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EARLY HEAD START INTERVENTION WITH FAMILIES AND FAMILIES’ INVESTMENT IN CHILDREN
Michaela L. Z. Farber, Elizabeth M. Timberlake, Shavaun
M. Wall and Nancy E. Taylor
The Catholic University of America
A federally funded program serving young economically disadvantaged families with children under 3, United Cerebral Palsy Early Head Start in Northern Virginia (EHS) promoted child development through a flexible mixture of individualized, needs-oriented child and family services. The child-focused services included center-based childcare, family-based childcare, and home visiting. The family-focused services included parent mobilization activities and linkage to community resources on behalf of parents and children. In particular, parent mobilization involved psychosocial, informational, and task-focused practice activities designed to enable parents to fulfill their parenting roles, achieve family well-being, and move toward family economic self-sufficiency. Linking to community resources involved EHS staff's assistance in connecting families to their communities in order to secure supplemental services that support and promote children's healthy development, parents' competencies in childrearing, and parents' personal development. To date, however, little is known about how the provision of EHS services strengthens family functioning, parental investment in their children, and children's social development.
In exploring program impact on 73 EHS participants, the research team from The Catholic University of America: (a) assessed family needs and identified family aspirations at enrollment; (b) documented the type and amount of EHS services delivered to families; and (c) assessed family functioning and child social development when the enrolled child reached 30 months of age, a date six months prior to program exit. The researchers further explored whether variance in service delivery was associated with a family’s status as a U.S. born or immigrant family. Last, the researchers explored whether EHS service delivery was congruent with families’ needs and aspirations at enrollment, and, in turn, whether such congruence empowered families to achieve greater competency in their pre-exit functioning; and whether family functioning created a family environment with increased investment in the targeted EHS children and, thereby, promoted the children’s social development at 30 months.
Research Design
The investigation of pathways to desired child and family outcomes is based on information gained from 73 families, who were randomly assigned to participate in the EHS program. This study used an experimental research design with quantitative enrollment and pre-exit measures and qualitative categorization of service activities by EHS staff.
Enrollment and Pre-Exit Measures
The enrollment data and pre-exit data from mothers were collected through structured interviews conducted by trained interviewers. Mothers were selected as respondents because of their universal presence and availability for interviews. Spanish-speaking interviewers and bilingual interpreters for other languages were used as needed.
Family Status. Because cultural identity affects people's perception of their needs, life style, and actions (Shonkoff & Phillips, 2000), families were identified as having an immigrant family birth status and lifestyle when the mother was born outside the U.S.
Enrollment Assessment of Family Needs and Resources. Adequacy of family resources for meeting needs was measured by the Family Resource Scale (Dunst & Leet, 1987; Wall, et al, 2000), a measure with established validity and reliability. The 33 items form five conceptual clusters denoting needs and wants for adequate level of living, needs for parenting supports, monetary resource wants, interpersonal resource wants, and personal resource wants. The 5-point Likert scale ranges from "never" to "always" adequate with a total score of less than 130 reflecting perception of family resources as usually inadequate.
Enrollment Family Goals and Aspirations. Family goals and aspirations were measured by an 11-item scale, which reflects parents' desire for future achievement and personal change in gaining greater economic self-sufficiency, improving their living situation, and increasing their family life satisfaction. The dichotomously scored items were adapted from the Teenage Parent Demonstration Second Follow-Up, a population survey similar in age and cultural diversity to the present sample (Aber, Brooks-Gunn & Maynard, 1995).
Pre-Exit Family Functioning Family functioning competencies were measured by an abbreviated 24-item Family Functioning Scale (Dunst, Trivette & Deal, 1988). The 5-point Likert scale reflects strengths associated with family commitment, appreciation, sense of purpose, congruence, communication, sense of relationship, coping, problem solving, positivism, flexibility, and sense of balance. The items cluster around three factors of family identity, information sharing, and coping and resource mobilization. The total score reflects overall competency in family functioning. The scale has established validity and an appropriate internal consistency alpha of .89. Pre-Exit Family Investment in their Child. Family investment in the targeted child was conceptualized as parents' perception of their emotional and time availability for their child and was measured by two Likert-scaled items comprising one factor with established validity from the long form of the Family Functioning Scale (Dunst, Trivette & Deal, 1988).
Pre-Exit Child Social Development. Children's social development was measured by the 83-item Child Behavior Checklist (CBCL) (Achenbach, 1992), a measure with an established validity and reliability. The total score of this 3-point Likert scale identifies problems in children's social behavior based on established age norms.
Documentation of EHS Services Delivered
In order to assess the range and scope of EHS services documented in children's case records, a structured case-record review guide was developed from the monthly staff notations of service activities targeted to EHS children and families. In collaboration with the program staff and research team, the leading author developed the data collection instrument and trained a doctoral social work student in its use. To achieve consistency, the researcher and the doctoral student cross-referenced their procedures until they reached complete agreement for data categorization, interpretation, and documentation.
Child Care and Program Services. As this particular EHS center provided a flexible mixture of individualized, needs-based child and family services, it was possible for targeted EHS children to be serially enrolled in one to three program types for up to 3 years. For example, the family could enroll the child in the child development center (CDC) program, family child care (FCC) program, or home visiting (HV) program, or some sequential combination of the three programs.
Linkage to Community Services. The staff's linking of families and children to community services included referrals (phone calls and letters), advocacy contacts (meeting with other professionals or other agency representatives) on behalf of children and parents, and assistance with transportation or accompaniment to services. The recorded monthly contacts were tabulated and average monthly scores identified.
Parent Mobilization Services. These services included practice activities targeting child and family needs. Content analysis of narrative themes yielded 19 items reflecting child needs, 26 items reflecting family needs for parenting and self-sufficiency, and 20 items reflecting parents’ personal needs. Specifically, practice activities targeting child needs clustered around child care, child health including insurance issues and illness status, child development (speech and language, eating and nutrition, gross and fine motor development, toilet training), developmental delay including provision of assessment and early intervention services, child psychosocial behavior (socialization, play, and behavior self-control), parent-child relationship, and age-related transitioning out of EHS services. Practice activities targeting family needs clustered around: (a) parenting issues such as knowledge of parenting and disciplinary practices appropriate for infants and toddlers, and parent management of issues surrounding child custody and abuse/neglect, toys, child safety at home and in the neighborhood, and siblings' developmental and educational needs; and (b) self-sufficiency issues such as parents' concern about their legal status, education, employment, family income, extended family living in their household, and provision of household necessities (living space, food, clothing, transportation, telephone). Practice activities targeting parents’ personal needs clustered around parents' health (insurance issues, health status, disability), mental health (mood, aggression, substance abuse), employment-related coping issues, marital or partner relationship issues, and community involvement.
Findings
Demographic Profile
Located along a busy corridor in a suburban Virginia county, the EHS center was part of a commercial strip mall in a densely populated multicultural area about 30 minutes south of Washington D.C. The center served economically disadvantaged families living predominantly in motels and low-rise apartments within a 10-mile radius.
Of the 73 EHS families, 19 percent enrolled in 1996; 44 percent enrolled in 1997; and 37 percent enrolled in 1998. Of all the families, 56 percent (N = 41) were U.S.-born and 44 percent (N = 32) were immigrant families. Most of the children in these families were enrolled by one year of age and several mothers were pregnant at enrollment. One third (32 percent) of all families had one child; one third (36 percent) had two children; and one third (32 percent) had three to five children. Close to three-quarters (70 percent) of the targeted children lived with two parents and relatives; one fifth (20 percent) lived with a single parent (mother), and few (10 percent) lived with a single mother and relatives.
The families differed in parents' age, income, education and cultural heritage (p< .05). Immigrant families had mothers (M = 28, SD = 6) and fathers (M = 33, SD = 7) who were somewhat older, had slightly lower average poverty-based income (M = $11,958, SD = $4,519), were mainly of Spanish-speaking heritage (78 percent), and had mothers who have not completed high school education (65 percent). In comparison, the US-born families had mothers (M = 24, SD = 4) and fathers (M = 26, SD = 7) in their mid-twenties, had slightly higher but still poverty-based income (M = $13,226, SD = $4,756), were predominantly of African American (41 percent) or Caucasian heritage (39 percent), and had mothers who were more likely to have completed high school (81 percent).
The participating families did not differ in employment self-sufficiency in that three-quarters (75 percent) of mothers were unemployed while four-fifths (86 percent) of fathers were employed either part- or full-time.
Amount and Type of EHS Services Delivered
Program Types. Over two-thirds (66 percent) of families received home visiting, family childcare, or a combination of the two; the remainder (34 percent) received center-based childcare or a combination of center-based child care with family childcare or home visiting. When analyzed by family status, however, almost all (94 percent) immigrant families received family childcare, home visiting, or the two combinations. The US-born families differed from immigrant families in that half (51 percent) received center-based child care or a combination of center-based childcare with home visiting or family child care, while the other half (49 percent) (received a combination of family childcare and home visiting ()X(2) = 16.8, df = 1, p = .000, Phi =.5).
To assess the amount of service received, the first and last known contact dates were adjusted for the number of times the EHS family could not be reached at their known address.
| Length of time in the program (months) = Date of the last monthly note – Date of the first monthly note Length of time served by the program (months) = Length of time in the program - Number of missed contacts |
Therefore, based on the presence of the first and last documented monthly contact note, families participated in EHS for 25 months (SD = 10) on average and missed contact for 3 months (SD = 3) on average. Adjusting for absences, the families averaged 22 months (SD = 10) of actual program contact. Table 1 suggests that almost half received 2 to 3 years of actual contact; one-third (33 percent), from 1 to 2 years; and one-fifth (22 percent), less than 1 year.
| Length of Program Contact |
Number of Families |
Families |
|---|---|---|
| 6 months or less | 7 | 10% |
| 7-12 months | 9 | 12% |
| 13-24 months | 24 | 33% |
| 25-39 months | 33 | 45% |
| Total | 73 | 100% |
Regardless of the type of EHS program received, immigrant families (M
= 26 months, SD = 8) participated significantly longer on average than
US-born families (M = 18 months, SD = 10) (N = 73, F = 4.1, df = 72, p
= .009).
Linkage to Community Services. Taking into account the actual service contact with families, four-fifths (82 percent) of the families averaged one to two monthly community service contacts; a few (6 percent), three to four monthly community contacts. Some families (12 percent) did not use such assistance. The type of program and family status did not influence provision of linkage.
Parent Mobilization for Children's Needs. Adjusted for the duration of actual EHS service contact, families received an average of two to three (SD = 1) activities per month (see Table 2) to assist with their children's needs. The type of program and family status did not influence the delivery of parent mobilization activities for children's needs.
| Number of Child-based Activities per Month of Service Contact |
Number of Families |
Percent of Families |
|---|---|---|
| Less than 1 Child Activity | 4 | 5% |
| 1-2 Child Activities | 15 | 21% |
| 2-3 Child Activities | 32 | 44% |
| 3-4 Child Activities | 14 | 19% |
| 4-5 Child Activities | 8 | 11% |
| Total | 73 | 100% |
Parent Mobilization for Family Needs. Adjusted for the duration of actual EHS service contact, families received an average of one to two (SD = 1) activities per month (see Table 3) to assist with their overall family needs.
| Number of Family-based Service Activities per Month of Service Contact |
Number of Families |
Percent of Families |
|---|---|---|
| Less than 1 Family Activity | 15 | 21% |
| 1-2 Family Activities | 39 | 53% |
| 2-3 Family Activities | 10 | 14% |
| 3-4 Family Activities | 5 | 7% |
| 4+ Family Activities | 4 | 5% |
| Total | 73 | 100% |
Family status, however, influenced the total amount of parent mobilization for family needs (see Table 4). That is, immigrant families received an average of two parent mobilization family-based activities per month while US-born families received one such service activity per month.
Furthermore, examining the range of parent mobilization for family needs revealed that immigrant families (M = .5, SD = .4) received activities slightly more focused on parenting issues per month than US-born families (M = .3, SD = .3) (N = 73, F = 6.4, df = 1, p = .01).
| Source | DF | Mean Square | F | Sig. |
|---|---|---|---|---|
| Model | 3 | 7.2 | 4.8 | 0.004 |
| Intercept | 1 | 102.9 | 68.3 | 0 |
| Program* | 1 | 1.63E-02 | 0.01 | 0.917 |
| Family Status** | 1 | 8.1 | 5.4 | 0.023 |
| Program by Family Status | 1 | 5.5 | 3.7 | 0.059 |
| Error | 69 | 1.5 |
| * HV or FCC and CDC program services ** US-born and Immigrant families |
Parent Mobilization for Parents' Personal Needs. Adjusted for the duration of actual EHS service contact, families received an average of one to two (SD = .7) activities per month targeting parents' personal needs (see Table 5). Family status and the type of EHS program did not influence parent mobilization for parents' personal needs.
| Number of Parents' Personal Needs Service Activities per Month of Contact |
Number of Families |
Percent of Families |
|---|---|---|
| Less than 1 Personal Need Activity | 25 | 34% |
| 1-2 Personal Needs Activities | 36 | 49% |
| 2+ Personal Needs Activities | 12 | 16% |
| Total | 73 | 100% |
Total Number of EHS Parent Mobilization Services. Adjusted for the duration of actual EHS contact, families received an average of five to six total parent mobilization activities per month targeting their overall needs or the needs of their children, the whole family, and their own personal needs (see Table 6). Family status influenced total parent mobilization in that immigrant families (M = 6, SD = 2) received slightly more total parent mobilization than US-born families (M = 5, SD = 3) (N = 73, F = 2.9, df = 1, p = .09). The type of program did not exert any influence.
| Number of Total Parent Mobilization Activities per Month of Service Contact |
Number of Families |
Percent of Families |
|---|---|---|
| Less than 4 Total Service Activities | 12 | 16% |
| 4-7 Total Service Activities | 50 | 69% |
| 8+ Total Service Activities | 11 | 15% |
| Total | 73 | 100% |
Psychosocial Assessment at Enrollment Interview
Family Needs and Resources at Enrollment. Participating families averaged a total score of 110 (SD = 20), denoting somewhat less than adequate needs and resources at enrollment. Immigrant families (M = 97, SD = 17) had significantly fewer resources to meet family needs at enrollment than US-born families (M = 120, SD = 16) (N = 73, t = 5.7, df = 73, p = .000).
Family Aspirations at Enrollment. Families averaged 8 (SD = 3) out of 11 possible future goals and aspirations. Goals and aspirations did not vary by family status designation.
Outcomes at Pre-Exit Interview
Fifty-five (75 percent) of the 73 families and children originally enrolled in EHS completed the pre-exit (when child turned 30 months) outcome measures, an attrition rate of 25 percent.
Pre-Exit Family Functioning. Families averaged a total family functioning score of 106 (SD = 12), denoting adequate competencies at pre-exit interview.
Pre-Exit Family Investment in Children. Families averaged a total pre-exit child investment score of 9 (SD = 1), denoting a good amount of family investment in children. In addition, families with greater pre-exit family functioning invested more in their children (r = .41, p = .001).
Pre-Exit Child Social Development. Targeted 30 month olds achieved an average social development score of 41 (SD = 20) on the CBCL, denoting absence of clinical problems in socio-behavioral development.
Family Service Delivery, Family Functioning, and Child Social Development
To identify the connection between EHS family-focused service delivery (parent mobilization and linkage to community services), family functioning, and child social development, several path analyses examined the connection among baseline assessment of family needs and resources, aspirations, and family status; total EHS services delivered; pre-exit family functioning and investment in the targeted child; and the development of children's socio-behavioral problems at 30 months of age.
First, bi-variate correlations identified significant (p < .05) correlations between the following pairs of variables and, thereby, possible hypothesized pathways: (a) moderate correlations between EHS parent mobilization and linkage to community services (.48), family status (.45), and family needs and resources (.40); (b) a moderate correlation between family status and family needs and resources (.56), and small correlations with family child investment (.28), and child social development (.29); (c) small correlations between family aspirations and needs and resources (.28), family functioning (.28), and child social development (.29); (d) a small correlation between family needs and resources with family functioning (.32); (e) a moderate correlation between family functioning and family child investment (.42); and (f) a small correlation between family child investment and child social development (.27).
Subsequent multiple regression analyses (MRA) identified the EHS service path to family functioning and child social development (see Figure 1).
|
[D] |
Specifically, 29 percent (R(2) = .29) of child social development at 30 months of age was significantly predicted by family investment in their child at 30 months and family future aspirations at enrollment (see Table 7). Families who were more invested in their children had children with fewer social developmental problems while families who had more goals for their future had children with more social developmental problems.
| Variable | Beta | T | Sig. |
|---|---|---|---|
| Investment | -0.33 | -2.6 | 0.01 |
| Aspirations | 0.35 | 2.6 | 0.01 |
| Family Status* | -0.19 | NS | |
| Functioning | 0.01 | NS | |
| EHS Activities | -0.02 | NS | |
| Needs | -0.26 | NS |
| * Immigrant family = 2, US-born family = 1 R2 = .29, F= 5.6, p =.002 |
Second, 27 percent (R2 = .27) of family investment in the targeted child was predicted by family status at enrollment and pre-exit family functioning (see Table 8). Specifically, immigrant families were invested slightly more in their children (M = 9, SD = 1) than U.S.-born families (M = 8, SD = 1). Families with better overall family functioning competencies invested more in their children.
| Variable | Beta | T | Sig. |
|---|---|---|---|
| Family Status* | 0.32 | 2.2 | 0.03 |
| Functioning | 0.33 | 2.4 | 0.02 |
| Aspirations | 0.11 | NS | |
| EHS Activities | -0.16 | NS | |
| Needs | 0.15 | NS |
| * Immigrant family = 2, US-born family = 1 R2 = .27, F=3.5, p=.01 |
Third, 18 percent (R2 = .18) of pre-exit family functioning was predicted by family aspirations and adequacy of family resources in meeting needs at enrollment (see Table 9). Specifically, families who had more aspirations or more adequate resources for meeting their needs had better family functioning when their child turned 30 months.
| Variable | Beta | T | Sig. |
|---|---|---|---|
| Needs | 0.38 | 2.4 | 0.02 |
| Aspirations | 0.24 | 1.7 | 0.08 |
| Family Status* | 0.19 | NS | |
| EHS Activities | 0.01 | NS |
| * Immigrant family = 2, US-born family = 1 R2 = .18, F=2.8, p =.03 |
Fourth, 38 percent (R2 = .38) of assessment of family needs and resources at enrollment was predicted by family status and family aspirations (see Table 10). Specifically, immigrant families had somewhat more inadequate resources for meeting their needs while US-born families had slightly more aspirations at enrollment.
| Variable | Beta | T | Sig. |
|---|---|---|---|
| Family Status* | -0.53 | -4.2 | 0 |
| Aspirations | 0.19 | 1.8 | 0.07 |
| * Immigrant family = 2, US-born family = 1 R2 = .38, F=19.3, p =.000 |
Last, 45 percent (R2 = .45) of EHS total parent mobilization services were predicted primarily by EHS linkage to community services, family status, and family needs and resources at enrollment (see Table 11). That is, immigrant families received more EHS parent mobilization than US-born families but similar linkage to community services.
| Variable | Beta | T | Linkage Activities | 0.47 | 5.2 | 0 |
|---|---|---|---|---|---|---|
| Family Status* | 0.34 | 3.2 | 0.01 | |||
| Needs | -0.21 | -1.8 | 0.08 | |||
| Aspirations | -0.01 | NS |
| * Immigrant family = 2, U.S.-born family = 1 R2 = .45, F=14.2, p = .000 |
Discussion of Findings
The analyses revealed statistically significant and conceptually meaningful pathway relationships among psychosocial assessment of family needs and resources, status, and aspirations at enrollment; pre-exit outcomes of family functioning, family child investment, and child social development; and EHS delivery of service activities (see Figure 1). As demonstrated by these paths, EHS intervention takes place in a psychosocial environmental context far broader than the consideration of the type of EHS program per se. Although it may appear puzzling that the type of EHS program (designated in this study by home visiting and family-based childcare or center-based childcare combinations) did not directly influence the proposed pathways to children's social development, it actually was not that surprising to the researchers. That is, in this study, the type of program designation based on the clustering of childcare services was related to family status at enrollment. Through this process, program designation became the extension of family assessment of needs at enrollment, and in turn guided the provision of EHS parent mobilization and linkage to community services.
Specifically, EHS family-focused services associated with the intervention objectives of parent mobilization and linkage to community resources were moderated by families' socio-cultural situation and psychosocial characteristics. The socio-cultural situation associated with economically-disadvantaged families’ status designation (immigrant, U.S.-born) aligned with both family needs and resources and family goals, as assessed at enrollment, to create the psychosocial context for EHS service delivery. Through this psychosocial family context, EHS service activities, in turn, influenced family needs and resources. It was observed that at program enrollment, immigrant families had demonstrably more inadequate resources for meeting family need than US-born families. In targeting resource deficits for all families, EHS service activities used the family status as a way of better understanding culturally-based needs and as an entry point for helping families gain a sense of who they are and what they need to do in order to function well in today's society. To facilitate culturally competent service activities and meet identified need, EHS hired staff to accommodate the cultural, linguistic, and individual needs of the predominantly Spanish-speaking immigrant families.
Since service activities matched the needs and resources and goals of families at enrollment, pre-exit family functioning competencies were promoted. Through the focus on identifying and matching the needs of family cultural life style, EHS service activities assisted families in gaining awareness of their strengths and weaknesses, the adequacy of their resources for meeting emotional and instrumental needs, and their goals for the future. Through these culturally based service activities, families gained knowledge about themselves. Thus, EHS services facilitated their pre-exit family functioning.
Further, the psychosocial context of family functioning and family status contributed to families' emotional investment and time availability for their children when children turned 30 months. Families were assisted in learning about themselves (their needs, wants, and aspirations) becoming more competent and investing more in their children.
Their pre-exit family investment in combination with their goals at enrollment became reflected in their children’s 30-month social development. This pathway highlighted children's social development as influenced by the meaning that children derive from parent-child interaction defined in this study as parental investment in their children. The pathways also highlighted family aspirations as subject to culturally-interpreted expectations of the future, underpinning parenting and life style actions, and, thereby bearing portent for children's social development. Families with lower family investment in their children or more family goals had children who demonstrated more socio-behavioral problems at 30 months than families with greater child investment or fewer goals for the future. It might be that families who set too many goals for themselves become over-extended. In turn this "over-drive" may become negatively reflected in their children's social development. However, as the children's social development at 30 months demonstrated age appropriate normative behavior, only future longitudinal investigation might clarify such effects or the effects of the EHS service delivery path upon children's future developmental accomplishments.
References
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Dunst, C. & Leet, H. (1987). Measuring the adequacy of resources in households with young children. Child: Care, Health and Development, 13, 111-125.
Dunst, C., Trivette, C., & Deal, A. (1988). Enabling and empowering families: Principles and guidelines for practice. Cambridge, MA: Brookline Books.
Shonkoff, J., & Phillips, D. (2000). From neurons to neighborhoods. National Academy Press.
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