Archive for July, 2014


    The Intersection of Poverty and Disability: What Does These Mean for Early Intervention

    Early Childhood Interventions July 23, 2014
    Percentage of women 15-50 with a birth in the past year who were in poverty
    Image Source: Washington Post

    Statistics show that poverty and disability are deeply intertwined. Nationally, 28 percent of children with disabilities fall below the Federal Poverty Level (FPL), compared to only 16 percent of children without disabilities (Emerson, 2007). This relationship is bidirectional, meaning that experiencing the environmental and psychosocial hazards that often accompany poverty increases the risk of disability, and the direct and indirect costs of having a disability increase the likelihood of falling into poverty, or at least of experiencing material hardship. These risk factors accumulate and interact over time; thus it is essential to intervene as early as possible in order to maximize positive outcomes for children with disabilities who have additional vulnerabilities such as being in poverty.

    Research shows that the effectiveness of early intervention (EI) in such vulnerable populations is substantial (Long, 2013). The purpose of EI is to support families in their care of their children to facilitate the child’s participation and sense of membership in his or her family and community (Long, 2013). Many early interventionists follow the biomedical model, which focuses on managing or eradicating symptoms in “patients” rather than looking at a person and his or her capabilities and limitations within a social and environmental context (Halfon, Houtrow, Larson, & Newacheck, 2012). It would be far more beneficial, however, to approach children with disabilities and their families, especially those who experience additional vulnerabilities such as poverty, with a more family-centered approach. Before interacting with vulnerable families, early interventionists should consider their approach to early intervention, what they know about families that could influence their interactions, and what they should provide for them, given their needs and limitations.

    Early interventionist’s use of an ecological approach will increase the likelihood that they will incorporate a systems perspective based on a strengths based, relationship, taking into account the life course of the child and family. Bronfenbrenner’s ecological systems approach posits that children develop in a system of nested environments, from their family and child care experiences (microsystems) to larger societal and cultural values and laws (macrosystem), and that these systems interact dynamically and change over time (Zajicek-Farber, 2013). From this perspective, the goal of intervention is not just to manage symptoms, but to improve the child’s social, physical, and psychological functioning within the contexts or environments he or she is expected to participate in. Using a relationship- and strengths-based approach means that early interventionists need to first develop a trusting, collaborative relationship with children and families, and to focus on their strengths (rather than limitations) that might be used as resources in helping to improve the child’s functioning and quality of life.

    From a life course perspective, the goal of EI is to improve functioning and quality of life not just for children with disabilities in the moment, but to look ahead and anticipate needs across the lifespan so as children transition to and experience adulthood, they can maintain these improvements throughout their lives (Long, 2013). This is especially important when interacting with families because many have worries, fears, and questions about their children’s futures and what they will look like. Additionally, a lot of supports fall away as children with disabilities transition to adulthood, so it is important to look forward and prepare for the future very early on. Interacting with families in poverty in particular (who likely experience resource limitations and lack of information) from a life course approach could have further benefits for children because it impresses on parents the importance of each visit and each component of the intervention, and how every facet is necessary to lead to benefits for their children in the long term.

    Before interacting with families in poverty or with other vulnerabilities, early interventionists should know what cultural beliefs, coping styles, priorities, strengths, and limitations families face on a regular basis. Cultural beliefs shape families’ relationships, behaviors, parenting practices, trust of professionals, and how they feel they can influence their children’s development. Early interventionists should pay particular attention to potential limitations and additional stressors that a family experiences. Strength-based interactions provide flexibility that may be necessary to provide the support needed to meet family needs.

    When interacting with children and families with particular vulnerabilities, such as being in poverty, early interventionists should be particularly careful to be culturally sensitive and appropriate, sensitive to limitations, flexible, responsive, and understanding. All communications (both verbal and written) should be in the family’s preferred language, and should be in terms that are easy for families to understand and not riddled with technical jargon. Early interventionists should also be sure to share as much information as necessary to help families make informed decisions. Professionals should be sure to answer any questions that families have in a responsive, sensitive, and thorough way.

    Best practice early intervention include establishing a collaborative partnership with families based on their strengths. Early intervention should empower families by informing them in a culturally appropriate and sensitive way and by modeling for them practices in which they can engage with their child on their own to promote his or her positive development. For vulnerable families in particular, early interventionists should be sure to connect them with community resources that will promote positive development, including transportation, health services, and assistance programs such as welfare, TANF, and WIC. It is especially important that professionals emphasize and facilitate the availability of these services because many families in poverty are not informed about programs for which they are eligible that could improve quality of life for themselves and their children. Professionals should also identify social supports that parents have and help them seek additional ones through support groups, mental health services, and other programs, because these parents are more likely to feel isolated and have mental health issues that could hinder the well-being of themselves and their children (Zajicek-Farber, 2013).  Connecting families with these resources augments moderating and protective factors for children with disabilities who are at high risk because of the interaction between poverty and disability.

    Overall, early interventionists should be respectful of children and families with vulnerabilities (especially being in poverty, which is associated with myriad other risks) and their desires, priorities, goals, limitations, and ultimate decisions. They should be cognizant of how the way they approach, think about, and interact with vulnerable families influences the course of the early intervention and thus the outcomes of the child with disabilities. Thus, early interventionists should make concerted efforts provide services that are family-centered, focusing on the child, in context, and across his or her lifespan, and his or her family.

    References

    Emerson, E. (2007). Poverty and people with intellectual disabilities. Mental Retardation and  Developmental Disabilities Research Reviews, 13, 107-113.

    Halfon, N., Houtrow, A., Larson, K., & Newacheck, P.W. (2012). The changing landscape of disability in childhood. The Future of Children, 22 (1), 13-42.

    Long, T. (2013). Early Intervention.  In M. L. Batshaw, N. J. Roizen, & G.R. Lotrecchiano, G.R. (Eds.), Children with disabilities. pp. 547-557.   Baltimore: Paul H. Brooks Publishing Co.

    Zajicek-Farber, M. (2013). Caring and Coping: Helping the Family of a Child with a Disability. In M. L. Batshaw, N. J. Roizen, & G.R. Lotrecchiano, G.R. (Eds.), Children with disabilities. pp. 757-672. Baltimore: Paul H. Brooks Publishing Co.  

    Shannon Reilly
    Georgetown University,
    College, Class of 2015

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