Fluent Essays

Assessments are an integral part of the planned change process. During this part of the process you will accumulate, organize, and review the information you will need to begin the planning and intervention phases of treatment. Content and information are obtained from multiple sources (the child, family members, school personnel, etc.) and in various forms (interviews, records, and observation). It is essential to collect data in a comprehensive manner—understanding the presenting problem from an ecological model that seeks to gain insight into the concern on a micro, mezzo, and macro level. Focusing on a multilevel approach to a client’s concern and taking into account the environmental factors that contribute to the presenting problem distinguishes social work from other disciplines. By Day 3 Post a description of the importance of using multiple evidence-based tools (including quantitative, open ended, and ecologically focused) to assess children. Explain how each complements the other in order to gain a comprehensive understanding of the young client’s concerns and situation. Then, describe the use of an eco-map in assessment and explain the different systems you will account for in your assessment of a child. Support your posts with specific references to this week’s resources. Be sure to provide full APA citations for your references. Chapter 1 Assessment of Children Michael E. Woolley Purpose: This chapter details and discusses the historical evolution and current trends in social work in the systematic, ecological, and evidenced-informed assessment of children. It includes the myriad struggles impacting children and the broad range of settings in which social workers serve children and their families. Rationale: Whether in schools, child protective services, juvenile justice, fam- ily or community centers, mental-health agencies, or hospitals, social workers assume many roles in providing services for children. A critical part of providing effective services is a comprehensive assessment informed by social work val- ues, ethics, interfacing with our evolving professional orientation, knowledge, skills, and tools. How evidence-informed practice is presented: One current trend is the increas- ing use of quantitative survey instruments in child assessment, and there is an increasing number of such assessment tools being developed by social work researchers. A second trend is the increasingly widespread need for the eval- uation of the effects of interventions. In order to offer such evaluations, valid and reliable assessment tools are needed that can show changes in the assessed struggles and targeted outcomes of those interventions. Overarching questions: Within specific social work practice settings serving children, in order to complete an ecologically oriented and comprehensive assessment of a child and family, what information would be needed, from whom should that information be gathered, and by what means or methods should that information be collected? Social workers are vital members of teams delivering services to children across a variety of settings, including, but not limited to, child welfare agencies, family service organizations, schools, health-care providers, and mental-health settings. The struggles and challenges faced by children served by those social workers covers a broad spectrum from day-to- day struggles to life-altering trauma. In all those settings and struggles, beginning the social work intervention process with a systematic and comprehensive effort to gather information about the child, the social contexts of the child, and the presenting struggle or challenge is a critical first step to providing professional, appropriate, and effective services to children who have been impacted by issues ranging from sexual abuse or mental illness to brain tumors or learning disabilities. Social work has been increasingly called on, from both outside and inside the profession, to demonstrate the effectiveness of its practices. This 1 Holosko, M. J., Dulmus, C. N., Sowers, K. M., & Sowers, K. M. (2013). Social work practice with individuals and families : Evidence-informed assessments and interventions. ProQuest Ebook Central <a onclick=window.open('http://ebookcentral.proquest.com','_blank') href='http://ebookcentral.proquest.com' target='_blank' style='cursor: pointer;'>http://ebookcentral.proquest.com</a> Created from waldenu on 2021-09-14 03:08:48. C o p yr ig h t © 2 0 1 3 . Jo h n W ile y & S o n s, I n co rp o ra te d . A ll ri g h ts r e se rv e d . 2 Social Work Practice With Individuals and Families scrutiny provides the impetus to engage in research to develop evidence- based practice (EBP) strategies and approaches (Gambrill, 1999). The needs for quality assessment tools and strategies as a fundamental task within that effort are twofold. First, all practice activities should start with and be informed by an assessment process. Second, gathering evidence as to the effectiveness of an intervention requires assessing the target of that intervention before and after that intervention is delivered; therefore, reliable and valid assessment measures are a fundamental tool in the pursuit of evidence to support practice. This chapter first defines what is involved in performing a systematic and comprehensive social work child-assessment process. The accumu- lated social work practice knowledge in the area of child assessment emerging across the first 100 years of professional social work is discussed. We then outline the current prevailing framework used to gather, organize, and present assessment information about children. More recent develop- ments in the assessment of children are then added to that framework—for example, the necessity of gathering information from multiple informants and using multiple information-gathering tools when assessing children. Within that evolving assessment framework, a growing effort in social work (and other helping professions) is to strive to utilize evidence-based strategies and tools in practice. What is meant by evidence-based practice and how that effort can inform the most effective and efficient assessment of children is explored. The limitations to the evidence in support of our current assessment strategies with children, as well as promising ways to reduce those limitations, are detailed. Finally, current trends and devel- opments in the assessment of children in social work practice settings, including child protection, schools, and mental health, are presented. Defining Assessment Assessment is used to describe an assortment of activities and processes in the social sciences and human services that involve gathering information about a client(s) and the presenting circumstances leading to an evaluation, determination, or plan of action focused on that client or client system. In social work practice, some aspects of assessment are driven by the practice setting, the population being served, and the practice model being applied by the social worker. However, this chapter offers a framework for social work assessment with children that, although embedded within the evolution of the social work perspective and the current effort to situate social work practice on an evidence base, can be applied by any direct practitioner regardless of setting, population, practice level, or model. In this chapter, a descriptive and evolving definition of assessment in the context of providing social work services to children is offered. As a starting framework, assessment in social work with children is defined as including three key components: (1) collecting data, (2) being informed by a contextual perspective, (3) leading to a prevention or intervention plan. Holosko, M. J., Dulmus, C. N., Sowers, K. M., & Sowers, K. M. (2013). Social work practice with individuals and families : Evidence-informed assessments and interventions. ProQuest Ebook Central <a onclick=window.open('http://ebookcentral.proquest.com','_blank') href='http://ebookcentral.proquest.com' target='_blank' style='cursor: pointer;'>http://ebookcentral.proquest.com</a> Created from waldenu on 2021-09-14 03:08:48. C o p yr ig h t © 2 0 1 3 . Jo h n W ile y & S o n s, I n co rp o ra te d . A ll ri g h ts r e se rv e d . Assessment of Children 3 Data Collection First, assessment of children is, in large part, defined by a range of activities used to gather information about a child, a struggle or challenge confronting that child, and relevant information about that child’s social environments. Those activities can include but are not limited to (a) clinical interviews, (b) structured interviews, (c) self-report instruments, (d) direct observations, and (e) reviews of existing records. Those data-collection activities may elicit information from multiple informants, including the child, parents/guardians, other family members, key individuals in the child’s life, and professionals who have direct experience with the child. Contextual Perspective The second component is illustrated by an enlightening distinction about assessment in social work practice made by Clifford (1998). He referred to ‘‘social assessment,’’ as opposed to psychological or medical assessment, in that social assessment ‘‘is centered on a social explanation—and will draw on social research and social science concepts’’ in identifying the service needs of an individual, small group, or community. Although social workers clearly also draw on and are informed by psychological and med- ical aspects of and explanations for client struggles, Clifford’s focus on the social aspects of the client and his or her struggles distinguishes assessment in social work from assessment in other disciplines. This focus on contex- tual factors in social work can be seen in many assessment orientations in social work, such as the person-in-environment perspective, psychoso- cial models, the widespread use of ecological-systems thinking, and the pervasive structuring of assessment information into a biopsychosocial assessment document. Prevention or Intervention Planning Third, child assessment in social work is also defined as having as the central goal in gathering that information to inform the development of a social work prevention or intervention plan to help that child or group of children. Although systematic information about a child and his or her social environments may be gathered for other reasons—such as part of a research endeavor or eligibility evaluation—unless the ultimate goal is a formulation leading to the implementation of a social work service plan, the gathering of that information does not constitute an assessment as it is referred to in this chapter. Thus, a social work assessment of a child includes (a) data collection, defined as a systematic gathering of information about the child, a struggle or challenge facing that child, and that child’s multiple social environments; (b) data pursued from a contextual perspective oriented to how the child’s social environments influence the child, the struggle or challenge, and efforts to resolve that struggle or challenge; and (c) development of an Holosko, M. J., Dulmus, C. N., Sowers, K. M., & Sowers, K. M. (2013). Social work practice with individuals and families : Evidence-informed assessments and interventions. ProQuest Ebook Central <a onclick=window.open('http://ebookcentral.proquest.com','_blank') href='http://ebookcentral.proquest.com' target='_blank' style='cursor: pointer;'>http://ebookcentral.proquest.com</a> Created from waldenu on 2021-09-14 03:08:48. C o p yr ig h t © 2 0 1 3 . Jo h n W ile y & S o n s, I n co rp o ra te d . A ll ri g h ts r e se rv e d . 4 Social Work Practice With Individuals and Families intervention plan to assist that child with that struggle or challenge as the primary goal of that data-collection effort. The application of systemic and comprehensive assessment strate- gies has become more important given profession-wide efforts to build an evidence-based approach to social work services (Gambrill, 1999). Because service-delivery activities start with and are built on the assessment pro- cess, reliable and valid assessment strategies and tools are fundamental to identifying, developing, evaluating, and providing evidence-based inter- ventions. For example, reliable and valid assessments provide a vehicle to evaluate interventions, thereby establishing evidence as to when and with whom such interventions can be effective. Further, the applica- tion of interventions with already established bodies of evidence as to their effectiveness should only be utilized after the application of system- atic, comprehensive, reliable, and valid assessment strategies and tools to inform the selection of interventions appropriate for a specific child in a spe- cific situation. Additionally, the results of a systematic assessment should influence the provision of the interventions chosen, thereby following long-established social work practice principles, such as starting where the client is, treating each client as an individual, and providing individualized services (Hepworth, Rooney, & Larsen, 2002; Pilsecker, 1994). The wide variety of settings in which social workers serve children, the larger array of struggles and challenges faced by those children, and the wide range of what and who social workers are actually assessing—for example, the child, a potential home placement, the risk of a caregiver to abuse or neglect, the appropriateness of a classroom setting—all make a truly comprehensive discussion of assessment of children in social work seem daunting. Therefore, one goal of this chapter is to set the current state of assessment of children in social work in a historical context that encompasses our collective professional knowledge inform- ing the assessment of children as a framework on which to add recent advancements. Historical Background Mary Richmond, in her seminal book Social Diagnosis (1917), presents the first comprehensive treatise on the assessment process in social work. Although she uses the term diagnosis, which, for most social workers today means something quite different than assessment, what she is referring to as a social diagnosis 90 years ago meets the three criteria for social work assessment offered here. In fact, for those who have not read all or even parts of her book, it is truly worth the time, and you may find it contains surprisingly still-relevant insights on assessment, social casework, and prescient glimpses of things to come. For example, Richmond describes her preparation to write Social Diagnosis as including systematically reviewing social work case records and recording interviews with caseworkers across five different sites over the course of a year ‘‘to bring to light the best Holosko, M. J., Dulmus, C. N., Sowers, K. M., & Sowers, K. M. (2013). Social work practice with individuals and families : Evidence-informed assessments and interventions. ProQuest Ebook Central <a onclick=window.open('http://ebookcentral.proquest.com','_blank') href='http://ebookcentral.proquest.com' target='_blank' style='cursor: pointer;'>http://ebookcentral.proquest.com</a> Created from waldenu on 2021-09-14 03:08:48. C o p yr ig h t © 2 0 1 3 . Jo h n W ile y & S o n s, I n co rp o ra te d . A ll ri g h ts r e se rv e d . Assessment of Children 5 social work practice that could be found’’ (p. 7). Is that not an effort to build a body of evidence about what works? Richmond further says of her efforts in the preparation of the book, ‘‘the most difficult of all my problems has been to make a presentation on the handling of evidence’’ (p. 9) in the assessment process. Richmond’s book culminates in a series of structured interview protocols for the assessment of various clients and situations. Assessment Informing Best and Evidence-Based Practices The pursuit of providing clients with the best possible social work services available at a given point in time, basing assessment on gathering the best evidence possible, and collecting that evidence in a systematic manner are distinctly not new endeavors in the social work profession. In fact, social work has a rich history of professional knowledge development in the area of assessment. Central to that accumulation of knowledge in the assessment of children has been the conceptual perspective of a child as embedded in a set of social contexts. Mary Richmond articulated that fundamental perspective 90 years ago. That perspective also guided Jane Addams and the Hull House staff. For example, in the area of juvenile delinquency, Hull House rejected dominant theories based on heredity and instead asserted that the most important factors leading to juvenile delinquency were environmental (Hart, 1990). With respect to assessment, that clearly means the gathering of information about, and analysis of, the social environment that a child inhabits in an effort to understand that child’s development, struggles, and behavior. The history of that perspective can be traced to today by examining social work textbooks over the decades detailing the state of the art and science of casework practices. For example, Hamilton (1951) states that assessment is an attempt to understand the client, the problem, and the situation; and such authors as Perlman (1957), Hollis (1964), and Pincus and Minahan (1973) iterate that triad of assessment. Hollis states this perspective succinctly when she points out that, in assessment, ‘‘strengths as well as weaknesses in both the person and the situation are important considerations’’ (p. 261). Hepworth et al. (2002) offer a similar triad. Assessment, they suggest, is a process ‘‘to gather information and formulation of that information into a coherent picture of the client and his or her circumstances,’’ leading to ‘‘our inferences about the nature and causes of the client’s difficulties’’ (p. 187). They do, however, describe a meaningful shift in one aspect of that triad in that they stress the assessment of the needs and the strengths of the client as much as the difficulties of the client. This strengths perspective continues to guide the development of structured assessment instruments for practice, such as a strength-based and culturally informed reliable and valid assessment tool for practice with Native American youth, their families, and communities (Gilgun, 2004). This sort of melding of the long-evolving social work ecological strengths Holosko, M. J., Dulmus, C. N., Sowers, K. M., & Sowers, K. M. (2013). Social work practice with individuals and families : Evidence-informed assessments and interventions. ProQuest Ebook Central <a onclick=window.open('http://ebookcentral.proquest.com','_blank') href='http://ebookcentral.proquest.com' target='_blank' style='cursor: pointer;'>http://ebookcentral.proquest.com</a> Created from waldenu on 2021-09-14 03:08:48. C o p yr ig h t © 2 0 1 3 . Jo h n W ile y & S o n s, I n co rp o ra te d . A ll ri g h ts r e se rv e d . 6 Social Work Practice With Individuals and Families and culturally informed orientation to helping clients with more recent and rigorous assessment methodology seems like a promising trajectory in social work assessment with children. The focus on strengths has grown in part from the long-standing fundamental humanistic perspective in social work that all clients are doing their best and have resources and that, when clients struggle, it is because of a deficit in those available resources. Such resources can be both internal and environmental, and clients can call on those resources—social workers can likewise call on those resources in the assessment process—to help meet challenges and struggles clients face (McQuaide & Ehrenreich, 1997). Such a strengths perspective grows out of social work’s values and ethical orientation to clients (a) as persons of worth, (b) as persons who have a fundamental right to choose their goals in the helping process and how they go about working on those goals, and (c) as persons who are capable of solving their own problems with appropriate support (Loewenberger & Dolgoff, 1985). The strengths perspective also stands in contrast to the still-pervasive medical model of diagnosing and labeling limitations, which is particularly prevalent in mental-health practice (Cox, 2006). The strengths perspective and the focus on the social environments of a client are reflected in the ubiquitous development of an ecological-systems orientation in social work practice. Evolving Ecological-Systems Perspective A seminal application of the ecological perspective in social work is the introduction of the life model of practice by Germain and Gitterman in 1980. As they put it, ‘‘the social purpose [of social work] calls for a practice method that is designed to engage people’s strengths and the forces pushing them toward growth, and to influence organizational structures, other social systems, and physical settings so they will be more responsive to people’s needs’’ (p. 2). In the 1980s, the ecological perspective was increasingly used to articulate the social work approach to assessment and service delivery. Further, some authors started adding concepts from the general systems theory to that ecological perspective to create what was termed the ecosystems perspective (Greif & Lynch, 1983). The adaptation of systems theory to practice endeavors introduced several helpful theoretical concepts into social work thinking. Those con- cepts are especially helpful in assessment, as they offer insights into how social systems—the interactions between a client and his or her environment—work. For example, equilibrium is a concept that states that human systems (read families) tend toward establishing a balance that can be maintained, whether that balance is good or not so good for the mem- bers of the system. Boundaries, such as between members of the family or between the family and other systems, such as the school or neighborhood, are critical in the flow of information, resources, and support within and among systems. Social work has long asserted that assessing and attending Holosko, M. J., Dulmus, C. N., Sowers, K. M., & Sowers, K. M. (2013). Social work practice with individuals and families : Evidence-informed assessments and interventions. ProQuest Ebook Central <a onclick=window.open('http://ebookcentral.proquest.com','_blank') href='http://ebookcentral.proquest.com' target='_blank' style='cursor: pointer;'>http://ebookcentral.proquest.com</a> Created from waldenu on 2021-09-14 03:08:48. C o p yr ig h t © 2 0 1 3 . Jo h n W ile y & S o n s, I n co rp o ra te d . A ll ri g h ts r e se rv e d . Assessment of Children 7 to these dynamic processes are critical to effective assessment of a child and his or her social systems (Germain & Gitterman, 1980). Another notable step in the evolution of the contextual orientation to assessment in social work is the person-in-environment (PIE) system, introduced by Karls and Wandrei (1992). The PIE system offers a common language and structure for social workers to use in formulating assessments from the unique orientation of social work. One goal in the development of the PIE system was to design an assessment structure that focuses on the ‘‘social well-being’’ of a client, which is identified as ‘‘different than physical or mental well-being’’ (p. 81), that assertion being supported by research about those three domains. The PIE assessment approach is sys- tematic and comprehensive and includes information about the client, the problem, and the client’s social environment, therefore possessing many of the characteristics described earlier for an effective assessment. It also introduces a coding system for client problems, with codes for duration, severity, and coping, as a way to quantify assessment information. The basic structure of the PIE system includes four factors: Factor 1–social role problems, Factor 2–environmental problems, Factor 3–mental disorders, and Factor 4–physical disorders. This system shares some structural char- acteristics with and foreshadows the multiaxial format of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Asso- ciation, 2000) diagnostic format, and, although not widely used today, the PIE system represents an important development in social work’s quest to build a professionally unique and uniform structure to assess- ment. Additionally, the PIE perspective continues to evolve; for example, the person-environment practice approach, as described by Kemp, Whit- taker, and Tracy (1997), offers an ecological competence-oriented practice model that stresses the importance of ongoing assessment, social support, empowerment, and collective action. Other developments in social assessment have also yielded systematic formats to gather and organize information. For example, there are two diagrammatic assessment tools that have seen widespread use in social work practice with children and families: the eco-map and the genogram (Hartman, 1995). Both tools grew out of the ecological-systems perspective and gained popularity in social work practice in the 1980s. Either or both can be drawn by a social worker in concert with a child and family during the assessment process and used as tools to elicit and synthesize information from the child and family as they help complete each diagram. Either can then be used to analyze family dynamics, gain a comprehensive picture of the family circumstances related to the struggle or challenge, or used to search for strengths, possible resources, and the ongoing collection of assessment information. Hartman (1995), a social worker, first developed the eco-map for use in child welfare practice. An eco-map has, at its center, the child and family drawn as a circle (Figure 1.1). Then, surrounding the family and child is a system of circles representing other important people, resources, or activi- ties, such as extended family; friends of the child and parents/guardians; Holosko, M. J., Dulmus, C. N., Sowers, K. M., & Sowers, K. M. (2013). Social work practice with individuals and families : Evidence-informed assessments and interventions. ProQuest Ebook Central <a onclick=window.open('http://ebookcentral.proquest.com','_blank') href='http://ebookcentral.proquest.com' target='_blank' style='cursor: pointer;'>http://ebookcentral.proquest.com</a> Created from waldenu on 2021-09-14 03:08:48. C o p yr ig h t © 2 0 1 3 . Jo h n W ile y & S o n s, I n co rp o ra te d . A ll ri g h ts r e se rv e d . 8 Social Work Practice With Individuals and Families Figure 1.1 Example of an eco-map for Eddie, a 10-year-old boy with behavior problems Church youth group leader Father— Edward Chris Basketball coach Teacher School principal Neighborhood peers Grandpa— Henry School peers JessEddie Sarah activities, such as recreation, sports, or hobbies; organizations, such as schools, churches, neighborhood groups, or workplaces; or other agencies, such as health-care providers, mental-health providers, or juvenile court. Care should be taken to include not just circles related to the presenting challenge or struggle but also those that represent strengths and resources to the child and family and other struggles or possible barriers to solving the presenting issue. Once all the needed circles have been drawn, various types of lines are drawn between the circles to represent the nature of the connection between the child and family and each particular circle. For example, a solid line depicts a strong relationship, and a dashed line represents a tenuous connection, whereas a line with hash marks across it suggests a stressful connection. Arrows are drawn along the connections to indicate the direction of flow of support, resources, and energy. Murray Bowen (1978), a psychiatrist who was a pioneer in the field of family therapy, developed the genogram as an assessment tool. Carter and McGoldrick (1980), social workers who have been at the forefront of the evolution of family therapy over the past 25 years, particularly with respect to gender and ethnicity issues, introduced the use of genograms in social work. In drawing a genogram, three or even four generations of the family are depicted (Figure 1.2). Males are drawn as squares and females as circles, and a system of lines is utilized to connect family members and indicate the nature of their kinship. A genogram has levels for each generation, such that family members in the same generation are on the same level across the page. Once all the multigenerational members of Holosko, M. J., Dulmus, C. N., Sowers, K. M., & Sowers, K. M. (2013). Social work practice with individuals and families : Evidence-informed assessments and interventions. ProQuest Ebook Central <a onclick=window.open('http://ebookcentral.proquest.com','_blank') href='http://ebookcentral.proquest.com' target='_blank' style='cursor: pointer;'>http://ebookcentral.proquest.com</a> Created from waldenu on 2021-09-14 03:08:48. C o p yr ig h t © 2 0 1 3 . Jo h n W ile y & S o n s, I n co rp o ra te d . A ll ri g h ts r e se rv e d . Assessment of Children 9 Edward Sr.— Died 20 years ago at age 42 Typesetter Eleanor— Loving but can be mean Homemaker Henry— Alcohol problems Bad temper Carpenter Edith— Quiet Teacher Sarah— Nervous at times Had affair that lead to the divorce Teacher Edward Jr.— Abusive Dropped out Truckdriver M—1973, D—1985 Jessica— Can be hyper Good student Eddie— Gets in fights at school Is oppositional with teachers Has trouble sleeping Has periods of withdrawal Chris— Ran away once Older boyfriend Sheila— M—1986 62 22 3 1 13 42 35 7 10 70 67 Figure 1.2 Example of a genogram for … Vol. 11, No. 2, March 2008 YOUNG EXCEPTIONAL CHILDREN 17 YEC DOI: 10.1177/1096250607311932 http://yec.sagepub.com © 2008 Division for Early Childhood Katherine M. McCormick, PhD University of Kentucky Sarintha Stricklin, PhD Louisiana State University Health Sciences Center Theresa M. Nowak, PhD Eastern Kentucky University Beth Rous, EdD University of Kentucky Using Eco-Mapping to Understand Family Strengths and Resources A s professionals and families work together to identify and celebrate the strengths and resources unique to each family, new and innovative ways to describe and discuss family characteristics are needed. The eco-map, borrowed from social science disciplines, is one method used to describe family strengths and resources. The eco- map was developed in 1975 by sociologist Hartman (1978) to help social workers in public child welfare practice better understand the needs of the families with whom they worked. An eco-map is a graphic representation or visualization of the family and linkages to the larger social system, including informal (e.g., friends, extended family members) and formal (e.g., early care and education providers, early intervention providers) supports. It illustrates how the family exists within the context of its Eco-Mapping / McCormick et al. YOUNG EXCEPTIONAL CHILDREN Vol. 11, No. 2, March 200818 “ ” relationships with other individuals and institutions with which the family has contact. Utilizing an ecological model (Bronfenbrenner, 1979), the eco-map provides a visual display of any group of interconnections and relationships, providing a graphic image of the family system within the larger social matrix. Eco-maps have been used in multiple ways by early intervention providers and rehabilitation specialists and within the clinical practice of social workers, psychologists, and other mental health professionals (Bailey & Simeonsson, 1988; Mattaini, 1995). Originally developed as a schematic “thinking tool” (Hartman, 1978, p. 117) for the social worker to use as a visual representation of the family system at the beginning of intervention, clinicians quickly came to value its use as a mechanism to (a) foster collaboration between families and professionals and (b) jointly organize and depict information. More recently, eco-mapping has been used in clinical practice to evaluate outcomes and to measure change and monitor progress by completing an eco-map at multiple points in time (Chatters & Taylor, 1994; Horton & Bucy, 2000). In short, practitioners use eco- maps as a mechanism to establish rapport with families (Cox, 2003), learn more about the perceptions of the family at their initial meeting (Hartman, 1978), organize information and facts (Hanson & Boyd, 1996), set goals in intervention (Horton & Bucy, 2000), and monitor progress (Mattaini, 1995). For each purpose, the primary value of the eco-map is in its visual impact and simplicity. That is, the eco-map provides a unique method to organize and present concurrently factual information and the relationships between variables in the family’s current ecology. Given the positive history of eco-maps within the area of social work, its usefulness as a technique to increase early interventionists’ awareness of the family within its community, assist in the assessment and planning phase of intervention, and evaluate the effectiveness of services (Swanson & Niles, 1997) holds great promise for the field of early intervention, specifically, the family needs assessment component of Part C of the Individuals With Disabilities Education Act (IDEA, 2004). The eco-map provides an opportunity to visually represent the family’s perspectives about the absence or presence, and nature and strength, of linkages to friends, coworkers, religious or spiritual institutions, schools, social service agencies, community groups, recreational activities, health care networks, legal systems, and volunteer or advocacy organizations (Cox, 2003). The eco-map provides an opportunity to initiate early intervention services and Individualized Family Service Plan (IFSP) processes in a family-centered manner, respectful of the diversity and individual resources and needs of families. The purpose of this article is to (a) provide a brief overview of the eco-map process, (b) describe the key steps in completing eco-maps with families, and (c) share implications for early intervention practice. The eco-mapping process will be illustrated through the use of a family vignette. The eco-map provides a unique method to organize and present concurrently factual information and the relationships between variables in the family’s current ecology. Vol. 11, No. 2, March 2008 YOUNG EXCEPTIONAL CHILDREN Eco-Mapping / McCormick et al. 19 “ ” The Eco-Map Process The eco-map is a simple paper- and-pencil simulation that was developed as an assessment, planning, and intervention tool (Hartman, 1995). It maps in a dynamic way the ecological systems in which the family lives and interacts. The eco-map facilitates an informal, conversational approach to family information gathering, including identification of immediate and extended family members, friends, and neighbors; recreational, employment, and community supports; and formal resources accessed by the family. Simple strategies are used to diagram identified resources and supports and relationships between the family and these other systems. In most instances, interventionists sit with the family and introduce the activity as a way of identifying the family’s current members, friends, and supports. Together with the family, they begin the process by putting a circle in the middle of the page with the child’s name in it. The eco-map can be designed simply with circles, or multiple symbols can be used to denote differences (e.g., circles for females, squares for males). In addition, metaphoric symbols or faces can be used to represent people or agencies (Van Treuren, 1986). It also helps to document who is completing the eco-map by putting a symbol such as a star in the respondent’s circle. The steps in the process include identifying informal supports, identifying strengths of relationships, and identifying formal supports. Identifying Informal Supports The interventionist should first describe how supports are defined and then ask the family members to think about the informal supports currently available to them. An example script of this initial step follows: I would like for us to work together to identify all the different types of people who currently provide support or help to your child and you. This could include family members, friends, and members of your church or neighborhood as well as people from your community. Support comes in many forms. For example, friendship, child care, spiritual support, and a listening ear are all types of support. Let’s start with your immediate family and more informal supports. First, I am going to put a circle in the middle of the page with your child’s name in it. Now, I will draw a circle with your name in it. Then, I will draw a circle for each of the informal supports you identify. Early intervention service providers also might be interested in the type of supports each person provides as well as the frequency of the support. Therefore, each of the circles may be labeled and additional information may be solicited about how each person relates to the child and family, the type of support each person provides, and how often the child and family receive the support. For example, below the circle, an R could indicate the relationship The steps in the process include identifying informal supports, identifying strengths of relationships, and identifying formal supports. Eco-Mapping / McCormick et al. YOUNG EXCEPTIONAL CHILDREN Vol. 11, No. 2, March 200820 of this person with the child and family (e.g., “R = neighbor”). An S might indicate the type of support provided (e.g., “S = babysitting”). Information about the frequency of the support provided by this person (e.g., daily, weekly, monthly, as needed, once a year) also can be documented. An example script of this step follows: For each of the circles we have drawn, we need to add some information about how each person relates to your child, the type of support he or she provides, and how often your child and you receive the support. Let’s start with grandparents. First, we will note their relationship as maternal or paternal grandparents, then list the type of supports they provide to you and your child. Figure 1 shows the first stage in the development of an eco-map of the Theriot family. Judi, the mom, is sharing information about her family, including her husband, Jodi; son, Paul; and daughter, Allie. Allie, in the center of the map, is an incredibly engaging, 35-month-old little girl, who was diagnosed with cerebral palsy at 7 months of age. Providing informal supports in her care and development are extended family members, friends, and neighbors. Each of these individuals or groups is represented by a circle on the map. Figure 1 First stage of an eco-map Vol. 11, No. 2, March 2008 YOUNG EXCEPTIONAL CHILDREN Eco-Mapping / McCormick et al. 21 Identifying Strengths of Relationships At the heart of the eco-map are the relationships between the family and other systems, which are represented by various types of sketched lines. Hodge (2005) suggests the following conventions: Thicker lines represent stronger or more powerful relationships. A dashed line represents the most tenuous relationship, while a jagged line denotes a conflicted one. An arrow is drawn on the line to indicate the flow of supports, energy, resources, or interests. (p. 320) Supports can go one way, such as babysitting services offered by a neighbor or assistance provided by a friend. Often, supports go both ways, such as between a parent and grandparent. Arrows are drawn between the circles to show whether the relationships benefit or help one or both people (e.g., one-way or two- way arrow). Hodge also suggests that short descriptions, important dates, or other symbols be written to clarify the relationships. In addition to seeing a quick, available-at-a-glance picture of a family and its interactions, families are able to use the eco-map to confirm their feelings of isolation or stress (e.g., “So this is why I’m so overwhelmed; I don’t have many supports or people to help me.”). Figure 2 shows the Theriot family’s eco-map with relationship Figure 2 Relationship lines Eco-Mapping / McCormick et al. YOUNG EXCEPTIONAL CHILDREN Vol. 11, No. 2, March 200822 lines drawn. The map shows that Judi and Jodi provide primary care for Allie, but it also shows that Allie spends many of her days with her Maw Maw and Paw Paw Theriot. They are retired and have taken an active role with Allie, bringing her to most of her special activities. Paw Paw is good with his hands and has built or adapted trays, standing frames, wagons, and many other toys and furnishings. Allie’s maternal grandparents are older. Judi worries about them and regularly helps them with household chores, doctor visits, and medical needs. Judi’s sister, Connie, also helps her parents and, over the years, has been a huge support for Judi. Connie often babysits for Allie and Paul and always is available for Judi to “talk things over.” These relationships are represented by the lines between Connie and Judi, Allie, and Paul. Although Judi worries about Paul, the family has a good friend and neighbor, Kevin, who takes Paul to many of his baseball practices and games. Judi and Jodi still worry that they are not giving Paul enough time or attention. The family relies on their faith and church for guidance and support. They attend services and have other families from their church at their home for barbeques and picnics. Most of these families have young children close in age to Allie and Paul. There also are lots of young children in the Theriots’ neighborhood. Identifying Formal Supports Finally, family members are asked to identify all of the formal supports they currently receive, and separate circles for these supports are drawn. Examples of these supports might include physicians, therapists, and other professionals from community agencies. Formal support comes in many forms. For example, information, child care, housing, financial assistance, early intervention services, medical care, and counseling are all types of support. The steps needed to label and denote family relationships with these formal supports are then repeated. That is, the interventionist asks, “What is the relationship or association of this person with your child? With you? What type of support does this person provide? And what is the frequency of this support?” Figure 3 illustrates a completed eco-map for the Theriot family. This map shows Allie’s favorite activities, horseback riding and swimming. It also shows her numerous doctors and therapies, including clinic-based speech and physical therapy, home- based special instruction, and occupational therapy. A family service coordinator also meets with the family monthly and has helped them access early intervention services and supported them in obtaining a wheelchair for Allie. Currently, Allie’s providers are discussing her need for an augmentative communication device. Judi and Jodi are confused about these devices, and they are having a difficult time trying to discuss this with the speech- language pathologist because of her busy schedule. They are frustrated that Allie’s therapists do not have time to communicate with each other. Jodi also is frustrated with Vol. 11, No. 2, March 2008 YOUNG EXCEPTIONAL CHILDREN Eco-Mapping / McCormick et al. 23 their health insurance agency’s slow determination and payment process. Summary of the Eco-Map Process During the process, family members are encouraged to take the lead in the identification of informal and formal supports and strengths of relationships. When a stopping point nears, the service provider, if needed, might ask about specific supports not addressed by the family (e.g., community, intervention services, medical or health), requesting that the family identify and describe these supports. These additional supports may then be added to the eco-map. Some families might need additional structure as they complete this activity. For example, a parent might have difficulty thinking independently of the various types of supports the child and family receives and would benefit from a listing of sources and examples of support. If this is the case, Table 1 lists categories and Figure 3 Completed eco-map Eco-Mapping / McCormick et al. YOUNG EXCEPTIONAL CHILDREN Vol. 11, No. 2, March 200824 examples of supports to share with the family. Once all informal and formal supports and their relationships are documented, the family and provider jointly review the eco-map and reflect on the usefulness of these supports in meeting the child’s and family’s identified concerns and priorities. The early interventionist then closes with, “Thank you for working with me to identify your family’s supports. Let’s review your map regularly as we consider the effectiveness of these supports in meeting your family’s needs. Here is a copy for you to keep.” Implications of the Eco-Map Process for Early Intervention Practice Some advantages of using an eco-map in early intervention service planning and provision include (a) establishing rapport with families to build a foundation for the provision of family-centered services, (b) appropriateness for families of culturally diverse backgrounds and families with limited literacy, (c) organizing information and facts and linking to the IFSP, (d) facilitating services in natural environments, and (e) maximizing utilization of informal resources. Family-Centered Early Intervention Services When used in initial meetings and information gathering with families, the eco-map facilitates a family-centered approach to assist families in identifying resources currently available to meet their needs. It is a tool to elicit from family members their own perceptions of their family’s functioning and organization around their children and their concerns, priorities, and resources. A well-constructed and in-depth eco-map can provide the family and early intervention provider valuable information that formal family assessment instruments might miss. For example, as noted in Figure 2, the Theriot family’s eco-map not only shows a large informal support system but points out those supports (i.e., maternal grandparents) that also are stressors for the family. Hartman and Laird (1983) suggest that the joint completion by provider and family in a side-by-side process is an important feature of the eco- map. This shared activity and perspective is congruent with other recommendations for family–professional partnerships (Woods & McCormick, 2002). Table 1 Categories and Examples of Potential Family Supports Example of Type(s) of Category Example of Person(s) Support Family Grandparent Financial assistance, emotional support Friends Friend of yours Friendship Neighborhood Next door neighbor Child care Church Church member Transportation Community Case worker Housing, financial assistance Child care Teacher Child care, parent education Intervention services Physical therapist Early intervention services Mental health Counselor Emotional support, parent education Medical/health Physician Medical care Vol. 11, No. 2, March 2008 YOUNG EXCEPTIONAL CHILDREN Eco-Mapping / McCormick et al. 25 “ ” The family’s cultural heritage and values become more transparent as the family and professional work together. Use With Families of Diverse Backgrounds Because the eco-map process asks the family to identify family members and community resources, it is useful across families of culturally diverse backgrounds. The eco-map has been used widely with families of diverse backgrounds and to map diverse components of family systems (Hodge & Williams, 2002). The family’s cultural heritage and values become more transparent as the family and professional work together to identify the family’s various linkages, which are unique to its culture and how the family interacts with the world. For example, Chatters and Taylor (1994) report that approximately 70% of African Americans attend church or a place of worship. It would not, therefore, be surprising to see church and church-related supports included in an eco-map for an African American family. In addition, the eco-map provides a way to reconceptualize the complex needs of families of children with significant disabilities (Imber-Black, 1988; Imber- Coppersmith, 1983, 1985). Morawetz and Walker (1984) suggest that this also is true for high-poverty, high-risk families: “Frequently a family will be involved with many helping systems and the relationships of these systems with each other in respect to the family will resemble the relationships of a group of angry and rivalrous relatives” (p. 333). These interactions and relationships can be seen readily in an eco-map. Working together, families and interventionists will not overlook powerful significant-other relationships that uniquely can assist and support the family (Cox, Keltner, & Hogan, 2003). The completion of the eco-map can confirm or challenge the perception about a family and its interactions in the multiple communities in which the family lives (e.g., school, work, neighborhood, family). Another form of diversity that is sometimes overlooked is the educational level of families. Eco-map construction is conducted through verbal interaction between the family and interventionist. This interaction eliminates the necessity for advanced reading levels, and thus is useful for families with low literacy levels or those for whom English is not their first language. Linkage to the IFSP Family information gathering is essential to the development of individualized early intervention services for children and families. The specific resources and needs of each family must be considered in the development and implementation of the IFSP. The eco-map facilitates (a) identification of sources of family support that can be utilized during service provision, (b) identification of information that will empower families and assist them in obtaining needed services for their child and family, and (c) decision making regarding currently used and needed resources—time and resources required of the family for services and supports (e.g., the Theriot family has to take off work early to pick up Allie and drive her to therapy). It provides a simple visual that depicts gaps in resources or Eco-Mapping / McCormick et al. YOUNG EXCEPTIONAL CHILDREN Vol. 11, No. 2, March 200826 relationships as well as identifies conflicting or stressful relationships. In short, the eco-map provides a comprehensive picture and summary of information that easily fits and supports the IFSP process. Support Services in Natural Environments The activities and routines in which young children participate are influenced by the resources, time, interests, and settings of the family (Dunst, Hamby, Trivette, Raab, & Bruder, 2000). The eco-map is designed to facilitate the identification of these prominent family resources and interactions first, setting the stage for the provision of supports and services within environments in which the child is already participating. For example, Allie Theriot (Figure 2) spends much of her time at Maw Maw and Paw Paw’s house. Mapping of this important resource for the Theriot family sets the stage for interventions incorporating Allie’s typical activities at Maw Maw and Paw Paw’s house. The eco-map then moves to other, more formal resources and visually diagrams the connections, or lack of connections, across these agencies or organizations. The sketched lines and arrows, as shown in the Theriots’ eco-map, depict how different individuals, interventionists, and agencies interact with one another. This helps to highlight the type of communication across family members, interventionists, and providers—a critical component of the provision of services in natural environments. Review of Informal and Formal Resources When the eco-map is used with families already receiving early intervention services, it can serve as a mechanism to facilitate a review of the family’s use of informal and formal resources. The eco-map can be a concrete tool for assessing, developing, and coordinating natural or informal resources and more formal networks (Flashman, 1991). Often professionals overlook informal resources, immediately arranging for formal programs or organizations to assist in meeting families’ needs. The visual display provided by the eco-map allows professionals and families to quickly identify the “got a need—get a service” phenomenon, which can drain family time, energy, and resources. Sequential Eco-Maps Additionally, eco-maps can be used at the onset of intervention, at transition, or at other points in time. Hartman (1978) recommended that eco-maps be used to monitor the progress of intervention by completing eco- maps at multiple points in time. A comparison of these eco-maps might help families and interventionists measure the changes that have occurred over time. Mattaini (1995) suggested that sequential eco-maps can be useful particularly in family situations where the interconnected networks of stressors, supports, resources, and issues are complicated and a single measure simply cannot capture all of the data of importance. The eco-map provides a comprehensive picture and summary of information that easily fits and supports the IFSP process. “ ” Vol. 11, No. 2, March 2008 YOUNG EXCEPTIONAL CHILDREN Eco-Mapping / McCormick et al. 27 Summary and Conclusions As illustrated by the vignette and the accompanying figures, eco- maps offer a feasible method for gathering extensive information about families and their resources and supports. It is a fun, easy-to-use paper-and-pencil simulation that organizes and objectifies a tremendous amount of data about the family system in space and through time. The family plays a vital role in bringing pertinent information to the table and laying the foundation for a meaningful IFSP. Van Treuren (1986) suggests that the eco-map has four advantages. It (a) is simple to use and understand, (b) is adaptable to any size family and can be used with children as well as adults, (c) is functional and useful, and (d) allows for the creativity of the family and practitioner. The eco-map represents the family within the context of significant relationships with other individuals and institutions (Horton & Bucy, 2000). It represents the connections between family and others—basically, family life. The authors of the eco-map consider the tool to be “practical and parsimonious . . . the usefulness of this simple diagram becomes dramatically clear if one considers the volume of words it would take to describe the family with words alone” (Hartman & Laird, 1985, p. 161). In summary, the use of the term ecology is purposeful. It describes the balance that exists between living things and the environment in which they function, the mutuality of these interactions, the flow of resources, the nature of interactions, and the points of conflict. It demonstrates both lack and abundance (Hartman, 1978). Note You may reach Katherine McCormick by e-mail at [email protected] uky.edu. References Bailey, D. B., & Simeonsson, R. J. (1988). Family assessment in early intervention. Columbus, OH: Merrill. Bronfenbrenner, U. (1979). Contexts of child rearing: Problems and prospects. American Psychologist, 34, 844-850. Chatters, L. M., & Taylor, R. J. (1994). Religious involvement among older African-Americans. In J. S. Levin (Ed.), Religion in aging and health: Theoretical foundations and methodological frontiers (pp. 196-230). Thousand Oaks, CA: Sage. Cox, R. P. (2003). Health related counseling with families of diverse cultures: Family, health and cultural competencies. Westport, CT: Greenwood. Cox, R. P., Keltner, N., & Hogan, B. (2003). Family assessment tools. In R. P. Cox (Ed.), Health related counseling with families of diverse cultures: Families, health, and cultural competencies (pp. 145-168). Westport, CT: Greenwood. Dunst, C. J., Hamby, D., Trivette, C. M., Rabb, M., & Bruder, M. B. (2000). Everyday family and community life and children’s naturally occurring learning opportunities. Journal of Early Intervention, 23, 151-164. Flashman, M. (1991). Training social workers in public welfare: Some useful family concepts. Journal of Independent Social Work, 5(3/4), 53-68. Hanson, S., & Boyd, S. (1996). Family health care nursing: Theory, practice, and research. Philadelphia: Davis. Hartman, A. (1978). Diagrammatic assessment of family relationships. Social Casework, 59, 465-476. Hartman, A. (1995). Diagrammatic assessment of family relationships. Families in Society: The Journal of Contemporary Human Services, 76(2), 111-122. Hartman A., & Laird, J. (1983). Family-centered social work practice. New York: Free Press. Hodge, D. R. (2005). Developing a spiritual assessment toolbox: A discussion of the strengths and limitations of five different assessment methods. Health and Social Work, 30, 314-323. Hodge, D. R., & Williams, T. R. (2002). Assessing African American spirituality with spiritual eco-maps. Families in Society: The Journal of Contemporary Human Services, 83, 585-595. Horton, C. B., & Bucy, J. E. (2000). Assessing adolescents: Ecological and person-environment fit perspectives. In W. E. Martin & J. L. Swartz- Kulstad (Eds.), An introduction to person-environment psychology and mental health: Assessment and intervention (pp. 39-47). Mahwah, NJ: Lawrence Erlbaum. Imber-Black, E. (1988). Families and larger systems. New York: Guilford. Imber-Coppersmith, E. (1983). The family and public service systems: An assessment method. In B. Keeney (Ed.), Diagnosis and assessment in family therapy (pp. 83-99). Rockville, MD: Aspen System. Imber-Coppersmith, E. (1985). Teaching trainees to think in triads. Journal of Marital and Family Therapy, 11, 61-66. Individuals With Disabilities Education Improvement Act, Amendments of 2004, Pub. L. No. 108-446, U.S.C. 20, §1400 et seq. (2004). Mattaini, M. (1995). Visualizing practice with children and families. Early Child Development and Care, 106, 59-74. Morawetz, A., & Walker, G. (1984). Brief therapy with single-parent families. New York: Brunner/Mazel. Swanson, J., & Niles, M. (1997). Community health nursing. Philadelphia: Saunders. Van Treuren, R. R. (1986). Self-perception in family systems: A diagrammatic technique. Social Casework, 67(5), 299-305. Woods, J. J., & McCormick, K. M. (2002). Toward an integration of child- and family-centered practices in the assessment of preschool children: Welcoming the family. Young Exceptional Children, 5(3), 2-11. YOUNG EXCEPTIONAL CHILDREN Vol. 11, No. 2, March 200828 Eco-Mapping / McCormick et al. << /ASCII85EncodePages false /AllowTransparency false /AutoPositionEPSFiles true …