Addressing the challenges of families with multiple risks.

Addressing the challenges of families with multiple risks. ABSTRACT: All families face challenges throughout their lifespan. Fora significant segment of the population, however, these challenges aremultiple and constitute risks for the children and other family members.This article reviews the changing structures and characteristics of theAmerican family and discusses the increased influence of severalsocietal concerns, including poverty, substance abuse, and exposure toviolence. These issues are considered in light of thei'rpotentially deleterious deleteriousadj. harmful. effects on child and family development andfunctioning. Recommendations include collaborations among educators,other service providers, and families to address the complex needs andchallenges presented by families experiencing multiple risks.Every 30 seconds a baby is born into poverty.Every 59 seconds a baby is born to a teen mother.Every 2 minutes a baby is born at low birth weight.Every 2 minutes a baby is born to a mother who had late or noprenatal care prenatal care,n the health care provided the mother and fetus before childbirth. .Every 5 minutes a child is arrested for a violent crime.Every 2 hours a child is murdered. (Children's Defense Fund The Children's Defense Fund (CDF) is a national organization that is committed to the social Welfare of children. Founded in 1973, the nonprofit group uses its annual $9 million budget to lobby legislators and to speak out publicly on a broad array of issues on the law, the family, and ,1994, p. xii)Approximately 5.4 million women are current users of illegal drugs.An estimated 4.5 million of that group are women of childbearing age. Asthese numbers have continued to rise, growing numbers of infants areprenatally exposed to drugs as well as to alcohol. (Child Welfare Leagueof America, 1993, p. 39)The number of children reported as abused or neglected increased 333%between 1976 and 1992. According to according toprep.1. As stated or indicated by; on the authority of: according to historians.2. In keeping with: according to instructions.3. National Committee for thePrevention of Child Abuse (NCPCA NCPCA National Committee to Prevent Child Abuse ), in 1992 an estimated 2.9 millionchildren were reported to be abused or neglected. (Child Welfare Leagueof America, 1993, p. 47)Hardly a day passes that the American public is not confronted withfacts such as these in the news media. These statistics highlight theshifts and realities that families are experiencing today. Though urbanareas, confronted with greater numbers of people, have often been thefirst to acknowledge and respond to these population trends, it is amistake to assume that these issues do not apply in communities acrossand throughout the United States United States,officially United States of America, republic (2005 est. pop. 295,734,000), 3,539,227 sq mi (9,166,598 sq km), North America. The United States is the world's third largest country in population and the fourth largest country in area. .These social concerns have profound implications for educators andother professionals providing educational, health, and social services social servicesNoun, plwelfare services provided by local authorities or a state agency for people with particular social needssocial servicesnpl → servicios mpl socialesto families today. The challenges faced by families exert a primaryinfluence on their ability and desire to access services, theirwillingness to seek out or participate in services, and their resourcesfor maintaining an active role with formal educational and servicedelivery systems.In this article, we examine the shifts in family characteristics andthe challenges for families in today's society. We pay specialattention to conditions that constitute risks for those families inperforming their functions as families. Finally, we discuss theimplications of these factors for educators and other service providersin light of these challenges and make recommendations for practice.DEFINING FAMILIESMedia and Cultural PerspectivesAgain, a look at the media - particularly television - brings intosharp focus a view of contemporary families. In the 1950s the mythicalfamilies portrayed in "Ozzie and Harriet Ozzie and Harrietdepicting home life, American style. [TV: “The Adventures of Ozzie and Harriet” in Terrace, I, 34–35]See : DomesticityOzzie and Harrietseries portraying the wholesome, American family. " and "Leave Itto Beaver Leave It To Beavertranquil life in suburbia (1957-1963). [TV: Terrace II, 18]See : Domesticity " were two-parent families in which the fathers worked ona full-time basis outside the home, the mothers were homemakers, and themarriages portrayed were the only marriages for these partners. As notedby Hernandez (1994), these family images were never the realities formost children growing up since the Great Depression. However, theprograms reflected a view held by many people. The view of the"nuclear" family as a "one size fits all" pattern isgiving way to a perspective that more clearly reflects the diversity offamilies today. Families come in all shapes and sizes. This reality ismirrored in the broad array of current television families - singleparent, blended families, extended families, foster families, and so on.This broader focus more closely approximates reality.Throughout history, families have been defined in many different waysby their cultural enclave, ranging from extended tribal, clan, orkinship networks to the narrowly defined nuclear family composed ofbiological parents and children. For purposes of this discussion,families are defined by themselves and include the following keyelements: "the members of the unit see themselves as a family, areaffiliated with one another, and are committed to caring for oneanother" (Hanson Lynch, 1992, p. 285).Characteristics and Concerns of Families TodayPerhaps the only generalization that can be made about families todayis that they represent tremendous diversity on all dimensions. Forexample, the population of the United States has become increasinglydiverse culturally and linguistically; and the terms"multicultural" and "cultural pluralism cultural pluralism:see multiculturalism. " are beingused to describe U.S. society (Lynch & Hanson, 1992). In thisarticle, however, we focus on diversity in family structures andcharacteristics and the potentially deleterious effects on child andfamily development and functioning of several key societal concerns:poverty, substance use, and the increased exposure of families toviolence.FAMILY STRUCTURES ANDCHARACTERISTICSMany shifts over several decades have changed the complexion offamilies and children's lives. These include changes in familycomposition and size, parents' employment outside the home, and ageof parenthood.Family Composition and SizeA substantial number of children historically have spent all or partof their childhood in a one-parent household due to parental death,divorce, or being born out of wedlock wed��lock?n.The state of being married; matrimony.Idiom: out of wedlockOf parents not legally married to each other: born out of wedlock. . A recent review indicated that28% to 34% of white children born between 1920 and 1960 lived with oneor no biological parents in their living situation (Hernandez, 1994).This report suggested that this percentage will increase toapproximately 50%, based on projections of children born since 1980. Thedata for African-American children born between 1920 and 1950 showed55%-60% living in one-parent households; the projections for this bornsince 1980 (Hernandez, 1994). A majority of single-parent households aremother-only families, with the increase in divorce accounting for theproportional shifts in white families, and divorce and never marryingaccounting for the shifts in black families (Hernandez, 1994). Adiscouraging consequence of these trends is the link betweenless-educated, mother-only households and poverty (Bianchi, 1993).Parent Employment PatternsAnother change families have experienced in recent Decades has beenthe number of parents employed outside the home. In 1993, nearly 60% ofmarried women with children younger than 6 years participated in thelabor force. This represents a shift from 11% in 1948 (Children'sDefense Fund, 1994). Hernandez (1994) suggested that many factorscontributed to this shift, including the smaller size of families,family moves from farm living to urban-industrial work, the educationalattainments of women, the rise in divorce rate, personal job rewards,and economic necessity.Another important employment trend is the greater discrepancy inearnings between less-skilled, less-educated persons and more-skilled,higher-educated people. As a result, those at the lower end of thesocioeconomic ladder are finding it increasingly difficult to keep theirfamilies out of povert (Levy & Murnane, 1992).Parental ageThe age at which women are bearing children has shown a change atboth ends of the age spectrum (Hanson & Lynch, 1992). More women aredeferring marriage and childbearing to later years, and more teens arebecoming parents. The Children's Defense Fund (1994) reported thatthe unmarried teen birth rate (number of births per 1,000 unmarriedwomen ages 15-19) increased by 119.6% from 1969 to 1991, with the birthrate for this teen group being 44.8% in the latter year. The ChildWelfare League of America (1993) indicated that approximately 1 millionadolescents become pregnant each year, and about half of thesepregnancies were carried to term. Further, the League reported thatalmost 25% of adolescents who gave birth in 1989 had one or morechildren already. The trends in adolescent pregnancy adolescent pregnancySee Teenage pregnancy. and parenthood arealarming in light of the lack of social and economic preparation andsupport for parenting for this age group Klein & Cordell, 1987).Moreover, the children of these young parents are at much greater riskthan the general population for cognitive, emotional, and physicaldifficulties (Smith, 1994).SOCIAL CONCERNS POSINGDEVELOPMENTAL RISKSPovertyThe number of Americans living in poverty has increased, according tothe 1990 census (U.S. Bureau of the Census Noun 1. Bureau of the Census - the bureau of the Commerce Department responsible for taking the census; provides demographic information and analyses about the population of the United StatesCensus Bureau , 1992). As indicated byStrawn (1992), 14.2% of the population, or 1 in every 7 Americans, wasliving in poverty. Based on census report figures (as reported inChildren's Defense Fund, 1994) in 1992, 14.6 million children wereliving in poverty. Of these children, 1 out of every 4 children underage 6 was poor, and 27% of those under 3 years were poor.The relationship of poverty to adverse developmental outcomes is wellestablished (see, e.g., the special issue of Child Development [Huston,McLoyd, & Coll, 1994] on children and poverty). Kaplan-Sanoff,Parker, and Zuckerman (1991) and others have noted that children borninto poverty are in "double jeopardy double jeopardy:see jeopardy. double jeopardyIn law, the prosecution of a person for an offense for which he or she already has been prosecuted. In U.S. ." They are at greaterrisk of illness, family stress, lack of social support, and health andenvironmental risks (e.g., lead poisoning lead poisoningor plumbism(plŭm`bĭz'əm), intoxication of the system by organic compounds containing lead. , failure to thrive Failure to ThriveDefinitionFailure to thrive (FTT) is used to describe a delay in a child's growth or development. It is usually applied to infants and children up to two years of age who do not gain or maintain weight as they should. , prematuredelivery premature deliveryn.The birth of a premature baby.Premature deliveryThe birth of a live baby when a pregnancy ends spontaneously after the twentieth week.Mentioned in: Stillbirth , low birth weight, developmental morbidity) (Huston, 1991;Kaplan-Sanoff, Parker, & Zuckerman, 1991).Substance UseThe reality of substance use as a factor affecting families and thequality of care giving is undeniable. Although substance abuse crossesthe boundaries of race, ethnicity, and socioeconomic status, studieshave revealed a higher incidence of reported use of illicit drugs bypoor, uninsured, minority persons from minority backgrounds (Castro,Azen, Hobel, & Platt, 1993) or among people who are unemployed orwho dropped out of school (Substance Abuse and Mental Health ServicesAdministration The Substance Abuse and Mental Health Services Administration (SAMHSA), an operating division of the Health and Human Services Department (HHS), was established in 1992 by the Alcohol, Drug Abuse, and Mental Health Administration Reorganization Act (Pub. L. No. 102-321). [SAMHSA SAMHSA Substance Abuse and Mental Health Services Administration ], 1993). In addition, the choice of drug seems tovary among ethnic groups - with higher proportions of people fromAfrican-American backgrounds reporting using illicit drugs and higherproportions of Caucasians reporting heavy uses of alcohol (SAMHSA,1993).Clearly, parental substance abuse can lead to family problems andpose serious threats to caregiving for children. A large body ofresearch links alcoholism with child maltreatment child maltreatment'…intentional harm or threat of harm to a child by someone acting in the role of a caretaker, for even a short time…Categories Physical abuse, sexual abuse, emotional abuse, neglect…', the last being most common. (Famularo, Stone,Barnum, & Wharton, 1986), longterm social and psychiatricdifficulties of children (Black, Bucky, & Wilder-Padilla, 1986), andfamily violence (Fitch & Papantonio, 1983). Evidence also is growingthat links illicit drug illicit drugStreet drug, see there use with impaired ability to parent (Famularo,Kinscherff, & Fenton, 1992). During cocaine binges the basicelements of parenting such as providing nourishment nour��ish��mentn.Something that nourishes; food. , safety, and caringabout loved ones as well as oneself, become immaterial (Gawin &Ellinwood, 1988).Children who are exposed to parents or other caregivers impaired inthese respects may be at significant risk for lapses in parentalcaregiving or protection. They also may become direct targets ofphysical or sexual abuse (Famularo, (Kinscherff, & Fenton, 1992). Inaddition, children who are prenatally exposed to alcohol or other drugsmay be at risk for a host of developmental problems (Deren, 1986;Streissguth, Barr, & Sampson, 1990). Consequently, substance use infamilies may affect children in many ways through adverse effects onparenting, through its prenatal prenatal/pre��na��tal/ (-na��tal) preceding birth. pre��na��taladj.Preceding birth. Also called antenatal.prenatalpreceding birth. effects, and through the risksassociated with the exposure to an environment affected by the use ofsubstances.Exposure to ViolenceA growing concern for all of today's families is the threat ofviolence in their communities. Children across the nation are growing upin conditions described as "inner-city war zones" (Garbarino,Dubrow, Kostelny, & Pardo, 1992). This problem is not restricted tourban communities. Children in all segments of society are affected byviolence in our country (Dodd, 1993).The effects of violence are greatest, however, in communities whereit is an ever-present reality. When families are constantly exposed toviolence, and also continuously and simultaneously challenged bypoverty, unemployment, inadequate housing, and family instability, thestress can be overwhelming and lead to a deterioration of basic copingskills (Osofsky & Jackson, 1994). For example, in neighborhoodswhere random shootings are commonplace, mothers often instruct theirchildren to lie flat on the floor while watching television and to sleepin the bathtub to avoid bullets (Osofsky & Jackson, 1993/1994).Parents prohibit their children from playing outdoors in theirneighborhoods and even in their own front yards. It is not uncommon tovisit families in the worst heat of the summertime with all theirchildren indoors with windows shut and draperies drawn.For many children, violence is not restricted to outside the home. Atleast 3 million children are at risk for witnessing domestic abuse eachyear, ranging from hitting or punching to fatal assaults Jaffe, Wolfe,& Wilson, 1990). In addition, children are often themselves thevictims of violent behavior in their homes. In 1992 alone, more than 1million children were confirmed victims of abuse and neglect (McCurdy& Dato, 1993). The consequences of being witnesses or victims ofviolence may be long lasting and affect man areas of children'sdevelopment, including their school performance, ability to concentrate,emotional stability, and social competence (Pynoos & Nader, 1990).Children and their parents who live with the constant stress of exposureto danger in their home environments are likely to feel helpless andfrustrated frus��trate?tr.v. frus��trat��ed, frus��trat��ing, frus��trates1. a. To prevent from accomplishing a purpose or fulfilling a desire; thwart: .Effects of These Social ConcernsThe stress associated with these societal concerns can sapparents' physical energy, try their patience, undermine their senseof competence, and reduce their sense of control over their lives.Educators and other service providers working with multiply vulnerablefamilies must understand that when parents interact with the school orother agencies, they do not bring only that part of themselves that isrelevant to school - they bring everything (Halpern, 1993).Schools and other agencies must determine what services they aregoing to provide and what resources they can help families findelsewhere to meet many needs. They must decide how much to focus onchildren, how much on parenting, and how much on the extrafamilialstressors that impinge im��pinge?v. im��pinged, im��ping��ing, im��ping��esv.intr.1. To collide or strike: Sound waves impinge on the eardrum.2. on families.CONCEPT OF MULTIPLE RISKSACROSS THE LIFESPANDescriptions of FamiliesWe hear almost daily about specific risks that families face today,such as physical and sexual abuse, mental health problems, exposure toneighborhood violence, homelessness, lack of adequate nutrition, andpoor health care; but we often fail to realize that many of todaysfamilies living in poverty face not just one of these factor but mustlive under the stress of multiple risks. Halpern (1993) suggested:"What has served in the literature as the paradigmatic See paradigm. example ofhighest-risk early childhood and family life - a vulnerable andoverwhelmed caregiver, an unsupportive community context, and perhaps, aconstitutionally vulnerable infant - is rapidly becoming the norm foryoung children in poverty and their families" (p. 165).Lizbeth Schorr (1988) underscored this point, stating that"persistent and concentrated poverty virtually guarantees thepresence of a vast collection of risk factors and their continuingdestructive impact over time" (p. 30).Many studies have documented the compounding effects of risk factorsassociated with low socioeconomic status that affect children'sdevelopmental outcomes (Sameroff, Seifer, Barocas Zax zax?n.A tool similar to a hatchet, used for cutting and dressing roofing slates.[Variant of sax, from Middle English, knife, from Old English seax; see sek- , & Greenspan,1987). Children growing up under these conditions are not only likely toexperience an "achievement gap" compared to their middle-classcounterparts, they are likely to fall behind their middle-class peerswith the passage of time.How does this happen? Schorr (1988) provided a vivid example of theways in which multiple risks interact and compound the effects thatcompromise children's development:The child in a poor family who is malnourished mal��nour��ishedadj.Affected by improper nutrition or an insufficient diet. and living in anunheated apartment is more susceptible to ear infection; once the earinfection takes hold, inaccessible or inattentive in��at��ten��tive?adj.Exhibiting a lack of attention; not attentive.inat��ten health care may meanit will not be properly treated; hearing loss in the midst Adv. 1. in the midst - the middle or central part or point; "in the midst of the forest"; "could he walk out in the midst of his piece?"midmost of economicstress may go undetected at home, in day care, and by the health system;undetected hearing loss will do long-term damage to a child who needsall the help he can to cope with a world more complicated than the worldof most middle-class children. When this child enters school, hischances of being in an overcrowded o��ver��crowd?v. o��ver��crowd��ed, o��ver��crowd��ing, o��ver��crowdsv.tr.To cause to be excessively crowded: a system of consolidation that only overcrowded the classrooms. classroom with an overwhelmed teacherfurther compromise his chances of successful learning. Thus risk factorsjoin to shorten the odds of favorable long-term outcomes. (p. 30)Schorr explained that the kinds of supports from family, friends, andformalized for��mal��ize?tr.v. for��mal��ized, for��mal��iz��ing, for��mal��iz��es1. To give a definite form or shape to.2. a. To make formal.b. service delivery systems that could serve to buffer theserisks are also less likely to be there for the poorest children. Toooften, the services these families are able to obtain are fragmented,narrow, and too difficult to access.What are some important aspects of the risks faced by these childrenand their families? First, the stresses experienced by familiesassociated with poverty (e.g., financial strain, malnutrition malnutrition,insufficiency of one or more nutritional elements necessary for health and well-being. Primary malnutrition is caused by the lack of essential foodstuffs—usually vitamins, minerals, or proteins—in the diet. , exposureto violence, isolation) often persist over children's lifetimes andcontinue their destructive impact, causing a downward spiral ofdevelopment. Second, these children may experience risks even beforetheir birth, beginning with inadequacies in their mothers' prenatalcare and nutrition. As infants and young children, they are morevulnerable than middle-class children to stressors, yet they are farless likely to experience protective factors that may buffer them fromthe harmful effects of these stresses. Third, children from families atmultiple risk have greater likelihood of growing up in environments thatare so out of control that caregivers have neither the energy nor theresources to provide the consistent nurturance, structure, andstimulation that prepares other children for school and for life.Fourth, Schorr (1988) relates that these children see little hope orsuccess in the future, and little reason to strive for achievement inschool Schorr states:These are the children whose experience of failure is compounded andreinforced by not learning the skills that schools are meant to teach,who soon become aware that the future holds little promise forthem....Because they perceive a future that holds few attractions, theyenter adolescence with no reason to believe that anything worthwhilewill be lost by dropping out of school, committing crimes (such as usingor selling drugs), or having babies as unmarried teenagers." (p.31)Ecology of Family - Risk! Factor TransactionsThe dynamic quality of lifespan human development can be bestunderstood through the frame work of a transactional model ofdevelopment. In 1975, Sameroff and Chandler analyzed the complexinteractions between children's characteristic and environmentalvariables. They describe sources of risk to child developmental outcomein terms of both a "continuum of reproductive casualty"(prenatal and perinatal perinatal/peri��na��tal/ (-na��t'l) relating to the period shortly before and after birth; from the twentieth to twenty-ninth week of gestation to one to four weeks after birth. per��i��na��taladj. factors that may influence the child'sdevelopment) and a continuum of caretaking casualty" (the socialand familial factors that may affect the child's developmentalcourse). Sameroff and Chandler discussed the "continual andprogressive interplay between the organism and its environment" (p.234). The transactional model explains the interdependence of child andenvironmental variables and how each is affected and altered by theother.The transactions between the child and caregiving environment occurat different levels of influence. Transactions can positively ornegatively interact with child characteristics. Bronfenbrenner (1979)provided a useful schema for understanding how the broader ecologyinfluences these transactions and the course of human development. Healso emphasized that an individual's interpretation of events orexperience of the environment may influence these transactions. Further,his model described interactions between and across systems, rangingfrom the child within the family to the interactions with the largercultural community. Like a rock thrown into a pond, changes in onestructure can have a ripple effect ripple effectEpidemiology See Signal event. on other systems. This type ofconceptual framework For the concept in aesthetics and art criticism, see .A conceptual framework is used in research to outline possible courses of action or to present a preferred approach to a system analysis project. greatly helps us understand the nature of humanbehavior and complexity of planning and implementing interventions.Factors That Protect and Sustain Children's DevelopmentOne other feature about families experiencing multiple risks is thatnot all children from these families are adversely affected. Manyresearchers have pointed out that some children escape the effects ofhigh-risk environments (Garmezy, 1991; Rutter, 1987). These are thechildren who are resilient and transcend the risks in their early livesthrough protective factors that prevent them from falling into a cycleof failure.In her longitudinal study longitudinal studya chronological study in epidemiology which attempts to establish a relationship between an antecedent cause and a subsequent effect. See also cohort study. of children who had experienced multiplerisks, Werner 1990) determined that one third of the children grew up tobecome competent young adults. She described the successful children asprotected from the stresses in their backgrounds by a combination ofindividual and family/environmental protective factors. Among theindividual characteristics associated with resilience are the following:* Cognitive skills (Garmezy, 1991; Werner & Smith, 1989). *Curiosity and enthusiasm Radke-Yarrow & Sherman, 1990). *Goal-setting behavior (Werner & Smith, 1989). * High self-esteem(Moran & Eckenrode, 1992).These individual characteristics are supported by and interact withfamily protective factors, such as the following:* Family stability (Werner & Smith, 1989). * Parents who setrules in the home (Werner & Smith, 1989). * Parents who show respectfor their children's individuality (Werner & Smith, 1989). *Parents who are responsive and accepting of the children's behavior(Bradley et al., 1994). * Home environmental factors, such as theavailability of toys and materials for children to engage (Bradley etal., 1994). * The availability of space for children's explorationand privacy (Bradley et al., 1994).Finally, social support within the larger community has beenidentified as a factor that can reduce parents' emotional strainand decrease coercive parenting behavior (Keltner, 1990). It appearsthat interactions among individual, family, and community factors bufferchildren from the effects of adverse circumstances and allow them toremain on a normal developmental path. What must special educators andother service providers realize? First, it is essential to understandthat the problems these children and their families face do not comefrom single causes; therefore, single interventions will probably not beeffective. Children and their families often will require more than justschool-based interventions. Many of children's earliest problemswill be preventable with better prenatal care and more accessible healthand nutrition programs for women and infants. More intensive andeffective family support programs will be necessary to prevent abuse andneglect of children. High-quality child care and preschool programs mustbe in place to ensure that children are ready for kindergarten. Finally,schools need to be responsive to the needs of children at risk and theirfamilies.Approaches to reaching out to multiple-risk families include thefollowing:* Providing a wide range of educational, health, and social servicesat the school (Finn-Stevenson, Linkins, & Beacon, 1992). * Usingfamily associates and paraprofessionals that assist families in gainingaccess to services (Koroloff, Elliott, Koren, & Friesen, 1994). *Employing home visitors to enhance contact with children's parentsand caregivers (Simeonsson & Covington, 1994).The comprehensive nature of these interventions requires acoordinated interagency response that integrates the variousinterventions needed to address the multiple risks of children andfamilies.Second, special educators must understand that for many reasons, itmay be difficult to enlist these parents and caregivers as partners onintervention teams. At times it may be challenging to engage them inplanning and decision making regarding their children. These familiesare so overwhelmed with meeting basic needs that they often cannotrespond to the specific developmental needs of their children. Even ifthey recognize the fact that their children may be experiencingproblems, they may not feel safe in discussing their concerns withprofessionals (Dryfoos, 1990).Third, special educators must acknowledge that families living with amultitude of stressors may find it difficult to follow through withplans or programs for their children. Many time is occurs becauseservices or programs for poor families are inaccessible or difficult toaccess (Margolis & Meisels, 1987). Even when services are available,families facing multiple challenges may lack transportation, financialresources, and the knowledge or motivation to access recommendedservices (Kendall & Morris, 1991).PRINCIPLES OF SUPPORT ANDINTERVENTION FOR CHILDRENAND THEIR FAMILIESA look at the changing demography demography(dĭmŏg`rəfē), science of human population. Demography represents a fundamental approach to the understanding of human society. of the U.S. population suggeststhat many citizens, due to language, differences in belief systems, orpreferred methods and modes of communication, may have difficultyaccessing traditional forms of educational support; or they may choosenot to participate in typical formal service systems. At the same timeas society is becoming aware of the diversity of its members, socialconcerns are producing new challenges for educators and other serviceproviders. In this section, we outline intervention principles forproviding support to children and their families, particularly thosefaced with multiple risks or challenges.Providing Opportunities for PositiveCaregiving TransactionsThe transactional model offers an optimistic op��ti��mist?n.1. One who usually expects a favorable outcome.2. A believer in philosophical optimism.op perspective forstructuring intervention practices. Providing support at the earliestpoint for children and parents or caregivers in establishing positiveand mutually satisfying relationships with one another holds promise forpreventing or relieving sources of stress. As parents or caregivers arehelped to understand and, in some cases, reframe Re`frame´v. t. 1. To frame again or anew. children'sbehavior and cues, they may feel more competent in providing care.Bronfenbrenner (1990) proposes that for optimal development, the childmust participate in "progressively more complex reciprocalactivity" p. 29); and this activity must occur over extended timeperiods and be "with persons with whom the child develops strong,mutual, irrational, emotional attachment and who is committed to thechild's well-being and development" (p. 29). This contentionemphasizes the need for primary and positive adult relationships in thechild's life.Shifting Focus from Deficits to Emphasis on Individual and FamilyStrengthsMost educational, social, and health! care professions havetraditionally employed a medical model of service delivery for guidingpractice. In this medical or main-effects model, the locus of thedifficulty with the child (or family) was seen through a professionallydriven assessment process and treatment protocols emphasizingremediation of the difficulties or defects. If the child did notprogress, the explanation was laid at the family doorstep. Oftenfamilies were viewed as not doing enough or not doing the right thingsfor their children, or the children were viewed as having problems thatwere too tough to be adequately treated.In recent years a more family-centered or family-focused model hasreplaced this view. This perspective views the family as a consumer ofservices and argues for "enabling" or "empoweringfamilies to gain access to resources and direct their usage of thoseresources. (Dunst, Trivette, & Deal, 1988). This perspective doesnot argue for focusing solely on the family unit rather than on thechild who may have special needs. Instead, intervention efforts areplaced in the context of the child within the family; andeducator/service provider's efforts are focused on supportingchildren and families within the larger ecological system in which theylive and learn (Bronfenbrenner, 1979).Closely akin to the medical or deficits models was the notion thatformal service delivery systems could or should "fix"families. Family-centered approaches to intervention ensure more familydecision making and a move away from professional control or"fixing." These approaches also recognize the many strengthschildren and families have. Werner (1990) found that many individualchild characteristics functioned as protective or buffering factors. Shealso found that certain family factors, such as the use of alternativecaregivers and certain family belief systems, could also serve asprotective factors for children reared under nonoptimal conditions.Recognizing and Encouraging Informal Sources of SupportMany investigators have alluded to the importance of building,encouraging, and supporting families' natural systems of support.Bronfenbrenner (1990) argued the case for support to families in childrearing through communication, mutual trust, and flexibility provided bythe people in the various settings in which children and their familieslies live. He also contended that this support must be extended to comefrom the broader community context, to include neighbors, friends,coworkers, and others within the family's community.Studies by Dunst and colleagues pointed to the importance of naturalsupports in enhancing families' welf-being and promotingfamily-driven services (Dunst, Trivette, & Deal, 1988; Dunst,Trivette, Gordon, & Pletcher, 1989). Finally, in her discussion offactors found to promote resilience, Werner (1990) reported thatcommunity members such as friends, schools, and teachers could provecrucial buffers to other harmful effects.Becoming Cross-Culturally CompetentEducators and other service providers often work with children andfamilies whose culture, values, beliefs, and lifestyle practices differfrom their own. The child and family's ethnic, racial, cultural,and linguistic identification strongly influence their values andbeliefs regarding disability, education, healing and health care, childrearing, and change/intervention (Hanson, Lynch, & Wayman, 1990). Inaddition, socioeconomic status and the "cultures" of povertyand drug use affect the individual's values and beliefs and abilityor willingness to participate in educational services. As such, atremendous training need exists nationally for educators and serviceproviders in the area of working with children and families from diversebackgrounds to become more "culturally competent" (Lynch &Hanson, 1992).The effectiveness of services is likely to be linked to the degree towhich educators and service providers are able to listen to children andfamilies as they identify their needs and concerns. Further,effectiveness is enhanced by the educator's or serviceprovider's ability to be sensitive to the range of these issues, tobe respectful of children's and families' needs even thoughthey may differ widely from that of the service provider, and to beknowledgeable about the range of options and supports available andvalued by individual children and their families. This process beginswith a clear understanding of one's own beliefs and values and anacknowledgement that these will differ from those of others.Providing Comprehensive, Coordinated ServicesProfessionals who serve children and families at multiple risk forpoor developmental outcomes face broad, complex challenges. Thesechildren and families need comprehensive and coordinated systems ofservice delivery. Educators and other service providers must work towardservices that are community based and appropriate and valued by thecommunity members who are being served.The various service systems and agencies with whom children andfamilies interact must build collaborative structures of support toprovide comprehensive services. As Hanson and Lynch (1992) noted, tocounteract the "continuum of risk," we need "a continuumof service options ... to match this risk continuum. Service providersmust be advocates for all children, not just those with specific labelsor in need of specific services" (p. 301).Recognizing the Need to Offer Families a BroadSpectrum of ServicesSchools and other agencies must realize that families with multiplechallenges may require assistance in numerous areas before they can makeuse of other interventions that address specific child needs. Familiesmay need emotional support or assistance with housing, food, income, oremployment. Programs that have been most successful in improvingchildren's outcomes have taken the broad view of children'sneeds, viewing them within the context of their families (Schorr, 1988).The operative principle of the most effective programs is that theproblems of children can be addressed only when other issues facingthese children's families are also considered. Educators andservice providers must be willing to regularly cross traditionalprofessional boundaries to allow this to occur.Delivering Flexible, Usable ServicesIn programs that have been successful in improving children'soutcomes, professionals exercise discretion in individualizinginterventions to meet families' and children's needs. Theseprofessionals have found that to be effective with a family, they cannotapply an intervention uniformly or routinely (Schorr, 1988). In workingwith families, professionals need to decide how often or how intensivethe intervention will be, where and how the services are to bedelivered, and how involved the parent is in the program.Beyond being flexible, service providers recognize that if they areto be successful in reaching out to these families, they must becreative in reducing the obstacles these families often face inaccessing services. Professionals in these programs realize thatfamilies may have difficulties with obtaining transportation, keeping aseries of appointments, making payments, or making phone calls to obtainservices. These professionals may meet families in their homes or inother locations (e.g., fast-food restaurants). They persevere per��se��vere?intr.v. per��se��vered, per��se��ver��ing, per��se��veresTo persist in or remain constant to a purpose, idea, or task in the face of obstacles or discouragement. to reachout to the most disenfranchised. They do not set difficult preconditionsfor families that have limited skills and resources.Crossing Professional Boundaries andOvercoming Bureaucratic bu��reau��crat?n.1. An official of a bureaucracy.2. An official who is rigidly devoted to the details of administrative procedure.bu LimitationsA related feature of successful programs is the need for educatorsand other service providers to go beyond traditional professional orbureaucratic limitations to meet the needs of families and children.Professionals, who may realize that a particular family's needs gobeyond the jurisdiction of their own agency, will work withrepresentatives of other agencies who also will cross professionalboundaries to work with families. Then, as a team, they can worktogether to meet families' needs.SUMMARYAt times, the complexity of the difficulties in the lives of childrenand their families appears overwhelming. Certainly families arechallenged to overcome tremendous obstacles. 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Poverty is a condition in which a person or community is deprived of, or lacks the essentials for, a minimum standard of well being and life. , 1991. Current PopulationReports, Series P-60, No. 181. Washington, DC: Government PrintingOffice. Werner, E. E. (1990). Protective factors and individualresilience. In S. J. Meisels & J. P. Shonkoff (Eds.), Cambridge:Cambridge University Press. Werner, E. E., & Smith, R. S. (1989).Vulnerable but invincible: A longitudinal study of resilient childrenand youth. New York: Adams Bannister Cox.ABOUT THE AUTHORSMARCI MARCI Mars Color ImagerMARCI Multi-host Automation Remote Control and Instrumentation (US government simulation community)J. HANSON (CEC (Central Electronic Complex) The set of hardware that defines a mainframe, which includes the CPU(s), memory, channels, controllers and power supplies included in the box. Some CECs, such as IBM's Multiprise 2000 and 3000, include data storage devices as well. CA Federation), Professor, Department of SpecialEducation, San Francisco State University ••[ , California. JUDITH J. CARTA(CEC #436), Associate Scientist, Juniper Gardens Children'sProject, University of Kansas The University of Kansas (often referred to as KU or just Kansas) is an institution of higher learning in Lawrence, Kansas. The main campus resides atop Mount Oread. , Kansas City Kansas City,two adjacent cities of the same name, one (1990 pop. 149,767), seat of Wyandotte co., NE Kansas (inc. 1859), the other (1990 pop. 435,146), Clay, Jackson, and Platte counties, NW Mo. (inc. 1850). .Address correspondence to Marci J. Hanson, 1600 Holloway Ave., SanFrancisco, CA 94132.