, D. B., Bruder, M. B., Hebbeler, K., Carta, J.,Defosset, M., & Greenwood, C. et al. (2006). Rec-ommended outcomes for families of young chil-dren with disabilities. Journal of Early Intervention,28, 227-251.


Bailey, D. B., McWilliam, R. A., Darkes, L. A., Heb-beler, K., Simeonsson, R. J., & Spiker, D. et al.(1998). Family outcomes in early intervention: Aframework for program evaluation and efficacyresearch. Exceptional Children, 64, 313-328.

Bakermans-Kranenburg, M. J., van Ijzendoorn,M. H., & Bradley, R. H. (2005). Those who have,receive: The Matthew effect in early childhoodintervention in the home environment. Review ofEducational Research, 75(1), 1-26.

Chan,J. B., & Sigafoos,J. (2001). Does respite carereduce parental stress in families with develop-mentally disabled children? Child & Youth CareForum, 30, 253-263.

Cowen, P. S., & Reed, D. A. (2002). Effects of respitecare for children with developmental disabilities:Evaluation of an intervention for at-risk families.Public Health Nursing, 19, 272-283.

Danaher,J., & Armijo, C. (2005). National early child-hood TA center: Part C updates No. 7. Chapel Hill,NC: National Early Childhood Technical Assis-tance Center.

Dunst, C.J., Bruder, M. B., & Trivette, C. M. (2001).Characteristics and consequences of everyday nat-ural learning opportunities. Topics in Early Child-hood Special Education, 21, 68-92.

Epley, P. (2006). Trends in family-centered concepts andliterature. Unpublished manuscript.

Erickson-Warfield, M. E., Hauser-Cram, P., Krauss,M. W., Shonkoff, J. P., & Upshur, C. C. (2000).The effect of early intervention services on mater-nal well-being. Early Education & Development, 11,499-517.

Fagan,J., & Stevenson, H. C. (2002). An experimen-tal study of an empowerment-based interventionfor African American head start fathers. FamilyRelations, 51, 191-198.

Gomby, D. S., Culross, P. L., & Behrman, R. E.(1999). Home visiting: Recent program evalua-tions-analysis and recommendations. The Futureof Children, 9(1), 4.

Hendriks, A. H. C., De Moor,J. M. H., Oud,J. H. L.,& Savelberg, M. M. H. W. (2000). Perceivedchanges in well-being of parents with a child in atherapeutic toddler class. Research in DevelopmentalDisabilities, 21, 455-468.

Herman, S. E., & Marcenko, M. 0. (1997). Percep-tions of services and resources as mediators ofdepression among parents of children with devel-opmental disabilities. Mental Retardation, 35, 458-467.

Hoffman, L., MarqUis,J. G., Poston, D.J., Summers,J. A. S., & Turnbull, A. P. (2006). Assessing familyoutcomes: Psychometric evaluation of the FamilyQuality of Life Scale. Journal of Marriage and Fam-ily, 68, 1069-1083.

Individuals with Disabilities Education Act, 20U.S.C. 1432 (2004). Ireys, H. T., Sills, E. M.,

Kolodner, K. B., & Walsh, B. B. (1996). A socialsupport intervention for parents of children withJuvenile Rheumatoid Arthritis: Results of a ran-domized trial. Journal of Pediatric Psychology, 21,633-641.

Kim, J. M., & Mahoney, G. (2003). The effects ofrelationship focused intervention on Korean par-ents and their young children with disabilities.Research in Developmental Disabilities, 26, 117-130.

Kucuker, S. (2006). The family-focused early inter-vention programme: Evaluation of parental stressand depression. Early Child Development and Care,176, 329-341.

Love, J. M., Kisker, E. E., Ross, C. M., Schochet,P. Z., Brooks-Gunn,J., & Paulsell, D. et al. (2002).Making a difference in the lives of infants and toddlersand their families: The impact of early head start.(Technical report no. Volume I: Final TechnicalReport). Washington, D.C.: Child Outcomes Re-search and Evaluation; Office of Planning, Re-search and Families; Administration for Childrenand Families; U.S. Department of Health andHuman Services.

Mahoney, G., & Bella,J. M. (1998). An examinationof the effects of family-centered early interventionon child and family outcomes. Topics in EarlyChildhood Special Education, 18(2), 83-94.

Mahoney, G., Kaiser, A., Girolametto, L., Mac-Donald, J., Robinson, C., & Safford, P. et al.(1999). Parent education in early intervention: Acall for a renewed focus. Topics in Early ChildhoodSpecial Education, 19, 131-140.

Mahoney, G., & Perales, F. (2005). Relationship-focused early intervention with children with per-vasive developmental disorders and other disabil-ities: A comparative study. Journal of Developmental& Behavioral Pediatrics, 26(2), 77-89.

Mahoney, G., & Perales, F. (2003). Using relationship-focused intervention to enhance social-emotionalfunctioning in young children with autism spec-trum disorders. Topics in Early Childhood, 23(2), 77-90.

Mannan, H., Summers, J. A., Turnbull, A. P., &Poston, D. J. (2006). Family outcomes in earlychildhood programs: A review of outcome mea-sures. Journal of Policy and Practice in IntellectualDisabilities, 3, 219-228.

Niccols, A., & Mohamed, S. (2000). Parent trainingin groups: Pilot study with parents of infants withdevelopment delays. Journal of Early Intervention,23, 133-143.

Park, J., Hoffman, L., Marquis, J., Turnbull, A. P.,Poston, D. et al. (2003). Toward assessing familyoutcomes of service delivery: Validation of a fam-ily quality of life survey. Journal of Intellectual Dis-ability Research, 47, 367-384.

Poston, D., Turnbull, A. P., Park, J., Mannan, H.,Marquis, J., & Wang, M. (2003). Family quality of


life: A qualitative inquiry. Mental Retardation, 41,313-328.

Roberts, C., Mazzucchelli, T., Taylor, K., & Reid, R.(2003). Early intervention for behavior problemsin young children with developmental disabilities.

International Journal of Disability, Development, andEducation, 50, 275.

Rosenberg, S. A., Robinson, C., & Fryer, G. E.(2002). Evaluation of paraprofessional home vis-iting services for children with special needs andtheir families. Topics in Early Childhood Special Ed-ucation, 22, 158-168.

Sandall, S., Hemmeter, M. L., Smith, B. J. &McLean, M. E. (2005). DEC recommended practices:A comtprehensive gui&.efor practical application in earlyintervention/early childhood special education. Long-mont, CO: Sopris West.

Singer, G. H. S., Marquis, J., Powers, L. K., Blan-chard, L., Divenere, N., & Santelli, B. et al.(1999). A multi-site evaluation of parent to parentprograms for parents of children with disabilities.Jotural of Early Intervention, 22, 217-229.

St. Pierre, R. C., Layzer,J. I., & Barnes, H. V. (1995).Two-generation programs: Design, cost and short-

term effectiveness. The Future of Children, 5(3),76-93.

Summers, J. A., Poston, D. J., Turnbull, A. P., Mar-quis, J., Hoffman, L., Mannan, H. et al. (2005).Conceptualizing and measuring family quality of

life. Journal of International Disability Research, 49,777-783.

Trivette, C. M., Dunst, C. J., Boyd, K, & Hamby,D. W. (1995). Family-oriented program models,helpgiving practices; and parental control ap-praisals. Exceptional Children, 62, 237-12.

Turnbull, A. P., Turbiville, V., & Turnbull, H. R.(2000). Evolution of family-professional partner-ship model models: Collective empowerment asthe model for the early 21st century. In J. P.Shonkoff, & S. L. Meisels (Eds.), The handbook ofearly intervention (2nd ed. pp. 630-650). NewYork: Cambridge University Press.

Wagner, M., & Spiker, D. (June 2001). Multisiteparents as teachers evaluation: Experience and out-comes for children and families, 2001 (No. SRIProject P07283). Menlo Park, California: SRI In-ternational.

Watkins, S., Pittnan, P., & Walden, B. (1998). Thedeaf mentor experimental project for young chil-dren who are deaf and their families. AmericanAnnals of the Deaf 143(1), 29-34.

Zeece, P. D., & Wang, A. (1998). Effects of thefamily empowerment and transitioning programon child and family outcomes. Child Study Journal,28, 161-178.

Received: 23 April 2008Initial Acceptance: 25 June 2008Final Acceptance: 20 October 2008


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SOURCE: Educ Train Dev Disabil 44 no4 D 2009

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