Evaluating the Use of Bright Futures Educational Materials with Parents of Young Children with Special Needs

1. Evaluating the Use of Bright FuturesEducational Materials with Parents of Young Children with Special Needs Janel D. Lauer, OTR/L Health Services MPH Candidate University of Washington

2. Bright Futures • Initiated by MCHB in 1990 • Currently sponsored by a variety of national agencies • Includes parent education component • Family Tip Sheets • Information on specific areas of child development • Designed to meet the needs of all families • Unknown use with parents who have children with special needs

3. Early Intervention • Services for children ages 0-3 with identified disabilities or delays • Includes supporting families and enhancing the developmental potential of children • Intervention is individualized, and often focused on child’s specific needs

4. Disability-Related Literature • Shifting focus away from medical model • Concept of “redefinition” • Allowing parents to provide typical, rather than specialized, parenting practices • Acknowledging the similarities rather than differences between children with special needs and their “typical” peers

5. Current Study Context • Boyer Children’s Clinic EI Program • Packet of Bright Futures handouts • Infancy Family Tip Sheet • Communicating with Children • Self-Esteem • Stimulating Environments • Special Time • Overall goal to improve parenting skills in order to enhance child development

6. Study Objective • Conduct a process evaluation of the use of Bright Futures materials at Boyer Children’s Clinic • Examine underlying assumptions • Focus on five domains • General Use • Content Opinions • Relevance for Parents of Children with Special Needs • Barriers to Use • Recommendations

7. Study Design and Methods • Cross-sectional, mixed-methods study • 30-item Questionnaire • Likert scale • Multiple choice • Open-ended • Mailed to families who received packet • Initial mailing (105) • Reminder postcard • Follow-up mailing (77)

8. Preliminary Results • To date, 43% response rate (n=43) • Demographics of respondents • Over 90% mothers • Average age 35 • About 80% with at least a Bachelor’s degree • Average age of child 24 months • Special needs of children • Developmental Delay (72%) • Speech-Language Delay (58%) • Physical Disability (26%) • Visual Impairment (19%) • Hearing Impairment (5%)

9. General Use • 75% of respondents read at least one handout • Tended to either read all or none of the handouts • Who read handouts? • 73% indicated Mother • 21% indicated Father • 9% indicated Grandparent • 2% indicated Foster Parent

10. Content Opinions • Overall positive ratings of individual handouts • Highest ratings of “Special Time” and “Communicating with Children” • Lowest rating of “Family Tip Sheet” • Overall positive opinions about content • Generally agreed that handouts were interesting, gave ideas about ways to interact, and had important information about safety, health, and development • Did not feel that information was new

11. Relevance • Over 80% indicated that the activities mentioned were appropriate for their child • Open-ended responses revealed concerns about relevance • “I’m a little annoyed to be reminded about when typical kids start to.....” • “Does a family with an older child with delays need to be reminded that typically developing children are ahead?”

12. Barriers • Common reasons for not reading handouts • Not having time • Already having enough developmental information • Misplacing packet • Other barriers noted in answers to open-ended questions • WA State DOH mailings • Not age-appropriate for children over 1 year • Sense that this was for parents of “typical” children

13. Recommendations • Majority of parents would recommend (64%) • Even parents who personally did not like or did not read the handouts felt that they would recommend for others • Open-ended answers described feeling that the use of handouts should depend on the individual child and family

14. Limitations • Small sample size • Low statistical power • Homogenous, selective sample • Limited generalizability • Possibility for measurement error • Non-validated survey

15. Conclusions • Handouts with information that is less specific to developmental stages may be more appropriate • Focus on handouts that pertain to all children • Special Time • Communication • Information on specific developmental skills more appropriately addressed individually • Selective use of handouts versus universal

16. Implications • Further research on use of Bright Futures materials with parents of children with special needs • Determination of whether written handouts are an effective way to promote redefinition, or if other methods may be more appropriate

17. Acknowledgements • Thesis Committee Members • Marcia Williams, PhD, MPH, PT (Chair) • David Grembowski, PhD • This work was funded in part by a grant from the U.S. Department of Health and Human Services, Health Resources and Services Administration’s Maternal and Child Health Bureau (Title V, Social Security Act), grant #T76MC00011-21-00.

18. Special Thanks • Jean Myers, MPH, PT Bright Futures, University of Washington CHDD • Cheryl Buettemeier, MS, CCC-SLP Program Director, Boyer Children’s Clinic • Staff and Families at Boyer Children’s Clinic • MCH ’06 Cohort • Family and Friends

19. Questions?