Engaging Families: Meeting Requirements While Building Relationships

PresPresented by:Gisela Jimenez Vazquez, M.Ed.Program Director for Parents as Teachers MaricopaWendy Puga, M.B.A.Senior Program Director for Parents as Teachers Programs

Objectives• Participants will learn about some of the tools used in Home

Visitation to measure the strengths and needs of families.

• Participants will learn strategies to build rapport when working with new family in order to facilitate their willingness to participate in the screenings.

• Participants will discuss ways to make assessment tools more meaningful to staff and families, including setting goals and showing program outcomes.

Tools Used in Home Visitation

• Family Centered Assessment & Life Skills Progression

• Parenting Interactions with Children: Checklist of Observations Linked to Outcomes

• Depression, Anxiety, Stress Scale

• Adverse Childhood Experiences & Protective Factors

• Adult Adolescent Parenting Inventory

Family Centered Assessment and Life Skills ProgressionFamilyCenteredAssessmentSetofquestions askedtofamilies,formallyorinformally,togettoknowthembetterintheareasidentifiedbytheprogram.

Background/ChildhoodPerceptionofChild&ExpectationsofDevelopmentFamilyandSocialRelationshipsLifeStressors,UseandAccesstoResourcesLifestyleBehaviorsSafety,Environment,Home

LifeSkillsProgression(LSP)Familyfunction assessmentwhichhelpsidentify familyneedsandstrengthsinthefollowing areas;caregiverrelationshipswithchildren, homesafety,useofresources, familyoverallhealthandaccesstomedicalcare.TheFamilyCenteredAssessment iscompletedtogathernecessary informationforLSPscores.Theinitialisdonewithin90daysofenrollment, andevery6months after.

Family Centered Assessment and Life Skills Progression

http://www.lifeskillsprogression.com/

PICCOLOParentingInteractionswithChildren:ChecklistofObservationsLinkedtoOutcomesMeasuresareasofparent-childinteractionona0-2scale.Provideshomevisitorswithinformationaboutstrengthsandareasforimprovementthatguidestheparent-childinteractionactivities.

Thevideo-taped10-minuteinteractionisscoredintheareasofAffection,Responsiveness,Encouragement,andTeaching.

Initialiscompletedwithin90daysofenrollment,andevery6monthsafter.

https://products.brookespublishing.com/

Depression, Anxiety, and Stress ScalesDASS-42

Asetofthreeself-reportscalesdesignedtomeasurethenegativeemotionalstatesofdepression,anxietyandstress.

Initialiscompletedwithin90daysofenrollment,everysixmonths and/orasneeded.

http://www2.psy.unsw.edu.au/dass/

Adverse Childhood Experience (ACE) QuestionnaireAdverseChildhood Experiences (ACEs)isthetermusedtodescribe alltypesofabuse,neglect,andotherpotentiallytraumaticexperiencesthatoccurtopeopleundertheageof18.ThepresenceofACEsdoesnotmeanthatachildwillexperiencepooroutcomes.However,children’s positiveexperiencesorprotectivefactorscanpreventchildren fromexperiencingadversityandcanprotectagainstmanyofthenegativehealthandlifeoutcomesevenafteradversityhasoccurred.

Thissurvey isconductedwithin90daysofenrollmentwiththeparent/guardian.ItisconductedduringthesamevisittheProtectiveFactorSurveyisconducted.

AdverseChildhoodExperience(ACE)QuestionnaireFindingyourACEScore

Whileyouweregrowingup,duringyour first18yearsoflife:1.Didaparentorotheradultinthehouseholdoften…Swearatyou, insultyou,putyoudown,orhumiliateyou?orActinawaythatmadeyouafraidthatyoumightbephysicallyhurt?YesNoIfyesenter1________2.Didaparentorotheradultinthehouseholdoften…Push,grab,slap,orthrowsomethingatyou?orEverhityousohardthatyouhadmarksorwereinjured?YesNoIfyesenter1________3.Didanadultorpersonatleast5yearsolderthanyouever…Touchorfondleyouorhaveyou touch theirbody inasexualway?orTrytooractuallyhaveoral,anal,orvaginalsexwithyou?YesNoIfyesenter1________4.Didyouoftenfeelthat…Nooneinyour familylovedyouorthoughtyouwereimportantorspecial?

https://www.ncjfcj.org/sites/default/files/Finding%20Your%20ACE%20Score.pdf

Protective Factors SurveyThistoolassessesfamilystrengths,ratherthanfocusingondeficits.Resultsoffersaframeworkoffiveresearch-basedProtectiveFactorsthatgiveparentswhattheyneedtoparenteffectively.Whentheseprotectivefactorsarerobustinfamilies,thelikelihoodofchildabuseandneglectisreduced.Thisapproachbenefitsallfamilies,notjustthoseexperiencingstress.

Thissurveyisconductedwithin90daysofenrollmentwiththeparentorguardian.ItisconductedduringthesamevisittheAdverseChildhoodExperience(ACEs)Survey isconducted.

https://www.friendsnrc.org/

Adult Adolescent Parenting InventoryTheAAPI-2.1isaninventorydesigned toassesstheparentingandchildrearingattitudesofadolescentsandadultparentandpre-parentpopulations.Basedontheknownparentingandchildrearingbehaviorsofabusiveparents,responses totheinventoryprovideanindexofriskforpracticingbehaviorsknowntobeattributabletochildabuseandneglect.TheoriginalAAPIfirstdeveloped in1979.

UponenrollmentandattheendofParentingGroupSeries.

https://assessingparenting.com/assessment/aapi

•ConstructA - Expectationsof Children•ConstructB - ParentalEmpathy towardsChildren’s Needs•ConstructC - UseofCorporal Punishment•ConstructD - Parent-Child FamilyRoles•ConstructE - Children’s Power andIndependence

Things to Consider• Is it evidence based?• Does it align with

services?• Is it Measurable?• Cost of implementing and

training• Training availability• Staff buy-in is important

Rapport Building• Setclearexpectationsuponenrollment;includingletting

themknowwhichscreeningstoolswillbeused

• Reassuringparents/caregiversthat answersareconfidential

• Providingdescriptionofscreening(what), howitwillbe

administered(how), andtheuseoftheresults(why)

• Givingparentsaheads-upwhenthescreeningwillbe

completed(onevisitsprior).Askiftheyhaveanyquestions

regardingthetopicofthescreenings(tobepreparedwith

informationorresources)

• Answerany questions

• Beingpreparedtogiveresourcesbasedonscreeningresults

• Planforculturalorlanguageissues

Group Activity

Lookingatthetoolinfrontofyou:• Review(2minutes)• Writedown atleastthreedifferentwaysyoucanmake

thistoolmoremeaningfulforfamilies(5minutes)• Reportout(5minutes)

How to use screening results to drive service delivery

• Support parents/caregivers in setting goals

• Planning for topics to discuss at home visits

• Connecting them to resources, as needed

• Partnering with community service providers/agencies to address common needs in families

How to use screening results to support staff

• During Reflective Supervision, asking and providing feedback on process of completing screening

• Providing further training or refreshers for staff to feel well-prepared to conduct each screening

• Ensure staff know the next step based on the screening results (Ex: Program Policies and Procedures, Matrix)

• Guiding staff to plan for Group Connections (socializations), trainings or workshops for parents/caregivers

Discussing Results• Betimelywithdiscussing results.Thiscanbedoneduringthevisitoratthe

followingvisitdependingonthescreeningtool.Iftheresultscallforaconnectiontoaresource, oranemergencyisidentified,donotleavethehomeuntilresourceisgiven.

• Reviewthepurposeofscreening.Review questionnaire.

• Focusonstrengthsfirst.Pointoutacoupleitemswheretheydidgreat.

• Forareasofopportunity,pointoutacoupleitemsthattheyscoredlowin.Askfurtherquestions ifneededtounderstandwhytheyscoredlow."Canyoutellmemoreaboutthis?"

• Becarefulwiththewordingofresults.

• Discussfollow up actions.Havinginmindthefamilymakesthedecisionwhethertheywanttoseekfurtherservices.

Discussing Results – cont.• Considerwherethefamilyisintheprocess• Parentsmayberelievedandreadyorupset,disagreeand notreadytoacceptresults

• Listen,readsubtlecues,andreflectback• Ifyoushareconcerns,bespecific• Reviewfactorstoconsider(e.g.health)• Support,guide,andinformparentsaboutresources• Youdonotneedtoconvinceparentstorefer• Supportparentsinreferralswhentheyareready• Giveparentstime

Goal Setting• After discussing the results, guide parent/caregiver to

identify one area to focus on. Goals are family-driven.

• When setting goals, make sure the goal is attainable and measurable. You can help the parent/caregiver break down the goal into smaller steps and set timeline.

• Regular follow-up leads to better success rate (asking at each visit, documenting progress at least monthly)

Goalsetbyparent:A)ThreetimesaweekIwillparticipateina pretendplayactivitywithSonia.

B)Everyday Iwilldescribeobjectsusingcolor,shape,sizeortextureduringbathtime.

Group Activity

UsetheFamilyCenteredAssessmentandthescreeningprovidedtosettwogoalsfortheparent/caregiver.

Measuring Outcomes

Why• Tomeasureprogramsuccess

• Identifyareasofgrowthopportunity

• Measurestaffperformance

• Providedatatofunder

• Securingfunding

• Identifyfundingsources

• Maintainaccreditation

Outputs and Outcomes

Outputs•#ofhomevisits•#offamiliesserved•#offamiliesreceivinghearingscreenings•#offamiliesreceivingvisionscreenings•#ofdevelopmentalscreenings•#ofGroupConnections•#ofLSPscompleted•#ofFSPscompleted•#ofPICCOLOAdministeredpreandpost•#ofBrackenAssessmentspreandpost

Outcomes•%ofchildrenwillmaintainor demonstrateprogresstowardsage-appropriatedevelopmental milestones.

•%ofparentswillshowincreased knowledgeaboutchilddevelopment

•%ofparentswillshowan improvementinparentingandchild interactions

•%ofchildrenbetweentheagesof 3-5yearsofagewilldemonstrate improvementoftheirexpressiveand receptivescores

Staff Performance

Staff Performance

• Settingbenchmarks• Measuringand

monitoringoutputs• Providingfeedbackand

support• Celebrating• WorkPlanssupported

bydata

Setting Benchmarks• Alignedwithactivities/outputs

•80%ofcaseloadwillhaveLSPcompleted

everysixmonths.

•80% ofcaseloadwillhave DASSCompleted

everysixmonths.

• Reasonable

• Monitormonthly

• Reviewedwithstaffmonthly

• Measuredquarterly

Contact Information

Contact information:Wendy Puga wpuga@cfraz.org (602) 396-9741Gisela Jimenez Vazquez gjvazquez@cfraz.org 480-739-7696

https://www.childfamilyresources.org/