Barriers to Family-Centered Services for Infants and Toddlers with Developmental Delays

Family-centered practice has a long tradition in social work (Briar-Lawson, 1998). The profession has consistently emphasized the importance of providing family support aimed at strengthening families (Briar-Lawson; Cole, 1995). Social workers have become increasingly involved in early intervention services for families with infants and toddlers who have developmental delays (Atkins-Burnett & Allen-Meares, 2000; Saunders, 1995). The principles of family-centered practice are a key component in this field of practice (Shelton, & Stepanek, 1994). The family-centered ideology in early intervention was formalized with the implementation of the Education of the Handicapped Act Amendments of 1986 (P.L. 99-457), which was renamed the Individuals with Disabilities Education Act (P.L. 101-476) in 1990 and was amended again in 1997. Part C is the section of the legislation that emphasizes family involvement in early intervention services (Atkins-Burnett & Allen-Meares). According to Laird (1995), the basic underlying assumption of the family-centered model is that "people can be best understood and helped in the context of their family of origin and current network of intimate relationships" (p. 151). In the context of early intervention, a family-centered approach focuses on helping families cope with the challenges of having children with developmental delays, empowering families to work collaboratively with services providers, and supporting families as they make decisions about which services will be most beneficial to the family (Dunst & Deal, 1994; McGonigel, Kaufman, & Johnson, 1991). According to Beckman and colleagues (1994), family-centered services must consider the complexity that exists within families; use intervention strategies that can accommodate diversity in family beliefs, values, and functioning styles; use flexible intervention strategies that can respond to evolving family priorities; and be community based. Early intervention encompasses services provided to families in education, health care, mental health, and human services settings (Erickson & Kurz-Riemer, 1999). Empirical analyses, however, have begun to suggest that there are many barriers to implementation of family-centered early intervention services (Guralnick, 1997). Families receiving services and early intervention professionals have identified issues with implementation of family-centered services. Families have expressed concern that professionals do not always respect their opinions or support their involvement in the intervention process (Able-Boone & Sandall, 1990; Gamel-McCormick, 1995; Summers et al., 1990). Families indicate the need for several services from professionals, including more and better information about available services, aspects of developmental disabilities, and early childhood development (Beckman & Bristol, 1991; Summers et al.); professionals to teach skills to help families work with their children in their everyday lives (Gamel-McCormick); and better services coordination to help families obtain and manage services (Able-Boone, Goodwin, Sandall, Gordon, & Martin, 1992; Dinnebeil & Rule, 1994). Professionals have expressed doubts about whether families have the necessary skills and initiative needed to participate fully in the early intervention process (Beckman & Bristol, 1991; Minke & Scott, 1995; Moxeley, Raider, & Cohen, 1989). In addition, professionals are concerned that family-centered services are impractical because they require considerably more time and resources to implement (Mahoney & O'Sullivan, 1990; Moxeley et al.) and may result in uncertainty in the roles and responsibilities for early intervention team members (Bailey, Palsha, & Simeonsson, 1991). Also, professionals are concerned about a lack of education and training regarding the concepts and practices of family-centered practice (Gallagher, Malone, Cleghorne, & Helms, 1997; Mahoney & O'Sullivan). …