Understanding Comprehensive Service Referrals Among Families in Early Head Start

• In Event: Comprehensive Family Services in Early Care and Education Programs Serving Infants and Toddlers

Abstract

A two-generation program, Early Head Start (EHS) provides comprehensive services to support children and their parents. These services include referring parents to supports to meet their self-sufficiency goals and their children’s developmental needs. Little research has documented families’ referral to these services, and how they may vary by family and child characteristics. The goal of this study was: (1) to examine families’ referral to comprehensive services within EHS and (2) to investigate associations between family and child characteristics and service referrals.
We draw upon the EHS Family and Child Experiences study (Baby FACES), a dataset on EHS programs, children, and families (N = 702). When children were 1 and 2 years old, parents reported on whether they had been referred to services in the areas of education/job training, child disability, mental health services, child care, employment, financial help, and health care. Families reported on characteristics at age 1: TANF receipt, not employed, less than a high school education, teen mother, single mother, maternal depression, poor physical health, smoking/drug use, financial risks, maternal race/ethnicity, urban, and non-English home language. Child characteristics were also reported by parents at age 1: developmental delay, low birthweight or premature, child health poor/fair, and a behavior delay.
Shown in Table 1, the most common service referral was to health care services (49%). Over one-third of parents were referred to child disability services (41%), education/job training (37%), and financial help (35%). Fewer parents reported receiving referrals to mental health services (19%) and child care (21%). Patterns of service referral varied between families enrolled in EHS center-based and home visiting services.
Logistic regression models were used to predict each type of service referral from family and child characteristics at age 1 (Table 2). Some findings suggested targeting of referrals according to specific risk factors. Notably, mothers with depression were more likely to be referred to mental health and health services (2.09 and 2.41 ORs); families with financial risk were more likely to be referred for financial support (2.25 OR); families receiving TANF were more likely to be referred to education/job training (2.56 OR); mothers with a history of smoking/drug use were more likely to be referred to child care (2.39 OR); and children with a developmental delay were more likely to be referred to disability services (1.65 OR). Other findings did not reflect alignment of risk factors and referrals. Specifically, teen mothers were less often referred to mental health services (0.52 OR); families with financial risk had more frequent referrals for child disability services (1.89 OR); and mothers with a history of smoking/drug use were less likely to be referred for health services (0.47 OR). Further analyses will examine patterns within center-based and home visiting and examine associations between service referrals and child and parent outcomes.
Findings suggest that there is an opportunity to increase understanding of comprehensive service referrals and their implications for child and family wellbeing. Results have direct implications for programs and for policy efforts to enhance the impact of EHS on children and families.

Authors

• Caitlin S Lombardi, University of Connecticut
  Presenting Author

• Rachel Chazan Cohen, University of Connecticut

• Martha Zaslow, Society for Research in Child Development (SRCD)