Communicating With Intention: Therapist and Parent Perspectives on Family-Centered Care in Early Intervention

Abstract

Importance: Responsive communication is critical to ensuring family-centered care in early intervention (EI). The Intentional Relationship Model (IRM) offers a framework for examining therapist–parent communication and offers strategies for supporting therapist responsiveness. Objective: To explore family-centered care and therapists’ communication in EI using the IRM. Design: Prospective descriptive study. Setting: Illinois EI program. Participants: Convenience sample of 101 therapists and 19 parents enrolled in an EI program. Therapist disciplines included developmental (n = 24), occupational (n = 32), physical (n = 17), and speech (n = 28) therapy. Outcomes and Measures: Demographic questionnaire, Early Interventionist Self-Efficacy Scale, Early Intervention Parenting Self-Efficacy Scale, Measure of Processes of Care (MPOC)–Short Form, MPOC–Service Provider, Clinical Assessment of Modes (CAM), and Clinical Assessment of Suboptimal Interaction–Short Form (CASI–SF). Results: Therapists used family-centered practices specific to relationship building more frequently than information sharing (especially sharing of general information). Therapists used the empathizing, encouraging, and instructing modes most frequently in their interactions with families. Participants’ scores on the MPOC, CAM, and CASI–SF were significantly correlated. Conclusions and Relevance: Therapist–parent interactions were aligned with family-centered care. Opportunities for practitioners were identified in (1) sharing specific and general information and (2) expanding the use of collaborating, problem-solving, and advocating modes. What This Article Adds: In this study, we explored how the IRM can inform family-centered practices in EI through examination of therapists’ interpersonal competency and therapeutic mode use.

Evidence-Based Implementation of the Family-Centered Model and the Use of Tele-Intervention in Early Childhood Services: A Systematic Review

“…The family-centered model of care was described as a facilitator in establishing a link with the clinical environment in the early intervention setting. This approach allowed both children and family to feel safe and motivated throughout the process [ 21 , 41 , 42 , 44 , 59 , 64 , 65 ].…”

“…Although there is a desire to generalize the family-centered model in current practices [ 22 ], different barriers are described that are independent of the practitioners, such as lack of time, resources, training, or aspects related to the organization and structure of the system [ 21 , 60 ].…”

“…It also takes into account usability, effectiveness, competence and trust, factors that are relevant to what the authors call social validity. Other studies such as those by McCarthy et al, Popova et al, García-Ventura et al, du Plessis et al, Rose et al and Vilaseca et al [ 20 , 21 , 52 , 58 , 60 , 66 ] assess factors that have to do with the technical staff who carry out the intervention, seeking their professional validation.…”

“…In this case, it was an intervention based on the family-centered model. For their part, Popova et al [ 21 ] advocate for future research to provide training opportunities, specifically to foster communication with families.…”

“…Within contemporary trends in Early Intervention, one of the tendencies is based on the involvement of families in supporting the early development of the child, which is essential to overcome the negative consequences associated with disability or developmental delays [ 18 ]. With a purely ecological and transactional model, working with the family must be one of the pillars in any system working with early childhood [ 19 , 20 , 21 ]. This trend is known as family-centered care, the key principles of which are empowerment in decision-making [ 22 ]; increased levels of competence and involvement of the family, and the strengthening of the family’s bonds with the practitioners involved in the process [ 20 , 23 ].…”