363400TECSE

Topics in Early Childhood

Supporting Families of Young Children Special Education

30(1) 20­–31
© Hammill Institute on Disabilities 2010
With Disabilities: Examining the Role of Reprints and permission: http://www.
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Administrative Structures DOI: 10.1177/0271121410363400

http://tecse.sagepub.com

Pamela Epley1, George S. Gotto IV2, Jean Ann Summers3,

Mary Jane Brotherson4, Ann P. Turnbull3, and Anna Friend5

Abstract
This article presents findings from two early intervention agencies examining how administrative structures affect providers’
ability to serve families of young children with disabilities. Based on previous research identifying three administrative
structures (i.e., vision/leadership, organizational climate, and resources), this article illustrates the relationship between
administrative structures, provider practices, and family supports and services. Findings include (a) the role of administrators’
knowledge and vision influencing provider practices, (b) the importance of organizational climates that foster partnership
and peer support for implementing and evaluating practices, (c) the effects of resource allocation decisions on family
supports and services, and (d) the need for accountability to ensure effective practices and family supports and services.

Keywords
early education programs, evidence-based practices, support for families, policy issues, case studies, research methodologies,
systems change

A major distinction between early intervention (EI) and
early childhood education and special education is its focus
on young children with disabilities within the context of
their families. This fundamental principle is evident in the
family-centered service delivery model, the provision of
supports and services to families of infants and toddlers with
disabilities, and the requirement that EI programs assess not
only child outcomes but family outcomes as well (Bailey et
al., 2006). Increased emphasis on accountability for child
and family outcomes prompted us to examine the role
administrative structures play in successful outcomes. Based
on our previous research (Summers et al., 2005), we define
administrative structures as an agency’s leadership and
vision, organizational climate, and resources. They are the
general operating processes that enable the staff to deliver
services in a way that embodies recommended practices.
Though the influence of administrative structures on ser-
vice delivery and outcomes may be generally acknowl-
edged, few researchers (Dinnebeil, Hale, & Rule, 1999;
Summers et al., 2001) have examined the relationship
between administrative structures, the provision of services,
and outcomes for young children with disabilities and their
families. Examining the effect of administrative policies on
collaboration, Dinnebeil and colleagues (1999) found that
the philosophy and principles that guided EI programs were
reflected in the programs’ overall organizational climate.
Additionally, they found that administrative policies and
practices, particularly those related to increasing profes-
sional competency, influenced collaboration between par-
ents and professionals. These findings suggest that
administrative policies, procedures, and service delivery
models may directly affect family-professional partnerships
(Brotherson et al., 2009; Dinnebeil et al., 1999; Hebbeler,
1997; Summers et al., 2001). Concluding that EI programs
are complex systems which include families, practitioners,
and administrative structures among other things, Dinnebeil
et al. (1999) emphasized the importance of understanding
the relationships between these various components and
how they interact to support effective EI. Similarly, Sum-
mers et al. (2001) found a relationship between administra-
tive structures and service integration in Early Head Start
and EI programs. Administrators and service providers iden-
tified networking activities, interagency agreements, staff
1
Erikson Institute, Chicago, IL, USA
2
University of Missouri–Kansas City, MO, USA
3
University of Kansas, Lawrence, KS, USA
4
Iowa State University, Ames, IA, USA
5
Pittsburg State University, Pittsburg, KS, USA
Corresponding Author:
Pamela Epley, Erikson Institute, 451 N. LaSalle Ave, Chicago, IL 60614, USA
E-mail: pepley@erikson.edu
Epley et al. 21
training, and structured opportunities for contact and col-
laboration as important administrative structures for effec-
tive service integration. In another study, Summers et al.
(2005) constructed a measure with 32 items drawn from the
literature about effective management and then asked 157
social service providers to rate how often an item was char-
acteristic of their agency on a 5-point scale. An exploratory
factor analysis identified three basic, underlying factors
comprising administrative structures: vision/leadership (the
degree to which the agency’s leadership embraces values
and focuses on expectations for evidence-based practice),
organizational climate (professional autonomy, workload,
and opportunities for collaboration with peers), and
resources (the degree to which the agency has flexible and
adequate financial, physical, and training resources to sup-
port practitioners and families) (Summers et al., 2005).
Effectively meeting the needs of young children with dis-
abilities and their families, however, requires more than sim-
ply identifying factors for effective management. It requires
knowledge and understanding about the context in which
practitioners deliver and children and families receive EI.
Whereas a few researchers have begun to investigate how
administrative structures affect EI, the focus has been lim-
ited to identifying administrative policies and practices that
support collaboration (Dinnebeil et al., 1999) or service inte-
gration (Park & Turnbull, 2003; Summers et al., 2001).
The purpose of this article is to examine the relationship
between administrative structures, practitioner practices,
and family supports and services in EI. This study builds on
the work of Summers et al. (2005) and used the three
administrative structures (vision/leadership, organizational
climate, and resources) identified in this previous research
as our definition of administrative structures. The purpose
was not to validate the three components of administrative
structures identified in our earlier work but rather to (a)
identify factors influencing the specific administrative
vision, organizational climate, and decisions about
resources; and (b) explore how these specific structures
may affect practitioners’ services to families of young chil-
dren with disabilities.
Method
A case study is a type of ethnography that focuses on a pro-
gram, event, or activity to understand and interpret the
group’s shared patterns of behavior, beliefs, interactions,
language, and economic and political structures over time
(Creswell, 2005). A case study offers in-depth understand-
ing of a situation and the means to investigate complex
social systems within a context (Merriam, 1998; Yin, 1994).
Furthermore, a comparative case study is the use of two or
more case studies to examine common themes or analyze
factors contributing to differences, thus enhancing overall
understanding of the phenomena under study (Creswell,
2005). The data reported here represent a strand of investi-
gation from a larger ethnographic study about family sup-
ports and services in EI (Brotherson et al., 2009; Friend,
2007).
Participants
Case Study Sites. We recruited two case study sites that
provided diversity and met three specific criteria (Merriam,
1998): (a) provided services for young children birth-to-
three with disabilities and their families, (b) utilized a home
visiting model of intervention, and (c) provided services to
a diverse group of children and families. We chose EI pro-
grams that differed in size and geographic location.
Although both in a Midwest state with the state’s Depart-
ment of Health serving as the lead agency, Program A
served a relatively small community within a larger metro-
politan area whereas Program B provided services to mul-
tiple rural communities across 12 counties. Program A was
part of the local school district’s special education depart-
ment. Program B, on the other hand, was a community-
based, not-for-profit child development center.
Early Intervention Practitioners and Families. Table 1
describes the demographic characteristics of participating
practitioners and families. In both programs, the 16 practi-
tioners (including the two program administrators) repre-
sented many disciplines/roles including early childhood
special education, social work, school psychology, speech/
language therapy, nursing, and service coordination. In both
sites the practitioners varied in age, number of years
employed, employment status (full- versus part-time), and
total years’ experience. All were European American,
except 2 practitioners in Program B who were Latina.
We asked the EI practitioners at each agency to recruit a
minimum of 4 families representative of typical and chal-
lenged families served by the agency. We purposely did not
define “typical” or “challenged” families for the practitio-
ners as one of the research questions for the larger study
was to understand the perspectives of practitioners about
the meaning of challenged versus typical families; see
Friend (2007) for results of that analysis. The research team
interviewed and/or observed a total of 14 families in home
visits and subsequently interviewed 9 of these families in
our two case study sites. Five families were unavailable for
follow-up interviews, but we retained them in the study
because we had their signed consent and notes from home
visit observations. Because of our request for practitioners
to identify both “typical” and “challenged” families, these
families represented a wide range of socioeconomic cir-
cumstances, single- versus two-parent households, strengths
in terms of social support networks or education, and chal-
lenges such as physical or mental health issues. We
22 Teacher Education and Special Education 30(1)

Table 1.  Demographic Characteristics of All Professional and Family Participants

Characteristics of professionals Characteristics of families

Program A Program B Program A Program B

Gender
  Male — — 1 1
  Female 7 9 3 9
Ethnicity
  White 7 7 3 7
  African American — — 1 —
  Hispanic — 2 — 3
  Other — — — —
SES
  Economically disadvantaged — — 2 5
  Non–economically disadvantaged 7 9 2 5
Total 7 9 4 10

provided incentives (e.g., including gift cards and library
donations) to practitioners and family participants. At Pro-
gram B’s request, we did not provide individual gifts to the
practitioners but rather made a donation to their library.
Data Collection
A team of two researchers collected data at each site using
multiple sources and methods. At Program A, these included
a focus group with the six EI practitioners and individual
interviews with administrators, practitioners serving the
families we observed, and families. We also observed a reg-
ularly scheduled home visit for each of the four families in
the study from Program A. The interview and focus group
protocols for administrators and practitioners included ques-
tions about their roles and responsibilities, supports the
agency provided to help practitioners do their job, barriers
they experienced, and supports and services provided to
families. The family interview protocol included questions
about the types of supports they received from the agency,
additional supports they would like to have, and impacts
they believed the agency has had on themselves and their
child. Program B was a long distance away from our research
offices; therefore, our research team traveled there and spent
two full days collecting data. The two team members split
up, and each spent a day riding along with different home
visitors to their regularly scheduled home visits; each home
visiting team consisted of two professionals and a translator.
This approach resulted in 10 home visit observations. Five
families participated in telephone interviews conducted the
following week. At Program B’s request, we did not conduct
a focus group but instead observed their weekly staff meet-
ing and instead conducted individual interviewed with all
professional staff members at the program as well as the
administrator and family liaison specialist. We used the
same protocol for the professional staff interviews as we had
for the focus group in Program A.
In addition to tape-recording the focus group and inter-
views for later transcription, site team members took
detailed notes during observations and completed contact
summary sheets following both observations and inter-
views. The contact summary sheet is an observational pro-
tocol for capturing data and organizing thoughts and ideas
(Creswell, 1998). Our contact summary sheet included gen-
eral descriptions and reflections, main themes and issues,
and potential future questions. The contact summary sheet
also served as a vehicle for regular peer debriefings. This
enabled the larger research team to meet and discuss emerg-
ing themes while waiting for audiotapes to be transcribed.
Using detailed field notes, researchers recorded data regard-
ing the context of the home visit, specific interventions and
assessments, interactions between the practitioner and par-
ent and between the practitioner and child, and specific
family and child supports observed.
Data Analysis
Data analysis was a three-step process. First, the entire
research team met at least biweekly to analyze data, develop
a coding system, and identify themes that were emerging
from the observation notes and contact summary sheets.
Data analysis and data collection were conducted simulta-
neously, using field notes and contact summary sheets to
discuss emergent themes. This enabled the team to process
information and develop emergent themes while waiting
for the audio recordings of interviews to be transcribed.
Also, these meetings enabled cross-site triangulation, with
reports and emerging themes identified by one site team
being checked in subsequent interviews with follow-up
probes in the other site. Second, these emergent themes in
turn formed the basis for an initial codebook to enable anal-
ysis of the data using QSR N6 (QSR, 2002). We coded tran-
scripts and observation field notes sequentially using a
constant comparative approach. Constant comparison is an
Epley et al. 23
I nfluencing Factor s
Vision/Leadership
Provider Practices &
Family Supports and
Services
Administrative
Structures
Organizational
Resources
Climate
Figure 1. Administrative structures conceptual framework
inductive data analysis procedure that involves generating
and connecting categories by comparing incidents in the
data to other incidents, and categories to other categories
(Creswell, 2005). Finally, through peer debriefing, discus-
sion, and comparison of these coded incidents, we moved
beyond the identification of codes to conceptual categories
and emerging themes (Harry, Sturges, & Klingner, 2005).
Part of the coding analysis included coding relevant sec-
tions of the data based on the three administrative structures
derived from previous research (Summers et al., 2005); as
this was our definition of administrative structures, the
coded material gave us insights into variations in these
three structures. We further used the data to develop a con-
ceptual framework to explain how various factors influence
these structures and how they in turn affect provider prac-
tices and family supports and services. We applied this con-
ceptual framework across the two case study sites, using the
coded transcripts and employing continuous rereading and
discussion, to analyze the impacts of influencing factors on
(a) the character of the three administrative structures and
(b) the ways in which family supports and services are
delivered. Finally, we compared the applied framework
between sites to identify overarching themes and patterns.
Findings
Figure 1 demonstrates how various environmental factors
within the community and/or agency influence the adminis-
trative vision/leadership, organizational climate, and
resources that formed our conceptualization of administra-
tive structures (Summers et al., 2005). These administrative
structures, in turn, interact to directly affect practitioners’
ability to serve families in two ways: by influencing the
practices in which the practitioners engage and the supports
and services families receive.
Table 2 provides a comparison of the influencing factors,
administrative structures, provider practices, and family
supports and services for the two programs. The table
reveals that in some ways the two programs are quite simi-
lar; for example, in training topics and in the degree to
which delivery of family supports such as diapers and find-
ing employment opportunities go undocumented. In other
ways the two programs are very different; for example, in
the integration of Parents as Teachers (PAT) with EI in one
program, whereas in the other program the PAT program
was involved more as an additional service offered to fami-
lies. The table illustrates how the divergent influencing fac-
tors and administrative structures may either create barriers
or facilitate practitioners’ ability to support families. In the
sections to follow, we compare and contrast the two sites on
each of the components shown in Figure 1 and listed in
summary form in Table 2.
Influencing Factors
Program A
The small urban community and independent school dis-
trict that Program A served had a long history of individual
identity, which they preserved within the larger urban area
that had grown up around them. The “we take care of our
own” philosophy was evident in the school district’s deci-
sion to retain responsibility for providing Part C services
rather than participate in the local countywide Part C
agency. The appointment of Program A’s director from
within the ranks of the district also demonstrated this phi-
losophy. With a teaching background in math and science
and administrative experience in the district’s alternative
high school, the director had limited experience with spe-
cial education but had been influential in bringing a PAT
program to the district. She described her appointment as
director of special services more than 13 years previously:
Not being a part of special ed [sic], I didn’t pay that
much attention.  .  .  . In August the superintendent
called me in and said “guess what, you’re going to be
the interim director of special ed.” I said “I can’t do
that because I don’t have sped certification.” . . . [T]o
make a long story short, I went back to school to get
my certification and have been director ever since.
The tendency of the community to “take care of our own”
and to hire from within directly influenced the appointment
of Program A’s director and ultimately shaped the pro-
gram’s administrative vision, climate, and resources.
Program B
In contrast to the rather compact geographic region served
by Program A, Program B serves a far-flung and sparsely
populated territory covering 12 counties. This large region
often required providers to spend the majority of their day
away from the office driving to small communities and
farm homes. One practitioner described the distances she
had to drive and the associated problems:
I [have] seven counties and the farthest that I drive is
probably an hour and a half . . . and sometimes you
get there and [families forget] you were coming and
24 Teacher Education and Special Education 30(1)

Table 2.  Comparison of Conceptual Framework Across Early Intervention Programs

Program A
Influencing factors
Administrative structures
  Vision and leadership
Program B
“We take care of our own” community
philosophy
Small, self-contained urban community
Administered by local school district
Director with administrative, Parents as
Teachers (PAT), and general education
background
Director’s role fiscal and personnel resources,
more hands-off style of supervision
Grounded in PAT belief that parents are
“teachers” and service providers are
“consultants”
Implicit policies and values
Not-for-profit organization
Large, rural geographic boundaries
High percentage of transient, multicultural
families
Director with early intervention background;
previous position was supervisor of home
visitors
Emphasis on evidence-based practice
Direct involvement of director
“Shared Values Statement” developed by
Board of Directors
Explicit policies and organization

  Organizational climate High level of professional autonomy Emphasis on team collaboration

Frequent and informal communication among Structured opportunities for team interac-
practitioners tion in weekly staff meetings

  Resources
Provider practices
Family supports and services
Staff assigned part-time to PAT program and
early intervention
Other staff assigned to Part B preschool part-
time
Small fund for family incidentals
Referrals to other urban area agencies
Routines-based intervention—implementation
shaped by PAT
Informal team evaluation/accountability
Informal and undocumented supports such as
diapers, food, and transportation
PAT playgroups
PAT social activities
Referral to community programs
Full-time family support specialist and trans-
lators
Diverse sources of funding for equipment
and materials
Respite fund
Relationship-based approaches
Routines-based intervention
Use of video-recording as intervention and
reflective practice
Informal and undocumented supports finding
employment and child care
“Respite” fund provides a variety of sup-
ports, e.g., transportation, orthopedic
shoes, space heaters

they’re not there, they’re in town somewhere and so
it’s like oh no, oh no.
Working under these conditions placed a premium on team-
work as practitioners frequency traveled in teams, in part to
make the delivery of services more efficient, and in part
because the home visitors needed translators. The demo-
graphic makeup of the community included 44% Latino
and 3% Asian families. The teams we observed consisted in
one case of a speech-language and physical therapist,
accompanied by a translator; and in the other of a nurse/
social worker and an early childhood special educator who
could also speak Spanish. The program created formal
teams of 8 to 10 professionals assigned by geography, that
is, one team served the northern half of the program catch-
ment area, and the other served the southern half. Each
regional team had a full complement of interdisciplinary
professionals, including speech-language, occupational,
and physical therapists; a psychologist and/or social worker;
a nurse; and early childhood special educators. The distance
and time practitioners spent together influenced decision
making about team organization, the time available for sup-
port and consultation among members of the staff, and
resources available to serve families.
Epley et al. 25
A second influencing factor for Program B is the loca-
tion of this EI program in a not-for-profit agency rather than
within a school district as in Program A. Program B had its
own board of directors and the ability to seek funding from
a variety of public and private sources in addition to the
state funding available through the Part C Lead Agency
(Department of Health). Furthermore, the administrative
separation from the school district meant that Program B
began as an EI program and only later added a contract to
support the area PAT program; this sequence is directly
opposite the evolution of Program A, which began life as a
PAT program and later added EI. Whereas both directors
were hired from within (Program B’s director was newly
promoted from a position as supervisor of the EI home visi-
tors), the backgrounds of the two directors mirrored the two
programs’ administrative location: The Program A director
had a background in general education administration, and
the Program B director had a background in early childhood
special education.
Administrative Structures
Administrative Vision/Leadership
Program A. The director’s strong PAT background and
her administrative experience were two particular factors
that influenced how she perceived her role and vision of
services for infants and toddlers and their families. Explain-
ing her role as director, she noted that Program A was the
only program within the special education department for
which she had a “coordinator-type” person. She described
the organizational structure and her role in Program A:
[Part C psychologist’s name] runs everything by me,
and we talk about it. But the day-to-day kind of stuff
and as far as working with the rest of the staff, she is
able to do that. So my role is . . . two major things:
making sure the resources are where they need to be
fiscally and the personnel part of it. But less so with
the day-to-day, making sure families are served.
The director’s PAT background was a pervasive influence on
how services were delivered to young children with disabili-
ties and their families. She described her philosophy, and that
of Program A, as grounded in the PAT belief that “parents are
the teachers, and service providers are the consultants.”
Program B. We began our research only 1 month after the
director took her position. The 4 years prior to this, she had
served as the EI coordinator. Program B’s director was more
“hands-on” in providing guidance on the delivery of ser-
vices on a daily basis. She said that as coordinator, she felt
practitioners were not using evidence-based practices and
had begun to offer professional trainings. She convinced the
board of directors to support in-house training each year as
well as travel expenses for practitioners to attend out-of-
town conferences. There was some resistance to the direc-
tor’s insistence on new practices (e.g., relationship-based
approaches), and some long-time staff members had chosen
to leave rather than change how they delivered services.
Others were slowly making changes. One practitioner
described the shift in her approach from a medical model to
a relationship-based approach.
Coming from a medical model when I first came here
4 years ago, I felt like my role involved direct ther-
apy; working directly with the child. But it’s
evolved . . . and now I feel like my role is as a parent
educator . . . we do a lot of direct teaching with the
parents and modeling and then giving them time to
interact with their child and to carry out the kinds of
things that you’re looking for.
In addition, the board of directors formalized a “Shared Val-
ues Statement” explicitly identifying the program’s vision,
its employees, and the families it served. This vision, devel-
oped and periodically updated in a retreat involving both
staff and leadership, included a commitment to quality ser-
vices and accountability; respect for and willingness to
accommodate the needs of families and staff; communica-
tion among staff, families, and community members; ongo-
ing teaming or collaboration; and quality staff and resources.
In contrast, Program A had no such formally articulated
document; thus, their shared values and operating princi-
ples were more implicit than explicit.
Organizational Climate
Program A. At Program A, the director’s focus on fiscal
and personnel matters resulted in a high degree of profes-
sional autonomy for the staff. Though she conducted some
annual evaluations, her involvement with day-to-day ser-
vice provision was limited. She stated, “I don’t go on the
home visits and participate in [the] weekly meetings all the
time, unless there’s a tough situation and they ask me to
come in.” In addition, many of the policies and guidelines
related to service delivery were implicit. Practitioners,
nonetheless, expressed feeling supported by both the direc-
tor and each other. A speech therapist commented,
It seems like I always have [someone who is] really
prompt at getting back to me. Like [director’s name]
called me last night at 5:30 to talk about a child . . .
it’s nice. I feel like I have a lot of support. . . . I can
always go to everybody else on the team and ask for
resources or . . . handouts . . . or information about
something, so that is nice.
26 Teacher Education and Special Education 30(1)
Program A’s limited size also influenced practitioners’
workloads and peer collaboration. The large majority of EI
service coordinators and other practitioners also had a role
in PAT, either as educators or consultants. Practitioners also
shared an office space consisting of a large room with desks
arranged in a square, so that the staff literally faced each
other routinely. Needless to say, that enabled frequent com-
munication and collaboration in addition to their weekly
meeting. Practitioners commented that their overlapping
roles and responsibilities and close physical proximity were
advantageous for effective collaboration:
Based on the belief that the parents are the “teachers”
and the service providers are the “consultants” we
also try to brainstorm how to most effectively and
efficiently provide services. . . . For example, instead
of offering just personal visits from the SLP [speech-
language pathologist], we also offer speech/language
services during playgroup sessions or through a lan-
guage-enriched PAT/Part C visit. We often brain-
storm together possible community supports for the
families or children.
Program B. Program B’s values statement specifically
addressed “ongoing teaming” or collaboration. The fact that
EI staff were typically out of the office for the majority of
the day required special efforts to make sure that team col-
laboration occurred. Program B designated Fridays as their
staff meeting day. On the day we observed these meetings,
the morning was spent as a whole group receiving informa-
tion about the director’s and other staff members’ recent
attendance at conferences. In the afternoon the two teams
(the northern and southern teams described earlier) met
separately. We observed that the director split her time
between the two teams but sat in the back of the room; she
only spoke when asked a direct question. One team debated
the advantages and disadvantages of scheduling joint home
visits versus separate visits for each team member involved
with a given child and family. They decided to continue the
practice of joint visits whenever possible because they
believed it was less intrusive for the families to have only
one visit on a biweekly basis. In our interviews, the staff
recognized and appreciated their ability to have a “say” in
the operation of the program. As one pointed out, “that
whole thing of making you feel like you are important, you
know coming from above or coming from within, that’s
really important . . . and you always feel like [the Director]
is there to listen too.”
Whereas the staff in both Program A and Program B
described the support received from coworkers, in Program
B the support derived from collaboration appeared to per-
meate the whole organization, as noted by one practitioner:
“Well . . . right down to our custodian who takes wonderful
care of our building, [everyone] takes great pride in [that]
and you know acknowledging that, I mean there’s just a real
team from top to bottom.” The practitioners also saw the
director as supportive because she had been a practitioner
herself prior to becoming director. One practitioner
expressed this very well:
I just think she brings that whole piece and having
been out there and  .  .  . then when we come to her
because I think she can either listen to us vent or help
us problem solve when she knows what we’re really
dealing with versus just sitting behind a desk and . . .
you know being the paper person that wears the nice
clothes and never gets out in the home.
Resources
Program A. The relatively small size of Program A, as well
as its location within a school district, placed some limita-
tions on the resources available for the program. The major-
ity of the staff were part-time in EI, with other parts of their
time assigned to PAT or to the Part B preschool services. The
director, practitioners, and families all mentioned benefits of
sharing these resources, including flexibility in funding, ease
of transition between Part C and Part B, access to additional
related service providers, and PAT-sponsored activities such
as playgroups and a lending library. Program A also had
access to a small emergency fund to purchase small items for
families such as diapers and formula. During the focus group,
one practitioner noted that although they did at times “go
above and beyond” to provide diapers, they did not want to
“advertise” the availability of this small fund for fear that it
would be overused.
Because of its location within a larger urban area, Pro-
gram A was able to provide referrals to a variety of other
programs for their families. These included the local Early
Head Start program, a teen mother program, area food pan-
tries and clothing exchanges, and other not-for-profit pro-
grams. However, in one instance, one of the parents we
interviewed expressed an interest in mental health counsel-
ing for his children, but he reported that Program A said it
could not provide those services.
Program B. Because Program B is a community-based
nonprofit organization, its financial resources come from
many sources, including the state Part C agency, federal and
state grants, county government, and donations from fund-
raising. Additionally, it pooled resources with the local PAT
to provide playgroup opportunities where parents could
network and practitioners could provide interventions.
The most important financial resources were devoted to
staff. In addition to the professional staff, the program pro-
vided support staff (e.g., translators) that practitioners
needed to meet families’ needs. Although there were a few
part-time practitioners (mostly therapists), the majority of
the staff worked full-time for the agency. Program B also
hired a full-time parent liaison, who was a parent of a child
Epley et al. 27
with a disability and a former participant in the program.
The program also provided equipment such as vehicles for
travel and cell phones. One practitioner explained that Pro-
gram B was good about providing training and then backing
it up by providing the equipment needed to implement the
training (e.g., handheld portable DVD recorders to enable
practitioners to implement the strategies from the relation-
ship-based training the program had recently sponsored).
Finally, an important resource enabling flexible support to
families was a “respite fund,” which was actually an all-
purpose fund available to address a variety of family needs.
We observed the use of this fund during several home visits;
for example, in one family, the home visitor provided the
parent with information and vouchers to cover her costs for
travel and lodging so that her child could get “fitted” for a
wheelchair at a tertiary care clinic located 300 miles away.
During another visit, the practitioner pointed to a space
heater the program had purchased for the family during the
previous winter using “respite” funds.
Practitioner Practices and Family Supports and
Services
Determination of the degree to which practitioners were
consistently engaging in evidence-based practices was
beyond the scope of this study due to our short engagement
in the programs. In this section, we focus primarily on the
practices and family supports we observed, the perceptions
of the practitioners about the degree to which they per-
ceived them as “evidence-based,” and the connection
between these perceptions and the administrative structures
of the two programs.
Program A
Practices. Practitioners in Program A had recently
received training on routines-based interviews and inter-
ventions. Several practitioners expressed what they per-
ceived to be congruence between their PAT philosophy (i.e.,
professionals as consultants and parents as teachers) and
routines-based intervention. One practitioner reported a
positive experience implementing a routines-based inter-
vention with the family of a 22-month- old girl with mild
speech and language delays. The practitioner discussed the
family’s success with a routines-based intervention: “I
made . . . the routine for them, and the next time I went, she
had it taped up on the back of the [bathroom] door . . . she
is very adamant on getting that child to talk, she wants that
child to be right on.” The idea that this practitioner “made”
a routine for a family is not congruent with EI conceptual-
izations such as those expressed by McWilliam (2005). It is,
however, congruent with the PAT approach. Thus, these
comments illustrate the degree to which the administrative
vision of PAT influences the practices of the staff.
Family supports. Regarding the provision of additional sup-
ports to families, the informal and unwritten policies of Pro-
gram A, as well as its more limited resources, led to a more
“under the table” approach to providing supports to families
and utilizing the resources of the program. In the focus group,
practitioners discussed how they supported families:
Practitioner 1: We’ve driven families to [the electric
company] to pay their bills. . . . I don’t know that
that ever would be documented because there are
some things we just do that we don’t want to be on
an IFSP [individualized family service plan].
Practitioner 2: We do it because you can’t not do it.
But maybe it’s something the higher-ups wouldn’t
approve.
Researcher: Why not?
Practitioner 2: Liability issues. It would probably not
be approved, but it’s one of those things that you
ask for forgiveness instead of permission,
because . . . because the administration wouldn’t
want to be liable for those things but it is one of
those things you would do off the record.
Administrative resources associated with the combined
Part C/PAT program and affiliation with the local school
district also directly affected the supports and services fam-
ilies received. All four of the families we interviewed iden-
tified family supports and services primarily associated
with PAT. One mother remarked,
The playgroups . . . they have had the most wonderful
playgroups  .  .  . all the information they give you
about food, potty training, every little thing they did
I was just ecstatic. . . . Being a stay-at-home mom, it
is hard to find something for them to do.
Program B
Practices. An example of the impact of administrative
structures on practices can be seen in the staff’s reaction to
training they had received on relationship-based
approaches. We observed a home visit in which the practi-
tioners viewed a video with the mother, pointing out how
her interactions influenced the child. The mother sat on
the floor and watched the video with her children and the
practitioners on a portable DVD player. They discussed
specific parts of the intervention and then reviewed them.
After the home visit, the practitioner said, “That was the
first time she ever got on the floor with us” and went on to
say that this mother had previously been disengaged in the
home visits. The practitioners were pleased that their new
process was enabling them to be more family-directed and
less child-directed. As noted earlier, one of the two teams
in Program B was actively using video tapes to explore
parent-child interactions, whereas the other was not. The
28 Teacher Education and Special Education 30(1)
team resisting the relationship-based approach was also
resisting other practices. During one home visit, the thera-
pist told the researcher that she did not “totally” subscribe
to the “no toy bag idea,” because many of her families did
not have many resources. She said she had, however, mod-
ified her practice by applying another training they had
received on making “Toys from Trash,” by bringing items
made from common household materials (e.g., a drum
made from an oatmeal box), and leaving them in the home.
On this day she had some plastic bubble wrap, which she
unrolled and showed the mother how to entice the child
(who had gross motor difficulties) to walk on it. The child
was delighted at the feel of the bubbles and the popping
sounds, and the mother was amused; the practitioner left a
second roll of bubble wrap behind for them to use. In
brief, it appears that even though the practitioners were
not completely embracing some of the practices their
director was advocating, they were modifying their prac-
tices to make sure families were more engaged and able to
follow up with activities they demonstrated.
Family supports and services. The agency’s formal values
statement expressed the belief that families are the key to
successful outcomes for children. This belief meant that the
program was structured to provide more than EI services.
The parent liaison described her job his way:
I call it case management sometimes, but maybe more
the family service coordination for those other pieces.
I do a lot of Medicaid paperwork and following up on
that. Helping families apply for Social Security
Income for their children, if that’s appropriate.
In addition to this, she also managed the respite care fund,
which, as described earlier, was an important resource due
to its flexibility to provide for a wide range of family needs.
The value placed on families enabled practitioners to
provide flexible supports and services. For example, two EI
professionals provided numerous supports to a young sin-
gle mother with two children in EI. The mother provided
this description:
Right now they’re trying to help me get the kids in a
day care, and I find that works, so that kind of helps.
They were trying to help me look for a job when I
was unemployed and they mentioned about U-Pump-it
so I went there and they helped me fill out the appli-
cation and stuff like that and I got that job.
Another important commitment to supporting families is
related to the fact that more than half of their families are
Latino, and many of these families do not speak English.
The same is true for many of the Southeast Asian families
(primarily Vietnamese) they serve. In addition to these lan-
guage groups, practitioners talked of serving Mennonite
families who spoke “Low German” as well as Chinese fam-
ilies. To serve these families, Program B employed two
full-time bilingual (English and Spanish) paraprofessionals
and contracted on an as-needed basis for other languages.
One of the bilingual paraprofessionals had worked at Pro-
gram B for almost a year. She felt very strongly that her
work was important. She felt that she was able to help the
interventionists do their jobs effectively, but more impor-
tantly she was able to help Spanish-speaking families ben-
efit from the services.
Discussion
Current conceptualizations of family-centered practice
acknowledge the particular circumstances and institutional
contexts in which EI practices occur (Sanderson, 2003).
This study adds another layer to the discourse on family-
centered practice: whether and how various influencing
factors and administrative structures affect how practitio-
ners implement family-centered practice, both in terms of
the practices they use and the supports and services they are
able to offer to families. To effectively meet the needs of
young children with disabilities and their families, we must
understand the context in which family-centered practice
occurs and the multiple factors affecting it. The conceptual
framework presented in Figure 1 provides one way of
examining how administrative structures shape family-cen-
tered practice.
Limitations
First, because our purpose was to explore the influence of
administrative structures on practices and family supports
at the local level, we deliberately restricted the sites in this
case study to programs within the same state to limit pos-
sible variation that might be introduced by very different
state policies. This decision, however, limits the variability
of program structures that we might have observed and
removes the opportunity to investigate how different state
policies might influence administrative structures. Because
the function of qualitative research is not to produce gener-
alizable data (Creswell, 2003; Maxwell, 2005), but rather to
develop a framework or a set of observed principles that
may be transferable to other sites and situations (Creswell,
2003; Merriam, 1998), this study should be replicated in
other states with different administrative and policy struc-
tures. We believe, however, that this study has value in that
it sheds light on the processes influencing how administra-
tive structures are implemented and the ways in which these
structures interact to shape both early childhood practice
and family supports.
A second limitation is that the predominance of mothers
compared to fathers and the limited representation of prac-
titioners from culturally diverse backgrounds. The fact that
Epley et al. 29
recruitment of families by practitioners may have skewed
the types of children and families selected for participation
should be taken into account as well. Finally, we cannot
claim that we had prolonged engagement in the sense that
many case studies involve repeated engagement with a site
over a period of months. This study includes approximately
20 hours at Program A and 37 hours (2 days with two
research team members, plus five follow-up interviews) at
Program B. Consequently, we have only a “snapshot” of
how each program provided family supports and services.
Implications
The case studies of two EI agencies illustrate how the over-
all structure of an agency and its administration are shaped
by the influencing factors inherent in the community and
the agency’s history. In turn, these influencing factors shape
the development of three important and interrelated compo-
nents of administrative structures: vision/leadership, orga-
nizational climate, and resources (Summers et al., 2005).
These administrative structures affect providers’ practices
and the supports and services families receive. We believe
these findings offer many insights for program administra-
tors and policy makers, to help maximize the ability of
practitioners to provide high-quality practices and family
supports. In this section, we discuss these implications for
each of the major components of our model: (a) influencing
factors, (b) vision/leadership, (c) organizational climate,
and (d) resources.
Influencing Factors
Influencing factors describe the basic culture of the com-
munity the program serves. The two cases highlighted in
this study are very different in size and location. The pro-
grams also differed in their administrative “home,” with
one directed by a school district and the other a not-for-
profit agency. These differing administrative and geograph-
ical locations require administrators to develop strategies to
maximize the benefits and compensate for the drawbacks.
For example, Program A’s location within a school district
had advantages in giving it access to district resources but
also had drawbacks in its lack of resources. Increased flex-
ibility as well as increased resources could result if Program
A could procure additional grants to enable a wider range of
supports.
Vision/Leadership
This study is consistent with literature emphasizing the
importance of leadership for program administrators
(Bruder, 2000; Johnson et al., 1992). Mitchell and Ross-
moore (2001) identified the ability to create a vision, trans-
form that vision into reality, and align all aspects of the
organization with the needs and expectations of those it
serves as qualities of good leaders. The administrative
vision may be explicitly articulated, as in Program B, or it
may be more implicit, as in Program A, but it drives the
program. The central role of PAT in Program A is an exam-
ple of how the leadership’s vision permeates all aspects of
the program design, perceptions of “evidence-based prac-
tice” by the practitioners, and delivery of services and sup-
ports to families. The PAT orientation of Program A has
implications for programs providing services in inclusive
settings. On the one hand, Program A is a good example of
embedding services for infants and toddlers with disabili-
ties within a general program serving all children (PAT); on
the other, the PAT philosophy perhaps impeded successful
implementation of some evidence-based practices such as
routines-based intervention. It suggests that, if a director’s
background is not in early childhood special education,
and/or if the program is to be implemented in a fully inclu-
sive setting, some consultation and support is needed to
make sure that evidence-based EI practices are imple-
mented with fidelity in the program.
In contrast, the EI background of the director in Program
B was leading to a gradual reformation of the staff to
embrace more current practices. Yet in this program we also
observed that evidence-based practices were not being con-
sistently implemented throughout the program, with one
team embracing change more than another. Program B’s
director was aware of this and was continuing to push for
changes in practices. The dilemma she faced is illustrative
of one of the issues of accountability: how to ensure quality
services in a program where the services are delivered away
from the center and thus away from the eyes of a supervisor.
Hopefully by filling the empty supervisor position (which
the director had recently vacated due to her promotion), this
issue could be addressed. The point is that having a vision
is a critical component, but it is not enough if the account-
ability mechanisms to implement it are not in place.
Organizational Climate
The second point this study highlights is the importance of
an organizational climate that fosters peer collaboration for
effective implementation of family-centered practice. This
is consistent with Decker, Bailey, and Westergaard (2002),
who found that the optimal relationship between supervi-
sors and workers is one that promotes self-growth and a
sense of significance as team members. In this study, prac-
titioners in both programs expressed a sense of autonomy
balanced by support from their supervisors and from each
other. In Program A, this was easier to do because of the
smaller size of the program, enabling staff to confer daily
across their desks. In Program B, collaboration had to be
deliberately arranged by designating a weekly staff meeting
day for team meetings, in-service training, and other group
30 Teacher Education and Special Education 30(1)
support. In both programs, the leadership appeared to be
successful in fostering a sense of autonomy and developing
a supportive coworker atmosphere. However, a dilemma is
how to foster autonomy while maintaining accountability.
An example is the uneven implementation of practices pre-
sented in training in Program B. As the director commented,
some of the more resistant staff members had left the pro-
gram, but others were still in the program, particularly in
one of the two teams. Especially in rural, sparsely popu-
lated communities where highly trained EI specialists are
not available to replace those who resist change, it is not
only infeasible to summarily discharge practitioners who
are resisting change but also could have a very negative
effect on organizational climate. One possible strategy
might be to rotate membership in the two teams from time
to time, which could improve the possibility that both teams
would be able to implement the training they had received.
Resources
Resource allocation is particularly relevant given the diffi-
culty EI programs face in managing multiple funding
sources and the resulting fragmentation of services that can
occur (Brown, Perry, & Kurland, 1994). The contrasts
between the two programs in this study reflect the impor-
tance of adequate resources. Program A had fewer resources,
which resulted in a discrepancy between the two programs
in the amounts and types of resources families received.
The fact that Program B had a full-time family support spe-
cialist, resources to hire translators, and a generous and
flexible “respite fund” enabled the program to do consider-
ably more for its families than Program A. The administra-
tive location of Program A within a school district may also
restrict the program’s flexibility in developing these
resources—for example, hiring a parent as a family support
specialist might require some bureaucratic athleticism that
Program B would not need to exercise. An implication of
the imbalance in resources between smaller and larger pro-
grams is that state Part C directors should consider these
potential imbalances and provide support (either technical
assistance in obtaining grants from other sources or direct
resource allocation) to address the imbalances.
Another issue raised in both programs was the lack of
visibility of the family supports provided. In Program A,
practitioners did not publicize the availability of their small
“emergency” fund for families for fear of depleting it. They
also described providing supports to families (e.g., trans-
portation) “under the table,” when they did not believe the
school district’s liability policies would allow them to do
so. In both programs, the practitioners often provided sup-
ports to families that never appeared on an IFSP. The help
given to find a job and child care to one of the parents we
interviewed in Program B is one example. Other examples
are the supports and referrals (e.g., to another agency) pro-
vided on the spot during home visits. In Program A, practi-
tioners avoided documenting these supports for fear of
being prohibited from doing it. In Program B, the lack of
documentation was due to a more simple—and yet more
difficult to resolve—aversion to excessive paperwork. As
one practitioner pointed out, “It seems kind of dumb to
come back to the office and write up an objective that is
already done.” The lack of data about the extent of family
supports provided is an issue for both accountability and for
the ability of advocates to document the true value of EI
services. One strategy may be to improve data record keep-
ing through technology, for example, equipping home visi-
tors with laptops and entering information about family
supports and other occurrences in home visits directly
online to a centralized database.
Conclusion
The two cases presented here illustrate the critical role of
administrative structures in facilitating practices and family
supports and services. The framework shown in Figure 1
illustrates how the influencing factors might create very dif-
ferent administrative structures in terms of vision/leadership,
organizational climate, and resources. The two programs pre-
sented very different characteristics and approaches that
played out as both barriers and facilitators to enable staff to
provide services to children and families. Implications for
administrators are that effective operation of a program
depends on a clear vision, an organizational climate that fos-
ters collaborative teams and balances autonomy with
accountability, and adequate and flexible resources.
Declaration of Conflicting Interests
The authors declared no conflicts of interest with respect to the
authorship and/or publication of this article.
Funding
The authors disclosed receipt of the following financial support
for the research and/or authorship of this article: This research
was supported by a grant from the U.S. Department of Education,
National Institute of Disability and Rehabilitation Research,
Grant No. H133B031133.
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About the Authors
Pamela Epley, PhD, is an assistant professor in early childhood
special education at Erikson Institute in Chicago. Her research
interests include child and family outcomes of early intervention
and early childhood special education and family-professional
partnerships.
George S. Gotto IV, PhD, is a research associate at the University
of Missouri–Kansas City–Institute for Human Development,
where he coordinates the activities of the National Gateway to
Self-Determination project. His research interests include self-
determination, preventative health care for men and women with
developmental disabilities, and medical transition for children and
youth with special health care needs and their families.
Jean Ann Summers, PhD, is a research professor at the
University of Kansas Schiefelbusch Life Span Institute and
research director, Beach Center on Disability. Her interests are in
family supports, early childhood and early intervention for chil-
dren with disabilities or disadvantaged backgrounds, and self-
determination for young children.
Mary Jane Brotherson, PhD, is a professor in the Department
of Human Development and Family Studies at Iowa State
University. Her current research include early intervention, fam-
ily support, and self-determination for young children with
disabilities.
Ann P. Turnbull, EdD, is a distinguished professor of special
education at the University of Kansas and codirector of the Beach
Center on Disability. Her primary interests include family-profes-
sional partnerships, family quality of life, and systems of
supports.
Anna Friend, PhD, is an assistant professor of Special Education
at Pittsburg State University, Pittsburg, Kansas. Her current inter-
ests include early career mentoring, teacher quality, and family
professional partnerships.363400TECSE