Bridging Disciplinary Boundaries (January 11 - 14, 2007)

Background and purpose: For adults with developmental disabilities (DD), families are often a critical source of care and support. DD interventions have become increasingly family-centered involving family members in planning and choosing services. Despite the increased emphasis on family decision-making, there has been a lack of empirical research which attempts to describe family involvement in decisions about services and to assess the benefits of this type of involvement. This study seeks to understand both patterns of family choice and the outcomes of family planning and decision-making.

Methods: Secondary data analysis of Washington State's 2004 National Core Indicators family survey was conducted. The sample included 547 parents, siblings, or other relatives who support a family member with DD in their home and receive services from the Washington State Division of Developmental Disabilities. A latent profile analysis (LPA), using Mplus version 3, was employed to model family member profiles. Indicators for the LPA included family involvement in: developing the service plan, choosing provider agencies, hiring support staff, and deciding how money is spent. Then, ANCOVA was used to examine the influence of class on number of services received controlling for income, consumer support needs, level of mental retardation, case manager contact, and age of consumer and family member. Finally, MANCOVA was used to examine the influence of class on satisfaction with case management and services. The influences of family income, age of family member and consumer, consumer support needs, number of services received, and frequency of case manager contact were controlled. Using a Bonferroni correction, a series of post-hoc tests were conducted to identify class differences.

Results: Fit statistics indicated that the four-class model fit the data the best (BIC = 8056.36). Class one (n=118) was highly involved all aspects of planning and decision-making. Class two (n=75) was involved only in financial decisions. Class three (n=166) was involved only in annual planning, and class four (n=188) was uninvolved.

An ANCOVA showed significant main effects for class on number of services received (F=34.39, p<.01). The highly involved class received more services than all other classes, and the planning class received more services than the uninvolved class. A MANCOVA showed that there were significant main effects for class on case management satisfaction (F=12.69, p<.01) and overall satisfaction with services (F=16.24, p<.01). Family members in the highly involved and planning classes were significantly more satisfied with their case management than family members in the money-only and uninvolved classes. The highly involved class demonstrated greater overall satisfaction with services than the money-only and uninvolved classes. The planning class expressed more overall satisfaction than the uninvolved class.

Implications for practice: The findings indicate both consumer and family members benefit from family planning and family choice. Consumers in highly involved families received more services. Family members who were highly involved or involved only with planning were more satisfied. The results suggest that social workers and professionals from other disciplines can influence family satisfaction with developmental disability services by encouraging families to become involved in decision-making processes.