FAMILY CHARACTERISTICS, STATE PROGRAM EFFECTIVENESS, AND REPORT OF INADEQUATE CARE AMONG FAMILIES OF YOUNG CHILDREN WITH HEARING LOSS

Approximately 1.6 per 1,000 newborns in the U.S. are born with hearing loss. Congenital hearing loss poses a risk to their speech, language, cognitive, and social-emotional development. Early detection and intervention can improve outcomes. Every state has an Early Hearing Detection and Intervention program (EHDI) to promote and track screening, audiological assessments and linkage to early intervention. However, a large percentage of children are “lost to system (LTS),” meaning that they did not receive recommended care or that it was not reported. This study used data from the 2009-2010 National Survey of Children with Special Health Care Needs and data from the 2011 EHDI Hearing Screening and Follow-Up Survey to examine how 1) family characteristics; 2) EHDI program effectiveness, as determined by LTS percentages; and 3) the family conditions of education and poverty are related to parental report of inadequate care. The sample comprised 684 children between the ages of 0 and 5 years with hearing loss. The results indicated that living in states with less effective EHDI programs was associated with an increased likelihood of not receiving early intervention services (EIS) and of reporting poor family-centered communication. Sibling classification was associated with both receipt of EIS and report of unmet need. Single mothers were less likely to report increased difficulties accessing care. Poor and less educated families, assessed separately, who lived in states with less effective EHDI programs, were more likely to report non-receipt of EIS and less likely to report unmet need as compared to similar families living in states with more effective programs. Poor families living in states with less effective programs were more likely to report less coordinated care than were poor families living in states with more effective programs. This study supports the conclusion that both family characteristics and the effectiveness of state programs affect quality of care outcomes. It appears that less effective state programs affect disadvantaged families’ service receipt report more than that of advantaged families. These findings are important because they may provide insights into the development of targeted efforts to improve the system of care for children with hearing loss.

REFUGEES AND RESETTLEMENT: A QUALITATIVE ANALYSIS OF REFUGEE INTEGRATION THROUGH SOCIAL & SUPPORT SERVICES

This dissertation studies refugee resettlement in the United States utilizing the Integration Indicator’s framework developed by Ager and Strang for the U.S. context. The study highlights the U.S. refugee admissions program and the policies in the states of Maryland and Massachusetts while analyzing the service delivery models and its effects on refugee integration in these locations. Though immigration policy and funding for refugee services are primarily the domain of the federal government, funds are allocated through and services are delivered at the state level. The Office of Refugee Resettlement (ORR), which operates under the Department of Health and Human Services, was established after the Refugee Act of 1980 to deliver assistance to displaced persons. The ORR provides funds to individual states primarily through The Refugee Social Service and Targeted Assistance Formula Grant programs. Since the inauguration of the ORR three primary models of refugee integration through service delivery have emerged. Two of the models include the publicly/privately administered programs, where resources are allocated to the state in conjunction with private voluntary agencies; and the Wilson/Fish Alternative programs, where states sub-contract all elements of the resettlement program to voluntary agencies and private organizations —in which they can cease all state level participation and voluntary agencies or private organizations contract directly from the ORR in order for all states to deliver refugee services where the live. The specific goals of this program are early employment and economic self-sufficiency. This project utilizes US Census, state, and ORR data in conjunction with interviews of refugee resettlement practitioners involved in the service delivery and refugees. The findings show that delivery models emphasizing job training, English instruction courses, institutional collaboration, and monetary assistance, increases refugee acclimation and adaptation, providing insight into their potential for integration into the United States.

Cultivating Collaborative Relationships: A Case Study of Teacher Collaboration and Professional Development

Students often receive instruction from specialists, professionals other than their general educators, such as special educators, reading specialists, and ESOL (English Speakers of Other Languages) teachers. The purpose of this study was to examine how general educators and specialists develop collaborative relationships over time within the context of receiving professional development. While collaboration is considered essential to increasing student achievement, improving teachers’ practice, and creating comprehensive school reform, collaborative partnerships take time to develop and require multiple sources of support. Additionally, both practitioners and researchers often conflate collaboration with structural reforms such as co-teaching. This study used a retrospective single case study with a grounded theory approach to analysis. Data were collected through semi-structured interviews with thirteen teachers and an administrator after three workshops were conducted throughout the school year. The theory, Cultivating Interprofessional Collaboration, describes how interprofessional relationships grow as teachers engage in a cycle of learning, constructing partnership, and reflecting. As relationships deepen some partners experience a seamless dimension to their work. A variety of intrapersonal, interpersonal, and external factors work in concert to promote this growth, which is strengthened through professional development. In this theory, professional development provides a common ground for strengthening relationships, knowledge about the collaborative process, and a reflective space to create new collaborative practices. Effective collaborative practice can lead to aligned instruction and teachers’ own professional growth. This study has implications for school interventions, professional development, and future research on collaboration in schools.

Counseling Self-Efficacy and the Relational Efficacy Model

Relation-inferred self-efficacy (RISE), a relatively new concept, is defined as a target individual’s beliefs about how an observer, often a relationship partner, perceives the target’s ability to perform certain actions successfully. Along with self-efficacy (i.e., one’s beliefs about his or her own ability) and other-efficacy (i.e., one’s beliefs about his or her partner’s ability), RISE makes up a three part system of interrelated efficacy beliefs known as the relational efficacy model (Lent & Lopez, 2002). Previous research has shown this model to be helpful in understanding how relational dyads, including coach-athlete, advisor-advisee, and romantic partners, contribute to the development of self-efficacy beliefs. The clinical supervision dyad (i.e., supervisor-supervisee), is another context in which relational efficacy beliefs may play an important role. This study investigated the relationship between counseling self-efficacy, RISE, and other-efficacy within the context of clinical supervision. Specifically, it examined whether supervisee perceptions about how their supervisor sees their counseling ability (RISE) related to how supervisees see their own counseling ability (counseling self-efficacy), and what moderates this relationship. The study also sought to discover the degree to which RISE mediated the relationship between supervisor working alliance and counseling self-efficacy. Data were collected from 240 graduate students who were currently enrolled in counseling related fields, working with at least one client, and receiving regular supervision. Results demonstrated that years of experience and RISE predicted counseling self-efficacy and that the relationship between RISE and counseling self-efficacy was, as expected, moderated by other-efficacy. Contrary to expectations, however, counseling experience and level of client difficulty did not moderate the relationship between RISE and counseling self-efficacy. These findings suggest that the relationship between RISE and counseling self-efficacy was stronger when supervisees saw their supervisors as capable therapists. Furthermore, RISE was found to fully mediate the relationship between supervisor working alliance and counseling self-efficacy. Future research directions and implications for training and supervision are discussed.