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 DOI: 10.1177/002246698802200112

1988 22: 108J Spec EducCarl J. Dunst, Hope E. Leet and Carol M. Trivette

Family Resources, Personal Well-Being, and Early Intervention  

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FAMILY RESOURCES, PERSONAL WELL-BEING, A N D EARLY INTERVENTION

The hypothesis that adequacy of resources is related to personal well-being and adherence to professionally prescribed child-level regimens was tested. T h e subjects were 45 mothers o f developmental ly delayed infants and toddlers participating in an early intervention program. The mothers completed three measurement scales about their family resources, personal well-being, and c o m m i t m e n t to professionally prescribed treatments. Hierarchical mult iple regression analysis showed that adequacy of re-

Carl J. Dunst Hope E. Leet

Carol M. Trivette Western Carolina Center

sources was related to both wel l -being and c o m -mi tment to child-level interventions even after the effects o f maternal age, family socio-e c o n o m i c status and i n c o m e , and child age and deve lopmenta l quot ient were statistically re-m o v e d . T h e results are discussed in terms of assisting families to m e e t self-identified needs before asking them to carry out professionally prescribed child-level treatments as part o f their involvement in early intervention programs.

Families w h o fail to a d h e r e to professionally prescr ibed reg imens are often labeled resistant, uncoopera t ive , and n o n c o m p l i a n t (Merton, Mer ton , & Barber , 1983). Practit ioners in the field of early in tervent ion, for example , often r epo r t that parents f requendy fail to i m p l e m e n t professionally prescr ibed child-level educat ional a n d therapeut ic t rea tments . However , what m a y b e in terpre ted as ei ther opposi t ional or apathet ic behavior may have less to d o with c o n t e m p t for professional op in ion a n d m o r e to d o with lack of consensus regard ing the na tu re of the present ing p r o b l e m , the need for t r ea tment (medical , educat ional , therapeut ic , etc.), and the course of act ion that should b e taken. As no ted by Mer ton (1976), peop le w h o occupy different posi t ions in a social s t ructure (client vs. professional, low vs. m i d d l e soc ioeconomic status [SES], etc.) t end to differ in their appraisals of the s ame situation, a n d c o n s e q u e n d y will differ in te rms of what consti tutes individual a n d family needs a n d h o w o n e shou ld allocate time and effort to obta in resources to mee t needs .

T h e s tudy repor ted in this p a p e r was des igned to assess the extent to which the adequacy of personal a n d family resources affected pa ren t well-being (emot ional and physical) a n d c o m m i t m e n t (time, energy, a n d investment) to professionally prescr ibed child-level t rea tments as par t of par t ic ipat ion in an early in tervent ion

This study was supported, in part, by a grant from the National Institute o f Mental Health, Pre-vention Research Branch (MH38862) . Appreciation is extended to Wayne deLoriea for assistance in data analysis, and Pat Condrey, Pam Lowman, and Clara H u n t for assistance in preparation of the paper.

H o p e E. Leet is now affiliated with Seven Counties Services, Inc., Louisville, KY.

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prog ram. Evidence from a n u m b e r of sources , inc luding those in the l i terature on social suppor t (Cohen 8c Syme, 1985), social ne twork (Gotdieb 8c Hall , 1980; Salloway & Dillon, 1973), a n d help-seeking (DePaulo, Nadler , 8c Fisher, 1983), suggests that adequacy of resources is likely to affect (a) heal th a n d well-being and (b) the extent to which professionally prescr ibed t rea tments a re seen as "re levant for ac t ion" by the client (Zola, 1966). C o n s e q u e n d y , we expec ted to find that families with i nadequa te persona l a n d family resources wou ld r epo r t m o r e physical a n d emot iona l p r o b l e m s a n d have less t ime, energy, a n d persona l inves tment with respect to i m p l e m e n t i n g professionally prescr ibed child-level intervent ions.

O u r investigation was gu ided by two different b u t c o m p l e m e n t a r y m o d e l s of h u m a n d e v e l o p m e n t a n d functioning: h u m a n ecology (Bronfenbrenner , 1979; Garbar ino , 1982) and family systems theory (Minuchin , 1985). H u m a n ecology emphas izes the in te rdependenc ies a m o n g ecological uni ts a n d subun i t s , a n d h o w events in these different settings reverbera te a n d affect h u m a n behavior . T h e no t ion of " e n v i r o n m e n t a l p r e s s " is central to h u m a n ecology a n d helps ex-plain t h e condi t ions tha t influence behavior . Ga rba r ino (1983) defined environ-menta l press as

the c o m b i n e d influence of forces working in an env ironment to shape the behavior and deve lop-m e n t of individuals in that setting. It arises from the circumstances confronting and surrounding an individual that generate (needs and) psychosocial m o m e n t u m , which tend to gu ide that individual in a particular direction, (p. 8)

This set of condi t ions suggests that those forces that a re s t rongest will take prece-dence a n d steer behavior in certain di rect ions . T h u s , a pe r son ' s pe rcep t ion of wha t const i tutes the m o s t impor t an t needs at a part icular po in t in t ime will p r o b -ably a s s u m e priori ty status and gu ide the pe r son ' s behavior in certain direct ions .

T h e p ropos i t ion that individual a n d family needs form one set of forces tha t af-fect behavior is fundamenta l to family systems theory ( H a r t m a n 8c Laird, 1983). Moreover , because needs can b e o r d e r e d roughly in a h ierarchy f rom the m o s t to the least impor tan t , emphas i s is likely to b e placed on mee t ing u n m e t needs tha t are at the top of the hierarchy (i.e., those that are m o s t impor tan t ) . T h e conten-t ion that needs can b e o rde red on a c o n t i n u u m , a n d that needs b o t h steer a n d p rope l behavior , is no t new. These no t ions can b e t raced to Lewin's (1931) field theory of env i ronmen ta l psychology, Hul l ' s (1943) a n d Murray ' s (1938) theor ies of mot ivat ion, a n d Maslow's (1954) theory of self-actualization. Maslow, for ex-ample , placed needs in a h ierarchy a n d st ipulated that u n m e t basic needs d o m i n a t e behavior a n d interfere with ach ievement of h igher level needs . W h e n e m b e d d e d within bo th h u m a n ecology and family systems theory, t he no t ions of needs a n d needs hierarchies take o n new m e a n i n g , especially in t e rms of a d h e r e n c e to professionally prescr ibed reg imens .

In o u r work with families of deve lopmenta l ly delayed infants and toddlers , we have c o m e to the real izat ion tha t u n m e t family needs in basic areas such as nut r i -tion, shelter, safety, heal th care, child care, and so forth, negatively affect pa ren t s ' heal th a n d well-being, which, in tu rn , decreases the probabi l i ty that pa ren t s will carry ou t professionally prescr ibed child-level in tervent ions , because t h e paren ts

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do no t identify child-related intervent ion needs as a h igh priori ty. It is o u r hypothesis that when self-identified needs go u n m e t , this acts as a force that presses o n e to invest emot iona l a n d physical energy to mee t these needs . This , in turn , takes its toll on persona l well-being a n d heal th , and makes a t tent ion to p ro -fessionally prescr ibed reg imens a low priority, part icularly w h e n professional r e c o m m e n d a t i o n s d o no t involve acdons des igned to mee t self-identified needs . Thus , a family's failure to a d h e r e to a professionally prescr ibed r eg imen may no t be because its m e m b e r s a re resistant, uncoopera t ive , o r noncompl i an t , b u t because the family's c i rcumstances steer behavior in other , m o r e pressing, direc-tions. A needs hierarchy perspect ive of env i ronmen ta l press suggests that u n m e t needs unre la ted to educat ing one ' s child will genera te m o m e n t u m a n d take prec-edence in te rms of guid ing behavior toward o ther goals, p lacing the educat ional and therapeut ic needs of a child low in the needs hierarchy, a n d c o n s e q u e n d y in-terfering with paren t c o m m i t m e n t to carrying ou t professionally prescr ibed regimens . If this in terpreta t ion is correct, it has major impl icat ions for working with families. Conf i rmat ion of the hypothes ized rela t ionships be tween family re-sources, well-being, a n d adhe rence to prescr ibed reg imens w o u l d indicate that before paren ts are asked to carry ou t child-level intervent ions, efforts to m e e t o ther family needs m u s t occur in o rde r for paren ts to have the time, energy, a n d personal inves tment to work with their ch i ldren in an educat ional o r therapeut ic capacity. T h e study repor t ed he re was des igned to test this hypothes is regard ing needs a n d needs hierarchies.

METHOD

Subjects

T h e sample inc luded 45 m o t h e r s of re ta rded , h a n d i c a p p e d , a n d deve lopmen-tally at-risk infants a n d toddlers part icipat ing in an early in tervent ion p r o g r a m . T h e m o t h e r s ' m e a n age a n d average years of school comple t ed were , respec-tively, 28.64 (SD = 7.76) and 12.49 (SD = 2.55). T h e subjects ' average SES (Holl ingshead, 1975) score was 30.03 (SD = 14.51), indicat ing that the m o t h e r s were p redominan t ly from lower to m i d d l e soc ioeconomic backgrounds . T h e families' average gross m o n t h l y i n c o m e was $1,285 (SD = $784).

T h e chi ldren 's m e a n chronological a n d men ta l ages were , respectively, 38.42 (SD = 18.36) a n d 20.26 (SD = 17.45) m o n t h s . The i r average deve lopmenta l quo t i en t was 53.54 (SD = 33.92) on the Griffiths (1954, 1970) Menta l Develop-menta l Scales. Thus , o n the average, the chi ldren were funct ioning in the m o d -erate range of re tardat ion.

Procedure

T h e m o t h e r s comple ted three scales as par t of their par t ic ipat ion in the study: Family Resource Scale (FRS) (Dunst 8c Leet, 1987), Heal th and Weil-Being I n d e x (HWI) (Dunst , 1986a), a n d Personal Allocation Scale (PAS) (Dunst , 1986b). T h e FRS is a 30-i tem rat ing scale that measures the adequacy of resources in

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househo lds with y o u n g chi ldren. T h e 30 i tems tap the adequacy of b o t h physical and h u m a n resources , inc luding food, shelter, t ranspor ta t ion , t ime to b e with family a n d friends, heal th care, m o n e y to pay bills, child care, a n d so forth. Each i tem is rated o n a 5-point scale ranging from N o t At All A d e q u a t e to Almos t Always Adequa te . Both reliability a n d validity of the scale have b e e n establ ished and repor t ed elsewhere (Dunst & Leet, 1987). Coefficient a l pha c o m p u t e d a m o n g the average correla t ion of the 30 i tems was 0.92. T h e split-half reliability was 0.95, corrected for length us ing the Spearman-Brown formula . A pr incipal c o m p o n e n t s factor analysis us ing var imax rota t ion yielded an eight-factor solu-tion account ing for 75% of the variance.

T h e individual FRS i tems are roughly o r d e r e d from the m o s t to least basic. (The hierarchy was establ ished t h r o u g h i n d e p e n d e n t rankings m a d e by 28 p ro -fessionals with extensive exper ience working with families of preschool -aged chi ldren—see Duns t & Leet, 1987). Subscale scores were c o m p u t e d by s u m m i n g the responses for i tems that fo rmed subcategories of needs , o r d e r e d from the mos t to least basic. T h e first series of i tems m e a s u r e d pr imar i ly financial re-sources. T h e second series m e a s u r e d food a n d protec t ion . T h e th i rd series m e a s u r e d intrafamily suppor t . T h e fourth series m e a s u r e d availability of ex-trafamily suppor t . T h e fifth m e a s u r e d adequacy of child care. T h e sixth meas -u red adequacy of specialized resources for the child. T h e seventh m e a s u r e d availability of luxur ies .

T h e H W I scale is a five-item rat ing scale that measures the r e s p o n d e n t ' s physi-cal heal th , psychological well-being, ability to cope with b o t h general life events and a child 's h a n d i c a p or delay, and stress m a n a g e m e n t skills. T h e s u m of the ratings of the five i tems provides a global index of heal th a n d well-being. Coeffi-cient a lpha c o m p u t e d based o n the correlat ions a m o n g the five i tems is 0.84, and a pr incipal c o m p o n e n t s factor analysis yielded a uni tary solut ion accoun t ing for 60% of the variance.

T h e PAS is a three- i tem rat ing scale that measures the extent to which the re-sponden t s have the t ime, physical and emot iona l energy, and pe rsona l belief a n d inves tment to carry o u t child-level in tervent ions prescr ibed by professionals. T h e s u m of t he ratings of the th ree i tems provides an overall i ndex of the degree of c o m m i t m e n t to child-level in te rvent ions . 1 Coefficient a lpha , c o m p u t e d based on the correlat ions a m o n g the scale i tems, is 0 .93, a n d a pr incipal c o m p o n e n t s factor analysis yielded a uni tary solut ion account ing for 88% of the variance.

'The families received weekly or bi-weekly h o m e visits by early intervention staff. During h o m e visits, mothers were instructed how to carry out a variety of child-level interventions with their off-spring and were asked to i m p l e m e n t the interventions at prescribed intervals between h o m e visits. The actual a m o u n t of t ime the mothers engaged in child-level interventions perhaps would have been a better c o m m i t m e n t measure; however, this type of data is nearly imposs ib le to obtain. Furthermore we were m o r e interested in the mothers ' bel ief systems (Sigel, 1985) about the relative importance of early intervention within the context of the broader family system and the factors that impinge u p o n family functioning. As T h o m a s and T h o m a s (1928) pointed out nearly 60 years ago, "If [people] define situations as real, they are real in their c o n s e q u e n c e s " (p. 572). Therefore, we opted to use a c o m m i t m e n t measure that assessed the degree to which mothers personally bel ieved they had the t ime, energy, and investment to carry out child-level interventions.

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Method of Analysis

Hierarchical mul t ip le regression analysis was used to discern the re la t ionships between adequacy of resources a n d b o t h well-being and c o m m i t m e n t to im-p lemen t ing child-level in tervent ions . T h e o rde r of entry of the variables into the analysis was as follows: pa ren t a n d family characteristics (mother ' s age, SES, a n d income) , child characteristics (age and deve lopmenta l quot ien t ) , a n d adequacy of resources (financial resources , food a n d shelter, intrafamily suppor t , informal suppor t , child care, specialized child resources , a n d luxuries) . T h u s , t he in-fluence of adequacy of the different categories of resources was assessed only after the effects of the o the r six variables were statistically r e m o v e d , therefore allowing the u n i q u e , n o n s h a r e d effects to b e d e t e r m i n e d in hierarchical m a n n e r .

RESULTS

T h e findings are shown in Tab le 1. T h e results showed that ne i ther pa ren t n o r family characteristics were related to ei ther pe rsona l well-being or parenta l com-m i t m e n t to child-level in tervent ions . Child age a n d D Q w e r e significandy related to well-being b u t no t c o m m i t m e n t to in tervent ion. T h e m o t h e r s of bo th o lder and h igher funct ioning chi ldren r epor t ed bet ter well-being. Collectively, the seven measures of adequacy of resources accoun ted for 47% (p < .01) and 48% {p < .01) of the variance in well-being a n d c o m m i t m e n t to in tervent ion, respec-tively, a l though there was cons iderable specificity in t e rms of which resource categories were related to the o u t c o m e measures .

T h e analysis of the well-being da ta showed that intrafamily s u p p o r t a n d ex-

TABLE 1 MULTIPLE Rs A N D INCREMENTS (I) IN R2 BETWEEN THE INDEPENDENT A N D

DEPENDENT MEASURES

Dependent Measures

Commitment to Well-Being Intervention

Independent Variables R2 1 R2 1

Maternal Age .02 .02 .01 .01 Family SES .02 .00 .02 .01 Family Income .02 .00 .08 .06 Child Age .13 . 1 1 * .10 .02 Child D Q .25* .12* .15 .05 Financial Resources . 3 1 * .06 .25* .10* Food and Protection .33* .03 .26 .01 Intrafamily Support .60*** .28** .50*** .23** Extrafamily Support .72*** .12** .52*** .02 Child Care .72*** .00 .56*** .04 Specialized Child Resources .72*** .00 .57*** .01 Luxuries ^2 * * * .00 .63*** .06

*p < .05; **p < .01 ; ***p < .001.

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trafamily s u p p o r t i ndependen t ly accoun ted for significant a m o u n t s of var iance in the o u t c o m e measu re . This indicated that provision of s u p p o r t f rom family m e m b e r s , fr iends, a n d o ther social ne twork m e m b e r s was positively related to the m o t h e r ' s well-being.

T h e analysis of the c o m m i t m e n t to child-level in tervent ion da ta showed that financial resources a n d intrafamily s u p p o r t i n d e p e n d e n d y accoun ted for signifi-cant a m o u n t s of variance, and that the aggregation of the informal suppor t , child care, a n d luxury measures accounted for an addi t ional 12% of the var iance [p < .05). I n instances in which families were financially solvent a n d in which m e m -bers p rov ided s u p p o r t to o n e ano the r , m o t h e r s indicated that they had the necessary t ime , energy, and inves tment to i m p l e m e n t prescr ibed child-level in-tervent ions. T o a smaller degree , m o t h e r s were m o r e likely to indicate a commi t -m e n t to in tervent ion w h e n they were adequate ly suppo r t ed by pe r sons ou ts ide the h o m e , h a d adequa t e child care a r r angemen t s , a n d had desired luxur ies .

DISCUSSION

T h e major p u r p o s e of this s tudy was to assess the re la t ionship be tween ade -quacy of family resources a n d bo th ma te rna l well-being a n d a d h e r e n c e to p r o -fessionally prescr ibed child-level in tervent ions . Mothers ra ther than b o t h m o t h e r s and fathers were s tudied because m o t h e r s have b e e n and con t inue to b e the family m e m b e r asked to a s sume p r imary responsibil i ty for i m p l e m e n t i n g child-level in tervent ions as par t of h o m e - b a s e d p rog rams for p reschoo l chi ldren . T h e results showed that the d e m o g r a p h i c characteristics of the m o t h e r s were generally unre la ted to ei ther personal well-being or c o m m i t m e n t to p ro -fessionally prescr ibed reg imens ; that child characterisdcs were related to well-be ing b u t no t c o m m i t m e n t ; a n d that adequacy of resources was related to b o t h the well-being a n d c o m m i t m e n t measures even after the shared var iance with the parent , family, and child variables was r emoved . T h e latter conf i rmed o u r hypothesis that adequacy of resources wou ld b e related to the m o t h e r s ' e m o -tional a n d physical heal th a n d would predic t the extent to which the m o t h e r s indicated that they h a d the t ime, energy, a n d persona l inves tment to carry ou t professionally prescr ibed , child-level educa t iona l a n d therapeut ic in tervent ions .

O n the o n e hand , o u r data p rov ided addi t ional evidence that resources a n d s uppo r t influence well-being a n d have positive heal th consequences (Cohen & Syme, 1985), a n d on the o ther hand , the pa t te rn of results provides s u p p o r t for a needs h ie rarchy perspect ive of env i ronmen ta l press (Garbar ino , 1982, 1983). Personal and family needs were found to b e a set of forces shap ing ma te rna l beliefs, a n d u n m e t needs took p recedence in t e rms of influencing paren ta l at-t r ibut ions a b o u t the i m p o r t a n c e of child-level in tervent ions . Tha t is, m o t h e r s w h o repor t ed inadequac ies in family resources were less likely to see child-level educat ional a n d therapeut ic needs as immediately impor tan t , a n d thus were no t likely to indicate that they wou ld invest the d m e a n d energy to carry ou t p ro -fessionally prescr ibed t rea tments . Presumably , the m o t h e r s were m o r e con-cerned a b o u t gett ing o the r family needs met , a n d were investing t ime a n d energy toward this end . T h e da ta f rom this s tudy a d d to a b u r g e o n i n g b o d y of evidence accumula ted from o ther studies we have conduc ted that replicate the findings

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that needs and resources influence bo th well-being a n d c o m m i t m e n t to carrying out child-level intervent ions as well as affect o the r aspects of pa ren t a n d family functioning (Dunst 8c Trivette, in press-a, in press-b , in press-c; Duns t , Vance, 8c Cooper , 1986; Trivette 8c Dunst , in prepara t ion) .

At least o n e unexpec ted finding deserves c o m m e n t and discussion. Accord ing to H a r t m a n a n d Laird (1983), " T h e need for m o n e y to pu rchase n e e d e d re-sources, whe the r food, shelter, a n d mater ia l goods , or oppo r tun i t y for enrich-ment , is a s sumed [to b e the m o s t basic of n e e d s ] " (p. 164). Yet we did no t find family i n c o m e at all related to well-being and only slightly related to the commi t -m e n t to intervent ion measu re . Moreover , family i n c o m e was no t significantly correlated with o u r financial resources m e a s u r e (r = — 0.13, ns). Close inspect ion of o u r da ta suggests that financial solvency a m o n g p r e d o m i n a n d y lower a n d midd le SES background families may have m o r e to d o with m a k i n g ends m e e t and spend ing within one ' s m e a n s than with absolu te a m o u n t s of i n c o m e pe r se and that the ability to m a n a g e financial resources seems to positively affect behavior in o the r areas, inc luding well-being a n d c o m m i t m e n t to intervent ion.

O u r findings have a n u m b e r of major implicat ions for work ing with families of chi ldren involved in early intervent ion p r o g r a m s in which paren t s are asked to function as educat ional a n d therapeut ic agents . First, it seems i m p o r t a n t that we assess family needs as a basis for de t e rmin ing the probabi l i ty of paren ts having the t ime a n d energy to carry ou t child-level intervent ions. T o the extent that non -child-related needs are u n m e t , the l ikelihood of parents m a k i n g a c o m m i t m e n t to child-level intervent ions is d imin ished . T h e Family Resource Scale (Dunst 8c Leet, 1987) was developed specifically for the p u r p o s e of measu r ing the ade-quacy of resources a n d shou ld prove useful for de t e rmin ing family needs . Sec-ond , if certain family needs are found to b e u n m e t , efforts m u s t b e m a d e to p ro -vide or med ia t e the types of suppor t that insure that a family has adequa t e resources. This will r equ i re a shift in how professionals perceive their roles as in-terventionists. We m u s t n o longer see ourselves as "chi ld educa tors or thera-pis ts" b u t "family specialists." Tha t is, we m u s t look b e y o n d the child to the family as the un i t of in tervent ion and function in a n u m b e r of capacities that s t rengthen the family by insur ing that child as well as pa ren t a n d family needs are addressed as par t of the intervent ion process (Dunst , Trivette, 8c Deal, 1988). Thi rd , we m u s t adop t a proact ive as o p p o s e d to a deficit perspect ive of paren ts who d o no t adhe re to professionally prescr ibed reg imens (Dunst , 1985). W e mus t no t view failure to follow professional r e c o m m e n d a t i o n s as reflecting deficits in the parents ; ra ther , we should view it as reflecting variations in behavior that are shaped by ecological influences b o t h inside a n d outs ide the family uni t . Indeed , if we are ever to b e successful with the majori ty of families that part icipate in early in tervent ion p r o g r a m s , we m u s t try to u n d e r s t a n d families a n d suppor t t h e m as they strive to m e e t individual a n d family needs .

In addi t ion to the above, the findings from b o t h this s tudy a n d o u r o ther in-vestigations (Dunst 8c Trivette, in press-a, in press-b , in press-c; Duns t et al., 1986; Trivette 8c Dunst , in preparat ion) have at least one o the r major impl icat ion as par t of early intervent ion practices, especially in light of e n a c t m e n t of Public Law 99-457 (Amendmen t s a n d Reauthor iza t ion of the Educa t ion of the H a n d i -

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capped Act). Title I (Part H) of this law author izes es tab l i shment of services to h a n d i c a p p e d infants a n d toddlers a n d their families. A major c o m p o n e n t of this par t is the Indiv idual ized Family Service Plan (IFSP). T h e IFSP mus t , a m o n g o ther things , inc lude a s ta tement of the chi ld 's and family's needs a n d the "ear ly in te rven t ion" services necessary to m e e t these needs . If the IFSP is to b e b o t h a flexible and functional tool for identifying a n d mee t ing family needs (see es-pecially Duns t et al. , 1988), we m u s t apply a m o r e b road ly based , needs hierarchy perspect ive of family concerns , goals, a n d aspira t ions as pa r t of developing a n d i m p l e m e n t i n g individual ized family plans . This necessitates that bo th child a n d non-chi ld- re la ted needs b e identified and addressed ; otherwise we are likely to involve families in early in tervent ion practices that have harmful ra ther than positive consequences (Dunst & Trivette, 1988).

In conclus ion, pe rsona l a n d family needs are likely to inf luence var ious as-pects of parenta l behavior . W e as professionals m u s t recognize these needs a n d take t h e m into considera t ion w h e n asking paren ts to function as educa t iona l a n d therapeut ic agents. T h e use of a b r o a d e r based , social systems perspect ive of family funct ioning (Garbar ino , 1982; H a r t m a n & Laird, 1983; Minuch in , 1985) and early in tervent ion (Dunst , 1985; D u n s t & Trivette, in press-a) seems essential in o r d e r to s u p p o r t a n d s t rengthen families in a positive, proact ive m a n n e r ra ther than b l a m e or s h a m e families for failing to subscr ibe to wha t professionals th ink is best for paren ts a n d their chi ldren.

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