UVM Theses and Dissertations
Format:
Print
Author:
Beatson, Jean E.
Dept./Program:
College of Education and Social Services
Year:
2004
Degree:
Ed. D.
Abstract:
The concept and practice of family-centered care has been evolving since the 1940's and is now considered best practice for serving children with special needs (Johnson, 1990; Shelton, 1999). Although the research strongly indicates that health and learning outcomes are improved when a family-centered approach is utilized (Thies & McAllister, 2001), there remain implementation challenges in healthcare and school-based settings (Letourneau & Elliott, 1996). The purpose of this qualitative study was to analyze the experiences of graduates of the Vermont Rural Autism Project (VT-RAP) related to the implementation of family-centered care within their practice and organizations, as well as to examine the impact of the training they received through VT-RAP on their philosophy and practice. Funded in 1997, VT-RAP was a three-year training grant that trained speech-language graduate students and related professionals in family-centered assessment and intervention for children with autism. Ten participants were interviewed using a standardized, open-ended interview guide (Patton, 1990).
Of the 10 participants, five were speech-language pathologists, four were early childhood special educators, and one was a service coordinator associated with an early intervention project. I found that philosophically, the participants' identified themselves as family-centered service providers. Most spoke of deep shifting within themselves related to implementing family-centered care that occurred during training and continued through the years since their training. They became more comfortable and forthright in sharing their opinions in a way that demonstrated their commitment to the families they served. They were more accepting and pragmatic about what families could manage. There was an overall theme of learning to "walk a mile in their shoes." This proved to be a transformational experience where participants came to deeply understand the realities and complexities of the lives of the families and children they served.
Coupled with this transformation, the findings suggested that increasing competence and skill in collaborative teaming, and assessment and intervention in autism created the context where the participants evolved into family-centered practitioners. Experiences with the families paired with the technical skills and knowledge they acquired, enabled the participants to create service plans responsive to families' needs and provided them with the confidence to persuade decision-makers to support family-centered services. The findings suggest that the most difficult challenge to the implementation of family-centered care was a lack of resources, most often, related to professional competence and beliefs within organizations. Health professionals untrained in family-centered care posed a significant problem as well. Despite challenges and barriers, the findings indicate that there are essential elements of family-centered care that can be practiced across-settings. These elements are attitudinal and involve faith, respect, and honor.
Of the 10 participants, five were speech-language pathologists, four were early childhood special educators, and one was a service coordinator associated with an early intervention project. I found that philosophically, the participants' identified themselves as family-centered service providers. Most spoke of deep shifting within themselves related to implementing family-centered care that occurred during training and continued through the years since their training. They became more comfortable and forthright in sharing their opinions in a way that demonstrated their commitment to the families they served. They were more accepting and pragmatic about what families could manage. There was an overall theme of learning to "walk a mile in their shoes." This proved to be a transformational experience where participants came to deeply understand the realities and complexities of the lives of the families and children they served.
Coupled with this transformation, the findings suggested that increasing competence and skill in collaborative teaming, and assessment and intervention in autism created the context where the participants evolved into family-centered practitioners. Experiences with the families paired with the technical skills and knowledge they acquired, enabled the participants to create service plans responsive to families' needs and provided them with the confidence to persuade decision-makers to support family-centered services. The findings suggest that the most difficult challenge to the implementation of family-centered care was a lack of resources, most often, related to professional competence and beliefs within organizations. Health professionals untrained in family-centered care posed a significant problem as well. Despite challenges and barriers, the findings indicate that there are essential elements of family-centered care that can be practiced across-settings. These elements are attitudinal and involve faith, respect, and honor.