Purpose: Students with emotional disturbances have the worst educational outcomes compared to their peers with other disabilities. Children with an emotional disturbance have the lowest grades in school, the lowest graduation rates, the fewest instances of full-time employment, the lowest paying jobs, and the highest risk of entering the adult mental health system. Recent research indicates that parent involvement is important in improving academic outcomes for students, yet parents of youth who have emotional disturbances are typically not as involved in their child's education compared to parents of students with other disabilities or students without disabilities. Families of children with an emotional disturbance may feel blamed, powerless, and stigmatized, which contributes to their lack of engagement with their child's school and social service system. To better use existing school and social services to help their child, parents of students with an emotional disturbance need information about what causes emotional disturbances and how they can help their child.

This research team is developing an intervention, Parent Connectors, aimed at increasing the engagement of families in the educational development of children with an emotional disturbance. Parent Connectors will promote the necessary knowledge, skills, and attitudes of parents to allow them to be effective partners with school personnel to improve their child's outcomes.

Project Activities: Researchers will conduct five interrelated studies. The first three studies will identify knowledge, skills, and attitudes that are drivers of parent involvement and guide the development of a training manual. The fourth study, a training validation study, will synthesize the results of the first three studies and conduct a trial of the feasibility of the training module. After analysis and refinement, study five, a pilot study of the proposed intervention, will be conducted in public schools.

Products: The products from this study will include a fully developed Parent Connectors intervention, including a training curriculum manual, and data from pilot studies of the intervention indicating the potential of this intervention to improve students' academic and behavioral outcomes.

Structured Abstract

Setting: The study will be set in large urban districts in south Florida.

Population: The project will include parents who have a child with an emotional disturbance. Some of these parents are parents who are raising, or have already raised, a child with an emotional disturbance, and who have been successful in navigating the education and mental health systems (i.e., potential "Parent Connectors"); others will be parents of children with emotional disturbances who are seeking help. The student sample consists of 160 students between the ages of 11 and 15 who attend self-contained classrooms in public middle schools and are served in special education programs for at least 50% of the day because of emotional and behavioral problems. The study will also include panel meetings of national and regional experts and interviews of staff from national advocacy groups.

Intervention: Parent Connectors is a parent-to parent support and education program for parents of children who have an emotional disturbance. The program consists of weekly telephone contacts between a Parent Connector (i.e., a parent who is successfully working with the education and mental health systems) and a parent who is seeking help. The core training modules for the Parent Connectors include: (1) the knowledge module, which addresses the causes of an emotional disturbance, special education procedures and regulations, and related services options available for students; (2) the skills module, which focuses on strategies a parent needs when collaborating with teachers, school personnel and service providers; and (3) the attitudes module, which addresses how to help parents feel empowered and efficacious so that they can effectively advocate for their child. Parent Connectors will also be trained in active listening, maintaining confidentiality, expressing empathy, supporting self-efficacy and promoting positive expectations in parents for their child’s success.

After training, the Parent Connectors are assigned up to ten parents of children who have an emotional disturbance. A two-hour weekly meeting of all Parent Connectors is held with a Parent Connector Supervisor, who is a pupil services professional that may be, for example, a social worker, school psychologist, or a guidance counselor. These meetings allow the Parent Connectors to support each other, cover potential issues of risk, and present an opportunity to monitor adherence to the model and fidelity to the intervention. The intervention is designed to last one school year.

Research Design and Methods: In this project, there are a series of studies that will contribute to the development, validation, and pilot testing of the intervention. The first study includes secondary data analysis of three extant data sets (National Community Mental Health Program for Children and their Families, Special Education Elementary Longitudinal Study, and the National Longitudinal Transition Study -2) to explore the relationship between characteristics of youth with emotional disturbances and their families, their use of support services, and educational outcomes. In addition, interviews with key stakeholders and reviews of their ongoing initiatives to support and engage families will provide additional clarity and validation of the components of the theory of change. The third study will produce training materials, procedures, and research protocols through collaboration with a panel of nationally recognized researchers and context experts in family support, training, and engagement. The training materials will be field tested with five Parent Connectors who will be providing support services to parents of youth with emotional disturbances. Lastly, a pilot study of the proposed intervention will be conducted in public schools. Half of the students will be randomly assigned to the Parent Connectors intervention and half to the control condition. Outcome measures will be collected pre- and post-intervention implementation. Separate focus groups will also be held for participants, including parents, teachers and school staff, and the Parent Connectors.

Control Condition: Students randomly assigned to the comparison condition will receive the related services traditionally provided to students with emotional disturbances and their families, or “services as usual.”

Key Measures: Parent measures include measures of parent empowerment, self efficacy, and satisfaction with school. Parent Connectors will be given a pre- and post-test assessment of their comprehension of the Knowledge, Skills, and Attitudes (KSAs) before and after the Parent Connectors' training sessions. In order to evaluate their ability to promote KSAs to the parent participants, a pre- post-test measure of their communication skills will also be administered. Student outcome measures include academic achievement, and school behaviors and functioning. Students' use of related services in and outside of school will be monitored. Variables that may mediate or moderate treatment effects will also be collected (e.g., demographic variables, intervention dosage).

Data Analytic Strategy: Secondary analysis will be conducted on the three national data sets. For each data set, continuous outcomes (e.g., parental stress) will be analyzed using hierarchical linear models. Count data (e.g., number of support services provided) will be analyzed using a hierarchical generalized linear model, which employs a Poisson sampling model and a log link function. Estimates of the variation in growth within groups and estimates of the variation in the average treatment effect across schools will be produced.

Data from national family organizations, regional school administrators, and consultants will be collected and analyzed using the Yin exploratory case study method which involves systemic and rigorous structured interviews and document reviews.

For the pilot study, main effects of the intervention program will be tested with ANOVA and ANCOVA for changes over time on continuous measures, and count variables will be analyzed using Poisson regression models. A second phase will explore potential moderators and mediators of the treatment effect. Hierarchical linear modeling will be used for continuous outcomes and hierarchical generalized linear modeling with a Poisson sampling model with a log link function for the count outcomes.

Products and Publications

Journal article, monograph, or newsletter

Duchnowski, A.J., Kutash, K., Green, A.L., Ferron, J.M., Wagner, M., and Vengrofski, B. (2013). Parent Support Services for Families of Children With Emotional Disturbances Being Served in Special Education Settings in Elementary Schools: An Examination of Data From the Special Education Elementary Longitudinal Study. Journal of Disability Policy Studies, 24(1): 36–52. doi:10.1177/1044207312460889

Kutash, K., Cross, B., Madias, A., Duchnowski, A.J., and Green, A.L. (2012). Description of a Fidelity Implementation System: An Example From a Community-Based Children's Mental Health Program. Journal of Child and Family Studies, 21(6): 1028–1040. doi:10.1007/s10826–012–9565–5

Kutash, K., Duchnowski, A.J., Green, A., and Ferron, J. (2013). Effectiveness of the Parent Connectors Program: Results From a Randomized Controlled Trial. School Mental Health, 5(4): 192–208. doi:10.1007/s12310–013–9106–4

Kutash, K., Duchnowski, A.J., Green, A.L., and Ferron, J. (2011). Supporting Parents Who Have Youth With Emotional Disturbances Through a Parent-to-Parent Support Program: A Proof of Concept Study Using Random Assignment. Administration and Policy in Mental Health and Mental Health Services Research, 38(5): 412–427. doi:10.1007/s10488–010–0329–5

Kutash, K., Garraza, L.G., Ferron, J., Duchnowski, A.J., Greene, C.W., and Green, A.L. (2013). The Relationship Between Family Education and Support Services and Parent and Child Outcomes Over Time. Journal of Emotional and Behavioral Disorders, 21(4): 264–276. doi:10.1177/1063426612451329