Developing Culturally Competent Programs for Families of Children with Special Needs
Richard N. Roberts
This monograph provides a framework for programs, states, and organizations to think about the issues in developing culturally competent programs for families of children with special needs. It offers a variety of examples from programs across the country that are providing exemplary services. The monograph is designed to help program makers compare their efforts with others, to provide options for planning additional services or altering services in existing programs, or to develop new programs. Monograph sections cover the following topics: (a) general issues in developing culturally competent programs as they relate to community-based family-centered care; (b) specific issues in policy and practice, such as assessment, outreach, family involvement, staffing, use of translators, client load, professional-paraprofessional partnerships, and training and support; and (c) descriptions of programs funded by the Bureau of Maternal and Child Health that serve families in several different types of settings.
Richard N. Roberts. Developing Culturally Competent Programs for Families of Children with Special Needs (1990). Early Intervention Research Institute: Logan, Ut.
(38 pages).
Sponsoring Agency: Maternal and Child Health Bureau
Language: English
Reading Level: Average
Formats Available: Printed Material
(Material is available at no charge, contact address below c/o Richard Roberts, the materials principal author)
Early Intervention Research Institute
Utah State University
6580 Old Main Hill
Logan, Ut
84322
Phone: (435) 797-1172
Languages Available: English
Intended User Audience:
The intended audience is service delivery personnel, program administrators, and preservice students. Teams, such as staff in a program or a particular early intervention setting, best use the material.
Product Development:
A multicultural workgroup developed this material. This group included
individuals from the following cultural and linguistic groups:
African American, Hispanic American, Asian American (including Laotian,Hmong, Cambodian), Native American, and European American. These individuals were from early intervention programs as well as from a variety of disciplines (e.g., psychology, nursing, child development, and family studies).
Product Evaluation:
No formal evaluation data has been collected. Informal feedback from
participants in training institutes has been overwhelmingly positive.
Participants in these institutes have been primarily service delivery
personnel and have represented a variety of cultural and linguistic groups.
Product Dissemination:
Approximately 8000 copies have been disseminated in the United States.
Individuals in Sweden and South Africa have also requested copies of this material.
Review #1
About the reviewer:
This reviewer's work experience has taken the form of special projects
performed through grants and contracts developed from successful
proposals. In the decade of the 1970s, he traveled extensively
throughout the United States as an applied anthropologist adapting
ethnographic research methods to three large-scale national
evaluations: Head Start, Follow Through, and Teacher Corps.
Since 1981 he has lived in his hometown in the Southwest, where
his work has focused on developing effective adult learning
strategies, including print and video materials, for use in
Native American early childhood settings. He has a BA and MA from
the University of California at Santa Barbara. He has served as an
administrator, teacher, and grants specialist in a community college
serving large numbers of Native Americans. Furthermore, he has
extensive experience as a private consultant in education.
Audience:
This is an excellent summary presentation on Developing Culturally Competent Programs for Families of Children with Special Needs. "This monograph and its accompanying workbook is designed to help programs, states, and organizations improve their ability to provide culturally competent services to families. The monograph provides a framework for you to think about the issues in developing culturally competent programs as well as a variety of examples from programs across the country that are providing exemplary services at this point. The accompanying workbook provides an opportunity for individuals and groups involved in program planning to examine their own efforts against a set of questions and activities which are drawn from the issues in the monograph."
The intended audience needs to be fluent in standard English, and the reviewer can assure the reader that the rest of the material lives up to the clarity and orderliness implied by the title and opening words. This is written for a national audience, using relatively brief examples from programs serving a variety of community groups broadly representative of the diversity in American life, including Black Americans, Native Americans, and Asian Americans. The presentation is respectful of diversity but is strongly rooted in a middle class, academic, bureaucratic Euro-American orientation.
A similarly broad range of potential users is identified by the authors and this reviewer agrees it could be helpful for service delivery personnel on the front lines, program administrators, members of Interagency Coordinating Councils, and students in preservice courses.
Strengths of the Material:
This material is a clearly written and well-organized presentation of the basic academic and bureaucratic understandings of the issues of cultural and linguistic diversity in this field.
The materials are organized into 3 major sections. The introductory section is a short discussion of what a family-centered, community-based, culturally competent program looks like in principle, and of certain specific issues that occur in practice -- such as the use of translators, client load, professional and paraprofessional partnerships, etc. The second section has 2-3 page descriptions of 7 specific programs from across the nation, with references for further information.
The third section is a 31-page self-study guide with workbook entries keyed to the discussions in parts 1 and 2. The self-study guides are presented in two formats: one for individual programs that actually deliver services and the other for state organizations or interagency groups that play a coordinating role. The checklist items are blended with short paragraphs that refer the users back to major considerations from sections 1 and 2.
One very nice feature of this material is the decision to include several edited oral history quotations from culturally diverse parents and front line paraprofessionals. Some of these move the discussion beyond the center of the comfort zone of the "mainstream" medical professional.
For example, one Native American parent who is also a paraprofessional in an early intervention program said, "When our child was diagnosed as having a disability, we sought out the elders within the family for advice and direction in the traditional treatment for our child. At the time, western medicine was not answering questions that we were seeking about our child's disability. We were given several traditional ceremonies that we could follow to help his progress and to mend the disharmony that was caused.…As for the ceremonies themselves, they are highly respected, and we seldom if ever talk about them, as they are a sacred part of our lives that we choose not to share with the outside...."
Limitations of the Material:
Western-trained medical and educational professionals put the ability to move easily among ideas, concepts, constructs -- abstractions all -- at or near the top of the list of qualities that lead toward knowledge, and knowledge is considered the base for recommended practices. This set of materials is an excellent representative of this tradition, and this is one of its virtues.
To the extent that one strength of this material is its allegiance to the professional standards in vogue right now, however, it may be fitting to remind ourselves that professional academic and bureaucratic intellectual traditions do not embody all of the routes towards wisdom. It may be that knowledge of an abstract Western flavor takes us just part of the way, and knowledge of concrete features of a localized natural landscape can also take us part of the way toward recommended practice.
The material under review does acknowledge this point when, for example, a program director is quoted: "Bridging the gap means looking at both sides of it. It is not just training parents to understand the professionals, but taking the next step and helping the professionals understand the parents' perspectives...." This comment underscores the importance of building service delivery systems that can work in a two-way direction. We, all of us, need help to build bridges that can carry us toward being more responsive in our thoughts and actions to cultural and linguistic diversity.
Adaptations:
Developing Culturally Competent Programs for Families of Children With Special Needs does the job it was designed for very well. As its title suggests, it is intended for use by professionals in the field who are familiar with the technical jargon of academic prose. This is a timely, clear, and well-organized summary of basic issues with some specific examples of programs actually operating in the real world -- an admirable achievement.
The only adaptation this reviewer would suggest refers to the limitations noted in section 3: the expertise of the presentation makes it easy to overlook what is not explicitly acknowledged -- that the academic and bureaucratic traditions of organizing conceptual knowledge are not the only paths toward wisdom, and wisdom is what is often called upon in handling the human dramas of early intervention programs.
To explore ways to move further toward the goal of understanding (and being able to use) other conceptual traditions is an adaptation this reviewer would suggest.
Generalizability:
The materials under review here are admirably designed for use with people fluent in bureaucratic, academic thought and language rooted in European American intellectual traditions. This reviewer does not believe they are generalizable (without much effort -- see Adaptations section above, for example) to other audiences.
Recommendations:
As indicated above, Developing Culturally Competent Programs for families of Children with Special Needs does well the job it was designed for; therefore, this reviewer recommends it as an inviting material for the CLAS purposes.
Producer's Response:
Not available at this time.
Review #2
About the reviewer:
The reviewer is the parent of two teenaged sons, the youngest of whom
was born with Down syndrome. She has been active in the fields of
advocacy, family support, personnel preparation, and early childhood
research for over a decade. She has been fortunate enough to work
with families from many diverse cultures, including families from
Russia, the Pacific Islands, Mexico and South America.
Audience:
This monograph and workbook is written for a wide variety of audiences from introductory/beginning levels to advanced levels. Family members, administrators, students, faculty/trainers, and service delivery personnel will find the materials interesting and useful. The material is designed to give information on cultural competency to members of local early intervention programs as well as interagency coordinating councils. There are descriptions of seven different projects, each of which was included in a group funded by Maternal Child Health in 1988. These projects are
located in Pittsburgh, for Native Hawaiians in Hawaii, for African American families in a public housing project in Chicago, Southeast Asian families in San Diego, for African American families in Washington, DC, Native Americans in Bernalillo, New Mexico, and Hispanic families that live in San Antonio and Houston, TX.
Strengths of the Material:
Presentation of the materials is very clear and easy to understand. Jargon is avoided or defined. The project descriptions in the monograph section are well-written examples of how seven different projects discovered a variety of creative ways to involve parents and include families in early intervention activities. The PREP project at the Kamehameha Schools/Bishop Estates involves family members at the prenatal level by working with them to create an individualized baby quilt. The Beethoven Project at the Center for Successful Child Development developed a naming ceremony for young children, based on the Ghanian "Adinto" ceremony.
Another strength of the monograph is the discussion preceding the project descriptions. Beginning with definitions for terms such as "cultural competence [is] a program's ability to honor and respect those beliefs, interpersonal styles, attitudes and behavior both of families who are clients and the multicultural staff who are providing services. In so
doing, it incorporates these values at the levels of policy, administration and practice." The discussion goes on to describe what makes a program culturally competent. Issues in policy and practices are presented, with sections on assessment, outreach, family involvement, staffing, translators, client load, professional-paraprofessional partnerships, training, and support. Both formal and informal systems of support for families are acknowledged.
The accompanying workbook is comprised of two self-studies, one designed for programs and the other for larger state interagency groups. The questionnaires are crisp, to the point, and underscore themes presented in the monograph, such as the importance of developing supports and services with flexibility, sensitivity, trust, and recognition of priorities. Instructions for "How to Use this Workbook" are provided along with the following quote: "Remember at the individual level that cultural competence is not an absolute label to be applied to programs or services, but is a cluster of skills, attitudes, policies, and statutes or practice which can be learned and incorporated into ongoing practice systems which can be learned."
Limitations of the Material:
These materials were first published in 1990 and references are made to legislation in the United States (P.L. 99-457) which has since been reauthorized and renamed. Occasionally words that are no longer considered respectful (handicapped) are used. These are mainly found in the introduction to the materials. As a reader, the reviewer was pleased to find, however, that the majority of the content reflects the best practice in family-centered care with respect for diverse populations.
Adaptations:
Alternative methods for using the materials are suggested in the workbook. Both the monograph and the workbook can be individualized and adapted for different groups quite easily.
Generalizability:
Many different kinds of interagency groups that work with families from diverse backgrounds can make use of the monograph and workbook for personnel preparation, retreats for boards of directors or advisory councils, and/or ongoing self-reflection.
Recommendations:
Recommend. The materials are not perfect (references to P.L. 99-457, use of the word handicapped), but their strengths outweigh their limitations.
Producer's Response:
Not available at this time.
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