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8.0 Head Start’s Special Populations
This chapter presents descriptions of three special populations served by Head Start: families of children with disabilities, families of Hispanic children, and families with grandparents as the primary caregivers of the children.
8.1 Overview of Families of Children with Disabilities
Since its inception, Head Start has promoted enrollment and delivery of services to children with special needs and has directed local programs to set aside a minimum of 10% of available program slots for these children and families, regardless of income [Head Start Program Performance Standard 1306.(c)]. Head Start guidelines promote inclusion of children with special needs in regular classroom activities and the development of an Individualized Education Plan (IEP), including an integrated service delivery program, to accommodate the needs of these children and their families. This section will present characteristics of families who have children with disabilities, how these families function, and their relationships with the Head Start program.
Definition of Children with Disabilities
Although parents reported in the parent interview whether or not their children had disabilities, for the purpose of this report, children were counted as having disabilities only when these parent reports were supported by subsequent responses that the children also had an IEP (an indication of a professional diagnosis). It was also recognized that while some children entered Head Start with an identified disability (and an IEP), other children were identified sometime during their Head Start experience, including some who received professional diagnoses and IEPs during their second year in the program. In order to be inclusive of all children with professionally diagnosed disabilities, children with disabilities were identified in the sample in the following way.
Classification was based on information taken from each data collection. First, 233 children were identified in the fall of 1997 as having an IEP. Similarly, 281 were identified with an IEP in the spring 1998 interview, while 102 were identified as having an IEP in spring 1999. After accounting for children who were reported to have an IEP in two or more parent interviews, a total of 424 children in the study sample were classified as having disabilities. Regardless of when the disabilities were first reported, fall 1997 parent interview data are presented in sections 8.1.1 through 8.1.3, which contain descriptive background information on these children and families. Starting with section 8.1.4, spring 1998 data were used for only the 281 families with children identified as having disabilities at that time. This process offers the largest number of families with responses to questions gathered at the end of the Head Start year, including satisfaction with program services.
8.1.1 Characteristics of Children with Disabilities
Ethnicity
The supplemental exhibit(Exhibit 8-2) in section 8.1.6, page 150, presents the distribution of child and family characteristics within groups of families with and without children with disabilities, as well as across five categories of disabilities (language, behavioral, cognitive, physical, and sensory). Among children with disabilities, the ethnic groups with the largest representation were African American children (36.7%) and White children (34.1%). While Hispanic children made up 28.9% of the children without disabilities, only 20.3% of the children with disabilities were Hispanic.
Distributions of children by ethnicity, as shown in Exhibit 8-2, display some differences across the five disability categories. While African American children made up the largest ethnic percentage of all children with disabilities, this was the case for only one of the disability groups. White children made up the largest proportions of children with cognitive, physical, and sensory disabilities. Among children with physical disabilities, only 6.0% were Hispanic, much lower than the proportion of African American children (27.7%) or White children (53.9%). Compared with the overall category of children with disabilities, the sensory disabilities category had fewer African American children (18.2%) and an increased percentage of Hispanic children (34.0%).
Gender and Age of Children
While the main sample of children was evenly split between boys and girls, almost two thirds of the children with disabilities were boys (62.6%). This finding was generally true within each of the disability categories, although the proportion of boys in the behavioral disability category was up to 74.5%. Exhibit 8-2 shows that the percentage of 3-year-olds among the children without disabilities was less than one third (30.0%). This was very similar to the proportion of 3-year-olds in the overall study sample. In contrast, more than two fifths of the children (41.8%) with disabilities were 3 years old. Within the five disability categories, more than one half of the children with behavioral disabilities were 3 years old, but less than one quarter of those in the cognitive disabilities (24.4%) and the sensory disabilities (22.8%) categories were 3 years of age.
Geographic Location
As noted in Exhibit 8-2, urban areas were home to approximately two thirds of the children with disabilities (64.4%) and children without disabilities (67.4%). This pattern was consistent across the disability categories, with the exception of children with physical disabilities (56.3%), who were more likely to come from rural areas. The distribution of children, both with and without disabilities, by geographic region was generally similar to the distribution of the regions across the study population as a whole. In looking at the five disability categories, physical disabilities had an increased proportion of children from the Midwest (41.4%), while only 17.2% of the children came from the South, which was the largest group of children, overall.
Child Birthweight
As seen in the supplemental exhibit (Exhibit 8-2), more than 80% of the children in the study were of normal birthweight, regardless of whether they had disabilities (81.8%) or not (86.5%). Among the disability categories, less then three quarters of the children in the cognitive category (64.1%) and the physical category (55.8%) were born with a normal birthweight. The physical disabilities category had the largest proportions of children with low (20.5%) and very low (7.5%) birthweights.
8.1.2 Characteristics of Families of Children with Disabilities
Age of Parents
As displayed in Exhibit 8-2, the distributions of parents’ ages across the groups of children with and without disabilities was generally mixed. Both groups had about one half of the parents under 30 years of age, but the percentage of children with disabilities having parents less than 20 years of age (5.0%) was about twice that of children without disabilities (2.1%). About one tenth of the children in the behavioral disabilities category (10.2%) had parents under 20, while none of the children in the physical disabilities category had parents less than 20 years of age. More than one half of the children with disabilities had parents under age 30, including 70.2% of the children in the sensory disabilities group; 71.3% of the children in the physical disabilities group and 58.3% of the children in the cognitive disabilities group had parents older than 30 years of age. Consequently, Exhibit 8-2 also shows that the mean and median ages for parents of children in these two groups were slightly higher than that reported for parents of children in the other disability categories.
Nativity of Parents
The parents of children without disabilities (20.6%) included a much higher proportion of non-U.S. born individuals than did parents of children with disabilities (7.3%)(Exhibit 8-2). For children in the behavioral disabilities category, only 1.7% of the parents were born in a country other than the U.S., while 15.5% of the parents with children sensory disabilities were born out of the U.S.
Marital Status
As noted in Exhibit 8-2, the parents of children with disabilities were very similar to the parents of children without disabilities on their distribution across four categories of marital status. Within the disability categories, parents of children in the cognitive disabilities group (66.9%) and the physical disabilities group (71.3%) had the highest percentage of married parents. More than two thirds of the children in the behavioral disabilities category had single parents (70.7%), as did 55.8% of the children in the language disabilities category.
Education and Training
As with some other characteristics, Exhibit 8-2 shows that the distribution of parents across the five education and training categories was similar for parents of children with disabilities and parents of children without disabilities. In both cases, just over one quarter had less than a high school diploma, and just over one third had diplomas or GEDs. Within the five disability categories, less then one tenth of the parents of children with physical disabilities (9.5%) had less than a high school diploma, while for the other four groups, the proportion was closer to one quarter. The largest percentages of parents with college degrees were within the cognitive disabilities (8.2%) and the physical disabilities (6.8%) groups.
Employment Status
Full-time workers represented approximately one third of parents of children both with and without disabilities (Exhibit 8-2). This figure was also true for parents of children in each of the disability categories, except for parents of children in the sensory disabilities category (24.7%). Parents of children in the sensory disabilities category were also the most likely to be unemployed (65.9%).
Household Income
Some important differences in monthly household income were noted between families with and without children with disabilities. As seen in Exhibit 8-2, a smaller proportion of families having children with disabilities (7.8%) also had monthly household incomes of less than $500 than was noted among families without children with disabilities (12.5%). In contrast, the families with children that had disabilities (21.2%) were more likely than families not having children with disabilities (14.8%) to have monthly household incomes of $2,000 or more. For the three middle categories of income, differences between the two groups of families were slight.
Families with children who were classified as having language disabilities had a distribution of income very much like that of the disabled group as a whole, but differences were apparent for families with children in the other groups (Exhibit 8-2). The very low family incomes (less than $500) were most likely found in families having children in the language disabilities category (8.2%), and less apparent among families with children in the cognitive (2.5%), physical (2.5%), and sensory (3.1%) disabilities groups. A big difference was noted in the highest monthly income category ($2,000 or more). While only 14.8% of the families with non-disabled children and 21.2% of all families containing children with disabilities were in this category, more than two fifths of families with children in the cognitive category (41.1%) and almost one half in the physical category (47.9%) had the highest level of monthly household income.
Housing Status
Exhibit 8-2 shows that a slightly higher proportion of children with disabilities (90.5%) lived in private homes than did children without disabilities (85.8%), while shared housing was used slightly less. Interestingly, although it was noted above that the families of children with disabilities had fewer families in the lowest income category and more in the highest income category than did families of children without disabilities, the former group had the higher proportion of families living in public housing (29.6% vs. 20.9%). The proportion of children with behavioral disabilities who also lived in public housing was 39.7%, about two times the level of most other groups.
Sources of Support
Exhibit 8-2 shows that WIC was used by more than one half of families, regardless of whether or not the children had disabilities, but that the receipt of TANF was slightly higher for families of children with disabilities (35.4%) than for families of children without disabilities (29.4%). WIC was used, similarly, by more than one half of the families with children in each of the disability categories. TANF receipt, however, was lower among families of children classified as having cognitive (53.9%), physical (19.5%), or sensory (21.8%) disabilities.
As expected, Exhibit 8-2 shows that the receipt of SSI or SSDI was much more likely among families of children with disabilities (20.4%) than among families of children without disabilities (9.4%). Among the disability categories, receipt of SSI or SSDI was highest by families of children in the cognitive (29.7%) and physical (29.0%) categories, and lowest for families with children in the behavioral (14.2%) and sensory (15.4%) categories.
Insurance Coverage
As noted in Exhibit 8-2, a higher proportion of children with disabilities were covered by private insurance (37.1%) and Medicaid (68.7%) than were children without disabilities (31.8% and 56.3%, respectively). Coverage by private insurance was highest among families of children classified in the cognitive (53.9%) and physical (53.7%) disabilities categories. Use of Medicaid was reported by over two thirds of the families in each of the disability categories, except by families of children with physical (49.0%) and sensory (56.4%) disabilities.
8.1.3 Functioning of Families of Children with Disabilities
This section presents information gathered from the parent interviews about the functioning of the Head Start families who had children with disabilities, including their psychological well-being, and their neighborhood environments.
Social Support
All families need outside sources of support in raising young children. This may be especially true for families of children with disabilities. In the spring of 1998, parents were asked about the people or groups in their lives that were helpful to them during the past six months in raising their Head Start children. Almost all of the parents of children with disabilities (91.5%) reported that Head Start was helpful (30.5%) or very helpful (61.0%) as a source of support. Overall, Head Start was considered slightly more helpful than grandparents or other relatives (82.1%) and much more helpful than friends (65.1%), other parents (61.9%), professional helpgivers (60.1%), people from religious or social groups (44.4%), child care staff (38.9%), or co-workers (24.2%).
Based on a summary variable measuring total support1 , parents of children with disabilities reported receiving more support in raising their children than parents of children without disabilities, t(2683) = 2.57; p = .01. Although both groups of parents were close on their reports of the amount of support they received from Head Start, grandparents and other relatives, friends, religious and social group members, and co-workers, a slightly larger proportion of parents of children with disabilities (38.9%) reported they received support from child care staff than parents of children without disabilities (30.8%), and a slightly smaller proportion of parents of children with disabilities reported receiving support from other parents (61.9% vs. 68.1%). As expected, almost twice as many parents of children with disabilities (60.1%) compared to parents of children without disabilities (31.0%) reported receiving support from professional helpgivers. Reports of social support did not vary by type of disability.
Psychological Well-Being
Depression among Head Start parents was measured using the CES-D Depression Scale2 (Radloff, 1977). Overall, most parents of children with disabilities were classified as not depressed (37.0%) or mildly depressed (26.9%). Still, one third of these parents were classified as moderately depressed (14.8%) or severely depressed (17.6%). Parents of children with disabilities were significantly more depressed, t(2682) = 3.04; p < .01, and had a more external locus of control, t(2682) = 3.31; p < .001, than parents of children without disabilities. Reports of parental depression did not vary by type of disability.
Social Service Needs
Because parents of young children sometimes need help of various kinds, they were asked, during the spring 1998 interview, to report whether they or someone in their household had needed or received help from various community agencies since September of 1997. Types of services included income assistance, employment assistance, help with health care, or other social service needs. Based on summary scores measuring need for services3 and receipt of services4, parents of children with disabilities had a greater need for services, t(2686) = 2.77; p < .01, and received more services, t(2686) = 3.06; p < .01, than parents of children without disabilities. The mean number of services needed by parents of children with disabilities was 8.9 (SD = 6.2) compared to 8.0 (SD = 5.6) services needed by parents of children without disabilities. The mean number of services received by parents of children with disabilities was 6.9 (SD = 5.4) compared to 6.3 (SD = 4.7) services received by parents of children without disabilities.
Health
Almost two thirds (65.2%) of the parents of children with disabilities reported they usually took their children to private doctors or HMOs for routine medical care. The remaining parents indicated that their children received routine medical care through public health departments (19.9%), or hospital outpatient clinics (14.1%). This use of routine health care services did not differ from that of parents of children without disabilities. However, parents of children with disabilities were significantly more likely to report that their children had chronic diseases, X2 (1, 2685) = 24.6; p < .0001. A significant chi-square was found when testing differences of health status between children with or without disabilities, X2 (4, 2688) = 39.9; p < .0001. Children with disabilities were less likely to be reported by their parents as having excellent health (35.2%) than children without disabilities (44.8%).
Involvement With Their Children
Parents were asked about their families’ activities with their children during the week and month prior to the spring 1998 interview. Almost all of the parents of children with disabilities (96.3%) reported that they or another family member read to the children during the past week. Almost one third of the children (32.1%) were read to every day, while 38.4% were read to three or more times, and 25.9% were read to once or twice during the week prior to the interview. A very small proportion, 3.7%, reported they had not read to their children at all during the past week. The frequency of reading reported by parents of children without disabilities was very similar. Families of children with disabilities also involved their children in a wide range of activities. No significant differences in the amount of weekly, monthly, or total activities with children were noted between families with or without children with disabilities. Reports of family activities with children did not vary by type of disability.
Child Behavior
Parents were asked to rate their children in several different areas, including their behavior and emergent literacy. Compared to parents of children without disabilities, parents of children with disabilities indicated their children had fewer positive social behaviors5, t(2672) = 4.90; p < .0001, and more problem behaviors6, t(2659) = 8.12; p < .0001, including behavior that was more aggressive7, t(2681) = 4.40; p < .0001, hyperactive8, t(2679) = 6.47; p < .0001, and withdrawn9, t(2671) = 8.34; p <.0001. Children with disabilities were significantly lower on emergent literacy10 than children without disabilities, t(2686) = 7.95; p < .0001.
One-way analyses of variance were used to test for overall differences in the parents’ reports on child behavior and emergent literacy, categorized by child disability type. Post-hoc Scheffe tests (ps < .05) identified individual differences between each group. For the child behavior, significant main effects were noted for type of disability by positive social behavior, F(5, 274) = 3.60; p < .01, overall problem behavior, F(5, 272) = 10.84; p < .0001, aggressive behavior F(5, 279) = 3.69; p < .0001, and hyperactive behavior, F(5,275) = 7.96; p < .0001. Children with behavioral disabilities had higher reported behavior problems, including aggressive and hyperactive behaviors, than children with language disabilities. They also had more reported problem behaviors and hyperactive behaviors than children with physical disabilities, and more problem behaviors and aggressive behaviors than children with multiple disabilities. There were no differences by type of disability on emergent literacy.
Neighborhood Environments
When asked in spring 1998 about their families’ exposure to neighborhood and personal violence during the past six months, slightly larger proportions of parents of children with disabilities reported having been exposed to crime, violence, and victimization than parents of children without disabilities. Almost one fourth of parents of children with disabilities (23.5%) reported seeing nonviolent crime in their neighborhoods and over two thirds reported exposure to violent crime (35.6%), while parents of children without disabilities reported less exposure to nonviolent (18.9%) and violent crime (23.3%) in their neighborhoods. Almost one quarter of the parents of children with disabilities (22.7%) knew someone who was the victim of a violent crime in their neighborhood, compared to 17.7% of parents of children without disabilities. Victimization in the neighborhood was reported by 4.5% of the parents with disabilities compared to 3.8% of parents of children without disabilities and 3.8% of the parents of children with disabilities reported being victims of violence in their homes compared to 3.4% of the parents of children without disabilities.
This finding was somewhat surprising, given parents of children with disabilities reported, on average, higher monthly household incomes than parents of children without disabilities. Further investigation through the use of a one-way analysis of variance and post-hoc tests found that those families reporting the lowest household incomes (less than $500 per month) scored higher on the exposure to violence scale then families whose reported income fell into any of the other higher income categories, F(4, 392) = 2.75; p < .05.
8.1.4 Relationships with Head Start
This section presents information regarding how satisfied parents of children with disabilities were with the overall Head Start program, the barriers to participation they faced, ways they felt Head Start had helped their families, suggestions for improvement, and how Head Start addressed the special needs of their children.
Program Response to Children with Disabilities
Over one half of the children with disabilities (57.8%) were diagnosed after enrolling in Head Start and two fifths of their parents (40.2%) reported that the disabilities affected their children’s ability to learn. While almost all of the children (81.6%) were members of Head Start classrooms that included children with or without disabilities, about one half of the children with disabilities (48.7%) left their classrooms for separate services or instruction.
By the spring 1998 interview, almost 70% of the parents indicated their children received all (62.1%) or most (7.0%) of the services identified in their Individualized Education Programs (IEP). Yet, close to one quarter of the parents reported their children only received some (14.6%) or none (8.9%) of the services needed. When asked where their children were receiving services for their disabilities, Head Start was mentioned by 64.3% of the parents, school districts were mentioned by 36.7% of parents, 22.5% cited doctors or clinics, and 18.6% reported receiving services from State or local health or social service agencies. Over three quarters of the parents were very satisfied (59.6%) or somewhat satisfied (16.5%) with the services their children were receiving. Close to one fifth reported they were somewhat (2.1%) or very dissatisfied (14.1%) with these services.
When asked how helpful Head Start was with assisting parents in talking with other schools and agencies, and knowing about other resources available for meeting their children’s special needs, close to three quarters of the parents indicated Head Start was helpful (19.8%) or very helpful (53.8%) to them. Head Start was also rated as helpful (22.9%) or very helpful (49.8%) in assisting parents to better meet the special needs of their children in the home, for example, providing a proper diet and exercise or continuing recommended therapy.
Slightly over one third of the parents (34.2%) felt there were areas or ways that the Head Start program could improve in providing services to children with special needs and their families. Suggestions included the following: provide therapy at the Head Start center (21.2%), give more attention to children in special situations such as having separated parents (9.0%), provide more information about services available for special needs children (8.3%), provide services more quickly (8.0%), offer more activities or routines focused on special needs children (7.5%), notify parents immediately about children’s special needs (6.2%), provide more individual attention (5.6%), and have more special education teachers and staff available (5.3%).
Involvement at Head Start
In the spring of 1998, parents were asked about the ways that they were involved in the Head Start program throughout the past school year. A summary score measuring total involvement11 showed that parents of children with disabilities were significantly more involved in Head Start than parents of children without disabilities, t(2685) = 2.16; p = .03. As demonstrated in Exhibit 8-1, although parents of children with or without disabilities participated at very similar rates, slightly larger proportions of those who had children with disabilities attended parent-teacher conferences (88.2% vs. 80.7%) and participated in Policy Council (42.2% vs. 35.1%).
| Weighted Percentages | ||
|---|---|---|
| Parents of Children | ||
| With Disabilities | Without Disabilities | |
| Observed classroom for 30 minutes or more | 76.8 | 77.4 |
| Prepared food or materials | 71.4 | 65.4 |
| Helped with field trips | 50.7 | 50.9 |
| Attended Head Start social events | 58.4 | 55.2 |
| Attended workshops | 55.1 | 54.7 |
| Attended parent-teacher conferences | 88.2 | 80.7 |
| Had Head Start staff visit at home | 83.0 | 82.9 |
| Participated in Policy Council | 42.2 | 35.1 |
| Called another Head Start parent | 35.9 | 30.1 |
| Prepared newsletters, fliers, etc. | 23.7 | 22.6 |
| Participated in fundraising | 63.0 | 59.5 |
Barriers to Participation
In the spring of 1998, parents were asked if there were particular barriers that prevented them from participating as much as they would have liked at their children’s Head Start program. The four barriers to participation mentioned by over 10% of the parents of children with disabilities were work commitments (56.0%), need for child care (36.9%), school schedules (18.8%), and lack of transportation (17.3%). Similar proportions of parents of children without disabilities mentioned these four barriers, except that slightly fewer of these parents reported a need for child care (30.7% vs. 36.9%). Interestingly, almost twice as many parents of children with disabilities felt Head Start did not provide enough opportunities to participate (7.6% vs. 3.8%) or reported a lack of support from their spouse or partner as a barrier to participation (20.4% vs. 11.5%).
Satisfaction with the Head Start Experience
Parents were asked how satisfied they were with Head Start’s performance in eight different areas, including helping their children to grow and develop, preparing their children for kindergarten, and supporting their family’s culture and background. A summary satisfaction score12 was created for each parent who responded to the questionnaire. While parents of children with disabilities were significantly less satisfied than parents of children without disabilities, t(2685) = 2.42; p = .02, the latter group’s satisfaction with the program was still high (M = 28.7 out of a possible 32; SD = 3.9). Further examination revealed that while overall satisfaction was comparable between the two groups, parents of children with disabilities were more likely to report that they were “somewhat” satisfied with Head Start whereas parents of children without disabilities more often indicated that they were “very” satisfied.
When asked if they could change anything about Head Start to help it better serve children and families, 38.1% of the parents of children with disabilities indicated that they were satisfied with the program and no change was needed. Areas for improvement mentioned by at least five percent of the parents included having extended hours and longer days (10.3%), involving parents more (9.1%), improving the special needs programs (6.3%), and focusing more on academic skills (5.7%).
8.1.5 Summary of Findings on Families of Children with Disabilities
Findings from this section contributed to a more complete understanding of Head Start families who have children with disabilities, including their involvement, perceptions, and satisfaction with the Head Start program. Highlights from Section 8.1 include :
Characteristics of Children
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Among children with disabilities, the ethnic groups with the largest representation were African American children and White children. In both cases, these proportions were larger than the proportions of the same two ethnic groups among children without disabilities.
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While the main sample of children was evenly split between boys and girls, almost two thirds of the children with disabilities were boys. This finding was generally true within each of the disability categories, although the proportion of boys in the behavioral disability category was up to three quarters.
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The percentage of 3-year-olds among the children without disabilities was less than one third. This was very similar to the proportion of 3-year-olds in the overall study sample. In contrast, more than two fifths of the children with disabilities were 3 years old. Within the five disability categories, more than one half of the children with behavioral disabilities were 3 years old, but less than one quarter of those in the cognitive disabilities and the sensory disabilities categories were 3 years of age.
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Urban areas were home to approximately two thirds of the children with disabilities and children without disabilities. This pattern was consistent across the disability categories, with the exception of children with physical disabilities, who were more likely to come from rural areas.
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The distribution of children, both with and without disabilities, by geographic region was generally similar to the distribution of the regions across the study population as a whole.
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In looking at the five disability categories, physical disabilities had an increased proportion of children from the Midwest, while only 17.2% of the children came from the South, which was the largest group of children, overall.
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More than 80% of the children in the study were of normal birthweight, regardless of whether they had disabilities or not.
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Among the disability categories, less then three quarters of the children in the cognitive category and the physical category were born with a normal birthweight. The physical disabilities category had the largest proportions of children with low and very low birthweights.
Characteristics of Families
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The distributions of parents’ ages across the groups of children with and without disabilities was generally mixed. Both groups had about one half of the parents under 30 years of age, but the percentage of children with disabilities having parents less than 20 years of age was about twice that of children without disabilities.
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About one tenth of the children in the behavioral disabilities category had a parent under 20, while none of the children in the physical disabilities category had a parent less than 20 years of age. The mean and median ages for parents of children in these two groups were slightly higher than that reported for parents of children in the other disability categories.
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The parents of children without disabilities included a much higher proportion of non-U.S. born individuals than did parents of children with disabilities.
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The parents of children with disabilities were very similar to the parents of children without disabilities on their distribution across four categories of marital status.
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Within the disability categories, parents of children in the cognitive disabilities group and the physical disabilities group had the highest percentage of married parents. More than two thirds of the children in the behavioral disabilities category had single parents as did slightly over one half of the children in the language disabilities category.
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The distribution of parents across the five education and training categories was similar for parents of children with disabilities and parents of children without disabilities. In both cases, just over one quarter had less than a high school diploma, and just over one third had a diploma or GED only.
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Within the five disability categories, less then one tenth of the parents of children with physical disabilities had less than a high school diploma, while for the other four groups, the proportion was closer to one quarter. The largest percentages of parents with college degrees were within the cognitive disabilities and the physical disabilities groups.
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Full-time workers represented approximately one third of parents of children both with and without disabilities. This figure was also true for parents of children in each of the disability categories, except for parents of children in the sensory disabilities category, who were also the most likely to be unemployed.
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A smaller proportion of families having children with disabilities also had monthly household incomes of less than $500 than families without children with disabilities. In contrast, the families with children that had disabilities were more likely than families not having children with disabilities to have monthly household incomes of $2,000 or more. For the three middle categories of income, differences between the two groups of families were slight.
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A slightly higher proportion of children with disabilities lived in private homes than did children without disabilities, while shared housing was used slightly less.
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Interestingly, although it was noted that the families of children with disabilities had fewer families in the lowest income category and more in the highest income category than did families of children without disabilities, the former group had the higher proportion of families living in public housing. The proportion of children with a behavioral disability who also lived in public housing was about two times the level of most other groups.
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WIC was used by more than one half of families, regardless of whether or not the children had disabilities, but the receipt of TANF was slightly higher for families of children with disabilities than by families of children without disabilities.
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WIC was used by more than one half of the families with children in each of the disability categories. TANF receipt, however, was lower among families of children classified as having cognitive, physical, or sensory disabilities.
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The receipt of SSI or SSDI was much more likely among families of children with disabilities than among families of children with out disabilities. Among the disability categories, receipt of SSI or SSDI was highest by families of children in the cognitive and physical categories, and lowest for families with children in the behavioral and sensory categories.
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A higher proportion of children with disabilities were covered by private insurance and Medicaid than were children without disabilities. Coverage by private insurance was highest among families of children classified in the cognitive and physical disabilities categories. Use of Medicaid was reported by over two thirds of the families in each of the disability categories, except by families of children with physical and sensory disabilities.
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Almost all of the parents of children with disabilities reported that Head Start was helpful or very helpful as a source of support. Overall, Head Start was considered slightly more helpful than grandparents or other relatives and much more helpful than friends, other parents, professional helpgivers, people from religious or social groups, child care staff, or coworkers.
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Overall, most parents of children with disabilities were classified as not depressed or mildly depressed. Still, one third of these parents were classified as moderately depressed or severely depressed.
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Parents of children with disabilities were significantly more depressed and had a more external locus of control then parents of children without disabilities. Reports of parental depression did not vary by type of disability.
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Parents of children with disabilities had a greater need for services and received more services than parents of children without disabilities.
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Almost two thirds of the parents of children with disabilities reported they usually took their children to private doctors or HMOs for routine medical care. This use of routine health care did not differ from parents of children without disabilities.
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Parents of children with disabilities were significantly more likely to report that their children had chronic diseases and less likely to report they had excellent health than children without disabilities.
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Almost all of the parents of children with disabilities reported that they or another family member read to the children during the past week. Almost one third of the children were read to every day. A very small proportion reported they had not read to their children at all during the past week.
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Parents of children with disabilities also involved their children in a wide range of activities. No significant differences in reported amounts of activities with children were noted between families with or without children with disabilities. Reports of activities with children did not vary by type of disability.
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Compared to parents of children without disabilities, parents of children with disabilities indicated their children had less positive social behavior, and more problem behavior, including behavior that was more aggressive, hyperactive, and withdrawn.
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Children with behavioral disabilities had more reported problem behaviors, including the aggressive and hyperactive behaviors, than children with language disabilities, more reported problem behaviors and hyperactive behaviors than children with physical disabilities, and more problem behaviors and aggressive behaviors than children with multiple disabilities.
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Children with disabilities also had significantly lower reports of emergent literacy than children without disabilities. There were no differences by type of disability on emergent literacy.
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Almost one fourth of parents of children with disabilities reported seeing nonviolent crime in their neighborhoods and over two thirds reported exposure to violent crime. Parents of children without disabilities reported less exposure to nonviolent and violent crime in their neighborhoods.
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Almost one quarter of the parents of children with disabilities knew someone who was the victim of a violent crime in their neighborhood. Victimization in the neighborhood was reported by approximately five percent of the parents with disabilities. Less than five percent of the parents of children with disabilities reported being victims of violence in their homes. These percentages were slightly higher than parents of children without disabilities.
Relationship with Head Start
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Parents of children with disabilities were significantly more involved at Head Start than parents of children without disabilities. Although parents of children with or without disabilities participated at very similar rates, slightly larger proportions of those who had children with disabilities attended parent-teacher conferences and participated in Policy Council.
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The four barriers to participation mentioned by over ten percent of the parents of children with disabilities were work commitments, need for child care, school schedules, and lack of transportation.
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While parents of children with disabilities were significantly less satisfied than parents of children without disabilities, their satisfaction with the program was still high.
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When asked if they could change anything about Head Start they thought would help it better serve children and families, two fifths of the parents of children with disabilities indicated that they were satisfied with the program and no change was needed.
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Areas for improvement mentioned by at least five percent of the parents included having extended hours and longer days, involving parents more, improving the special needs programs, and focusing more on academic skills.
8.1.6 Supplemental Table
| Weighted Percentages | ||||||||
|---|---|---|---|---|---|---|---|---|
| All (N = 3,120) |
Families without Disabilities (n =2,696) |
Families with Disabilities (n = 424) |
Disability Categoriesa | |||||
| Language (n =341) |
Behavioral (n = 59) |
Cognitive (n = 53) |
Physical (n = 36) |
Sensory (n = 39) |
||||
| Ethnicity | ||||||||
| African American | 28.8 | 27.5 | 36.7 | 36.7 | 35.7 | 30.6 | 27.7 | 18.2 |
| White | 30.6 | 30.1 | 34.1 | 31.9 | 42.6 | 45.7 | 53.9 | 36.4 |
| Hispanic | 27.6 | 28.9 | 20.3 | 22.0 | 13.9 | 16.5 | 6.0 | 34.0 |
| Native American | 1.9 | 1.9 | 1.6 | 2.0 | 3.5 | 0.0 | 0.0 | 3.9 |
| Asian | 1.3 | 1.4 | 0.4 | 0.5 | 0.0 | 1.9 | 0.0 | 0.0 |
| Other | 8.7 | 9.0 | 6.7 | 6.8 | 4.4 | 5.6 | 12.4 | 5.8 |
| Urbanicity | ||||||||
| Urban | 66.9 | 67.4 | 64.4 | 65.4 | 55.3 | 59.0 | 43.7 | 66.0 |
| Rural | 33.0 | 32.6 | 35.6 | 34.6 | 44.6 | 41.0 | 56.3 | 33.9 |
| Region | ||||||||
| Midwest | 23.1 | 23.7 | 19.4 | 17.0 | 34.0 | 21.0 | 41.4 | 26.2 |
| Northeast | 15.5 | 14.8 | 19.6 | 19.2 | 15.0 | 23.0 | 22.1 | 30.7 |
| South | 39.4 | 39.3 | 40.5 | 43.0 | 40.3 | 38.6 | 17.2 | 32.2 |
| West | 22.0 | 22.2 | 20.5 | 20.7 | 10.8 | 17.4 | 19.3 | 10.9 |
| Gender of Child | ||||||||
| Male | 50.4 | 48.3 | 62.6 | 63.1 | 74.5 | 69.1 | 61.9 | 58.0 |
| Female | 49.6 | 51.6 | 37.4 | 36.9 | 25.5 | 30.9 | 38.1 | 42.0 |
| Age of Child | ||||||||
| 3 years old | 31.7 | 30.0 | 41.8 | 40.4 | 54.2 | 24.4 | 47.8 | 22.8 |
| 4 years old | 68.3 | 70.0 | 58.2 | 59.6 | 45.8 | 75.6 | 52.2 | 77.1 |
| Child Birthweight | ||||||||
| Normal | 85.8 | 86.5 | 81.8 | 84.2 | 77.1 | 64.1 | 55.8 | 85.4 |
| Low | 7.6 | 7.3 | 9.4 | 9.3 | 10.8 | 9.3 | 20.5 | 7.5 |
| Very low | 1.8 | 1.7 | 2.7 | 2.4 | 0.3 | 2.2 | 7.5 | 2.5 |
| Age of Parent | ||||||||
| Less than 20 years old | 2.5 | 2.1 | 5.0 | 5.8 | 10.2 | 3.0 | 0.0 | 4.5 |
| 21-29 years old | 53.1 | 54.2 | 46.9 | 47.2 | 45.3 | 38.8 | 28.7 | 65.7 |
| 30-39 years old | 32.4 | 31.7 | 36.3 | 36.4 | 31.9 | 38.6 | 53.4 | 22.9 |
| 40 and older | 11.7 | 11.8 | 11.5 | 10.2 | 12.6 | 19.7 | 17.9 | 6.8 |
| Mean age | 30.2 | 30.0 | 31.4 | 30.9 | 31.8 | 33.1 | 32.6 | 30.5 |
| Median age | 28.0 | 28.0 | 29.0 | 29.0 | 29.5 | 31.0 | 32.5 | 28.0 |
| Nativity of Parent | ||||||||
| Born in country other than US | 18.7 | 20.6 | 7.3 | 8.1 | 1.7 | 3.6 | 3.3 | 15.5 |
| Marital Status | ||||||||
| Married | 43.1 | 43.1 | 43.1 | 44.2 | 29.2 | 66.9 | 71.3 | 57.6 |
| Single, never married | 33.7 | 33.4 | 35.1 | 35.0 | 47.2 | 19.3 | 17.8 | 30.8 |
| Divorced or widowed | 13.5 | 13.5 | 13.4 | 12.2 | 15.8 | 11.7 | 8.2 | 4.6 |
| Married, but separated | 9.6 | 9.9 | 8.3 | 8.6 | 7.7 | 2.1 | 2.7 | 7.0 |
| Education and Training | ||||||||
| Less than high school | 27.2 | 27.5 | 25.4 | 27.1 | 28.2 | 17.0 | 9.5 | 30.8 |
| High school diploma/GED | 37.5 | 37.7 | 36.4 | 36.1 | 26.1 | 36.8 | 47.8 | 25.7 |
| Some college/AA degree | 32.5 | 31.9 | 36.1 | 35.4 | 45.7 | 38.0 | 35.9 | 43.5 |
| College degree or higher | 2.8 | 2.9 | 2.1 | 1.4 | 0.0 | 8.2 | 6.8 | 0.0 |
| Vocational or trade school | 41.8 | 41.0 | 46.4 | 45.8 | 46.6 | 39.4 | 51.9 | 33.0 |
| Employment Status | ||||||||
| Full-time | 34.5 | 34.8 | 32.2 | 33.5 | 36.8 | 31.3 | 34.0 | 24.7 |
| Part-time or seasonal | 17.8 | 17.0 | 22.3 | 21.6 | 23.6 | 17.5 | 16.6 | 9.3 |
| Not employed | 47.3 | 47.7 | 44.9 | 44.3 | 39.7 | 51.2 | 47.6 | 65.9 |
| Household Income | ||||||||
| $499 or less | 11.8 | 12.5 | 7.8 | 8.2 | 4.0 | 2.5 | 2.5 | 3.1 |
| $500-999 | 29.6 | 29.1 | 32.9 | 35.0 | 39.4 | 11.0 | 13.5 | 23.9 |
| $1,000-1,499 | 24.8 | 24.9 | 24.5 | 24.2 | 17.4 | 32.2 | 23.8 | 33.5 |
| $1,500-1,999 | 14.4 | 14.9 | 11.8 | 10.4 | 15.8 | 13.1 | 7.3 | 10.5 |
| $2,000 or more | 15.7 | 14.8 | 21.2 | 20.7 | 21.9 | 41.1 | 47.9 | 28.9 |
| Housing Status | ||||||||
| Private housing | 86.4 | 85.8 | 90.5 | 91.1 | 93.0 | 90.0 | 89.2 | 89.9 |
| Shared housing | 12.5 | 13.3 | 7.7 | 8.2 | 2.9 | 3.5 | 6.8 | 10.1 |
| Transitional housing | 1.1 | 0.9 | 1.8 | 0.7 | 4.2 | 6.5 | 4.1 | 0.0 |
| Public housing | 22.2 | 20.9 | 29.6 | 28.7 | 39.7 | 16.9 | 21.0 | 20.9 |
| Sources of Support | ||||||||
| WIC | 54.5 | 54.7 | 53.4 | 51.8 | 61.8 | 61.4 | 50.0 | 47.9 |
| TANF | 30.2 | 29.4 | 35.4 | 35.5 | 38.7 | 18.8 | 19.5 | 21.8 |
| SSI or SSDI | 11.0 | 9.4 | 20.4 | 18.8 | 14.2 | 29.7 | 29.0 | 15.4 |
| Insurance Coverage | ||||||||
| Private insurance | 32.6 | 31.8 | 37.1 | 38.8 | 27.0 | 53.9 | 53.7 | 48.0 |
| MEDICAID | 58.1 | 56.3 | 68.7 | 67.5 | 74.1 | 68.7 | 49.0 | 56.4 |
| aChildren with multiple disabilities may be represented in more than one disability category.(back) |
8.2 Hispanic Head Start Children and Families13
In Head Start, as in the United States, population growth among people of Hispanic heritage is greater than for any other ethnic group. As displayed in Exhibit 8-3, the Head Start Program Information Report(PIR) (ACYF, 1993; ACYF, 1999) data indicate that enrollment of Hispanic children has increased by 77,571 children or 51.0% since the 1992-93 school year, compared to 15.7% for Asian/Pacific Islanders, 8.5% for African-American, 3.5% for American Indian, and 3.1% for White children. Overall, enrollment of Hispanic children in Head Start has increased from 21.3% to 27.9% of the total enrollment since 1992-93.
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| Source: Head Start PIR |
The focus of this section is to describe Hispanic Head Start children and families. Exhibit 8-4, located at the end of Section 8.3, presents weighted data describing basic variables of interest. The first column presents data on all FACES families. The next two columns present data on non-Hispanic families and all Hispanic families, respectively14. The last three columns present data on Hispanic families and children living in Puerto Rico and families of Hispanic children who are mainland residents, both those who speak English and those who are Spanish-speaking15. Head Start families residing in Puerto Rico generally speak only Spanish in a society where Spanish is the common language and the culture is primarily Hispanic. Mainland Hispanics may differ from Hispanics living in Puerto Rico on a number of issues, making it important to describe this group separately. Although many mainland Hispanic families are native English speakers, others live in households where the spoken language is predominantly Spanish while the common language outside the home is English. Further, mainland Hispanics include diverse groups of families originating in Mexico, Puerto Rico, Cuba and other nations in Latin America, South America, and the Caribbean. Due to this diversity, cultural issues may not have an impact on these families similar to the impact on families residing in Puerto Rico.
This section first presents the results of analyses on descriptive variables of interest. Subsequent sections assess Hispanic family risk factors, health care, child care, family activities with their children, social support, and family involvement in Head Start. Each section presents analyses comparing all Hispanic families and children to non-Hispanic families and then compares findings among the three Hispanic groups – families residing in Puerto Rico, mainland Spanish-speaking families, and mainland English-speaking families.
8.2.1 Characteristics of Hispanic Children in Head Start
Age and Gender
Results presented in Exhibit 8-2 indicate that the majority of Hispanic children in Head Start, like the overall sample, were 4 years old (72.6%). More Hispanic children were 4 years old than non-Hispanic children (66.8%). Among Hispanic groups, while almost three fourths of mainland Hispanic children were 4 years old, proportionally fewer children living in Puerto Rico were 4 years old (60.8%). In regard to gender, like the overall sample, an equal proportion of Hispanic children were male and female. Differences among the Hispanic groups in terms of gender were not significant.
Birth Weight and Disabilities
The majority of Hispanic children in Head Start, like the overall sample, were normal birth weight(86.5%). There were no significant differences in birth weight between children from all Hispanic families and non-Hispanics or among children across the three Hispanic groups. Exhibit 8-5 displays the percent of children with disabilities and indicates that proportionally fewer Hispanic children were reported to have one or more disabilities16 (16.8%) than non-Hispanic children (20.6%). Head Start families living in Puerto Rico had almost twice as many children identified with one or more disabilities (32.7%) than mainland English-speaking (16.1%) and Spanish-speaking (7.3%) families.
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8.2.2 Characteristics of Hispanic Families in Head Start
Family Residence
The majority of Hispanic families lived in urban areas and was geographically concentrated in the West and South regions of the country. More than three quarters of the families (86.4%) resided in urban areas. Likewise, more than two fifths of all Hispanic families lived in the South (40.4%) and the West (38.0%) regions of the country. Compared to non-Hispanic families, Hispanic families were more likely to live in urban areas and the West and less likely to live in the Midwest.
Nativity of the Parents
As seen in Exhibit 8-6, 52.0% of all Hispanic Head Start parents were foreign born. Of this group, 90.4% have lived in the U.S. five or more years (M = 10.9 years; SD = 6.6). There was large variability among the Hispanic groups in terms of parents’ nativity. Almost all the mainland Spanish-speaking Hispanic parents were foreign born (97.1%), while less than one half of the English-speaking parents were born outside the U.S. (42.5%). Only 7.7% of parents living in Puerto Rico reported having been born outside the U.S. However, the majority of parents in each of these groups had lived in the U.S. for more than five years, with an average time in the U.S. of 9.4 years (SD = 5.5) for parents in Spanish-speaking families and 12.8 years (SD = 7.4) for parents in English-speaking mainland families.
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Language
As displayed in Exhibit 8-7, the vast majority of Hispanic families reported Spanish was the primary language spoken in their homes (90.4%). Among Hispanic groups, almost all parents living in Puerto Rico and Spanish-speaking mainland families spoke Spanish as the primary language in their homes while 81.4% of English-speaking mainland families also primarily spoke Spanish in their homes. Over one half of all Hispanic Head Start children were assessed in Spanish (56.1%) in the fall of 1997. This included almost all of the children living in Puerto Rico (98.0%), 72.9% of the mainland children with Spanish-speaking parents, and over one fourth of mainland children with English-speaking parents (29.1%).
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Marital Status and Household Size
As displayed in Exhibit 8-8, most Hispanic children enrolled in Head Start resided in families with married parents (55.9%). Proportionally, more Hispanic parents were married or married but separated than non-Hispanic families. The patterns of family structures were generally similar across the Hispanic groups, although more Spanish-speaking mainland Hispanic parents were married (72.5%) than English-speaking mainland Hispanic families (45.4%).
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Hispanic families, on average, had only slightly larger households than non-Hispanic families. Hispanic families had an average of 4.7 persons (SD = 1.6) in the household compared to 4.5 (SD = 1.7) for non-Hispanic households. Among Hispanic groups, mainland Hispanic households were larger than households in Puerto Rico. On average, Spanish-speaking mainland households had 5.2 persons (SD = 1.7) and English-speaking mainland households had 4.6 persons (SD = 1.6) compared to 4.2 (SD = 1.0) per household in Puerto Rico.
Educational Attainment
As displayed in Exhibit 8-9, more than one third of Hispanic parents had not received a high school diploma or GED (38.5%), a higher proportion than non-Hispanic parents (22.6%). Fewer Hispanic parents had a high school diploma/GED (34.4%) and attended some college or received an AA degree (24.3%) than non-Hispanic families (39.3% and 35.4%, respectively). However, similar to non-Hispanics, 2.8% of Hispanic parents have attained a college degree or higher. Fewer Hispanic parents were working toward a degree (21.0%) than non-Hispanic parents (25.6%).
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There was a large degree of variability across the Hispanic groups in terms of educational attainment. Over one half of Spanish-speaking mainland Hispanics (54.3%) had not received a high school diploma or GED compared to one third of English-speaking mainland Hispanics (35.8%). Similar to non-Hispanics, less than one fourth of parents who resided in Puerto Rico (21.6%) did not have a high school diploma. Attainment of a high school diploma or GED was fairly similar across the three groups, ranging from 34.0% to 35.5%. In terms of post-secondary education, proportionally more parents living in Puerto Rico had attended some college or received an AA degree (35.1%) than either mainland Spanish-speaking (9.9%) and English-speaking parents (28.7%), and this proportion was comparable to non-Hispanic parents (35.4%). Interestingly, parents living in Puerto Rico were more than twice as likely to have a college degree or higher (7.8%) than non-Hispanics (2.7%). Fewer Spanish-speaking mainland Hispanics had attended some college or received a college degree (11.5%) than English-speaking mainland Hispanics (30.2%) or residents of Puerto Rico (42.9%). Similar proportions of the parents living in Puerto Rico and English-speaking mainland residents were working toward a degree (25.5%) compared to Spanish-speaking mainland residents (13.9%).
Employment
Less than one third of Hispanic parents (29.9%) were employed full-time and as seen in Exhibit 8-10, over one half of Hispanic parents (53.0%) were not employed. Proportionally more Hispanic parents were unemployed than non-Hispanics (44.7%) and fewer were employed full-time than non-Hispanics (36.4%). Among the Hispanic groups, proportionally more residents of Puerto Rico (58.0%) and Spanish-speaking mainland residents (61.9%) were not employed. However, English-speaking mainland residents appeared to be more similar to non-Hispanics, with fewer not employed (45.5%) and more employed full time (35.5%) or part time/seasonally (18.8%).
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Income and Other Sources of Support
Exhibit 8-11 displays the percentage of families with monthly household incomes less than $1,000. Almost one half of Hispanic households had an income of less than $1,000 per month (45.6%), which was proportionally higher than non-Hispanic households (39.6%). Among Hispanic groups, although parents living in Puerto Rico reported higher levels of education, they proportionally had more households making less than $1,000 per month (71.1%) than any other group. Mainland Hispanic households were more comparable to non-Hispanic households in terms of monthly income, with 36.8% of Spanish-speaking households and 40.6% of English-speaking households making less than $1,000 per month.
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Similar to non-Hispanics, more than one half of Hispanic families (57.6%) received financial assistance from the WIC program (see Exhibit 8-12). However, fewer Hispanic parents received TANF (22.6%) and SSI or SSDI benefits (4.5%) than non-Hispanic parents (33.3% and 13.9%, respectively). Among Hispanic groups, almost one half (49.2%) of parents living in Puerto Rico received assistance from the WIC program compared to almost 60% of mainland Hispanic parents. English-speaking mainland Hispanic families were fairly comparable to non-Hispanics in terms of the percentage who received TANF benefits (30.4%), while fewer Spanish-speaking mainland residents (19.2%) and even fewer residents of Puerto Rico (8.3%) received TANF benefits. Slightly over 5% of mainland English-speaking Hispanic families and families living in Puerto Rico received SSI or SSDI while fewer Spanish-speaking mainland families received SSI or SSDI (2.7%). Finally, fewer Hispanic children were covered by private health insurance (27.9%) or Medicaid (54.0%) than non-Hispanic children (34.5% and 59.7%, respectively). Spanish-speaking mainland children were much more likely (30.8%) to not receive any form of insurance coverage relative to children living in Puerto Rico (4.4%) and English-speaking mainland children (16.0%).
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Housing
As shown in Exhibit 8-4, the majority of Hispanic families lived in private housing; however, more Hispanic parents (15.2%) lived in shared housing than non-Hispanic parents (11.4%), while fewer Hispanic parents (17.6%) lived in public housing than non-Hispanic parents (24.1%). Findings were generally similar among Hispanic groups, although fewer families living in Puerto Rico lived in shared housing (5.3%) and more Spanish-speaking mainland residents lived in shared housing (21.2%). However, more families who were residents of Puerto Rico lived in public housing (36.6%), while fewer Spanish-speaking mainland residents lived in public housing (8.2%).
8.2.3 Family Risk Factors
Exhibit 8-13 presents the percentage of Hispanic families with selected family risk factors that are aligned with factors identified in the Kids Count Data Book (Annie E. Casey Foundation,1999). As discussed earlier in Section II, Chapter 5 of this technical report, findings from recent research have pointed to the importance of looking at the multiplicative effects of selected risk factors in predicting negative outcomes for children.
The most prevalent risk found among Hispanic families was living in a household that was below the Federal Poverty Level (FPL) (70.2%). Approximately two fifths of Hispanic children also had a mother who did not complete high school (40.8%) or lived in a single parent household (40.7%). Compared to non-Hispanic families, Hispanic families were proportionally more likely to have a mother who did not complete high school (40.8% vs. 24.5%), household income below the FPL (70.4% vs. 62.4%), and to have a child not covered by health insurance or Medicaid (24.0% vs. 15.8%). Hispanic families were less likely than non-Hispanic families to be living in single parent households (40.7% vs. 57.7%), households with no parents with a job (22.0% vs. 27.0%), and households receiving TANF benefits (22.6% vs. 33.3%). Among Hispanic groups, families living in Puerto Rico (88.2%) were proportionally more likely than other Hispanic groups and non-Hispanics to have household incomes below the FPL. Almost twice as many parents living in Puerto Rico (30.8%) reported living in households with no parent working than mainland Spanish-speaking families (15.2%). About one fourth of mainland English-speaking families (22.6%) lived in households with no parent working. The profiles for mainland Hispanic families looked fairly similar. Both Spanish- and English-speaking mainland Hispanic families were more likely than non-Hispanic families to have monthly household incomes below the FPL (65.2% and 66.3% vs. 62.4%, respectively), mothers who did not receive a high school diploma or GED (55.0% and 39.4% vs. 24.5%, respectively), and had no medical insurance coverage for their children (30.7% and 22.6% vs. 15.8%, respectively). In terms of maternal education and children’s health insurance coverage, Spanish-speaking mainland families were proportionally more at risk than English-speaking families.