Keeping Families Together: A Mixed-Methods Examination of a Parenting Intervention for Caregivers with Intellectual Disabilities Involved in Child Welfare

Background: An estimated 2.3% of parents in the U.S. have an intellectual disability (ID). Research demonstrates that parents with ID are disproportionately represented in child welfare systems. Additionally, children whose parents have an ID are more likely to be placed in foster care than children of parents without IDs. Foster care has been associated with long-term negative health and mental health outcomes. Providing specialized support to parents with IDs is recognized as an intervention to prevent foster care placement however there is limited empirical research to guide practice. This study contributes to the research on parenting interventions for parents with ID by examining the experiences and outcomes of parents who participated in Project IMPACT (Improving Parenting Achievements Together) an intensive in-home parenting intervention for caregivers with ID’s at risk for child removal and placement in foster care.

Methods: We employed a mixed-methods design based on Fraser and colleagues’ 5 Steps in Intervention Research to examine the research questions: 1) Which clients are referred to Project IMPACT? 2) Which clients benefit most from participating? 3) What do stakeholders report as the most beneficial aspects of the program? The quantitative sample included program records from parents (n=133) with ID who participated in Project IMPACT. The qualitative sample included open ended survey responses from participants (n=99) who completed Project IMPACT and child welfare workers (n=59). Additionally, semi-structured interviews were conducted with DSS workers (n=6) who referred clients to Project IMPACT, and a focus group with Project IMPACT staff. The quantitative data were analyzed using growth curves, a form of multilevel modeling and logistic regression, and binary logistic regression, to examine the degree to which parenting skills and the home environment changed over time. The qualitative data were analyzed using thematic analysis.

Findings: Time spent in Project IMPACT was predictive of improvement in parenting skills and the home environment. Parents with more children had less improvement in outcomes. Parents whose children exhibited more behavioral problems demonstrated less improvement in the home environment. Qualitative findings support these results, as stakeholders emphasized that intensity and duration of services significantly benefited families. However, staff also argued that they perceived families with greater difficulty needing more services such as mental and behavioral health services Those parents completing Project IMPACT saw a 91% reduction in the odds of out-of-home placement for their children, and each additional month participating in the program reduced the odds by 37%. Clients reported the intensity of services, tailored education, and relationship with their caseworker as the most beneficial aspects of Project IMPACT.

Implications: The Family First Act of 2018 prioritizes funding for evidence-based preventive services and in-home parenting skills programs. Thus, the study findings have the potential to make significant contributions to the child welfare prevention and intervention literatures. Implications for social work policy, practice and future research will be discussed.