Phoenix Michelle, Rosenbaum Peter
a CanChild, Centre for Childhood Disability Research , McMaster University , Hamilton , Canada.
b School of Rehabilitation Science , McMaster University , Hamilton , Canada.
Disabil Rehabil. 2019 Jan;41(2):244-249. doi: 10.1080/09638288.2017.1385650. Epub 2017 Sep 29.
Several concepts - risk, resilience, disability and hard-to-reach families in early intervention services - are talked and written about in many ways. Family Stress Theory can be usefully applied to explore these issues systematically.
The relationship between risk and disability is complex, and the role of resilience is not fully understood. The idea of "hard-to-reach families" is not well defined, thus presenting challenges to service providers and policy makers. Reflection: This paper presents the Model of Risk, Disability and Hard-to-Reach Families and uses the model to: (1) define the groups of high risk families and families of children with disabilities and explore the concept of resilience within these groups; (2) describe services offered to these groups; and (3) reflect on service use and so-called "hard-to-reach families". Each section includes suggested applications for service providers that may inform the work done with young children and their families who experience risk or disability.
Service providers can apply the Model of Risk, Disability and Hard-to-Reach Families to consider each family's unique strengths and challenges, and use those individual elements to influence service recommendations and anticipate service use. Implications for rehabilitation The concepts of risk, resilience, and hard-to-reach families are poorly defined in the literatures, but have important implications with respect to early childhood intervention services. Family Stress Theory can help to identify high-risk families and account for family resilience It is important for clinicians, researchers and policy makers to consider the relationship between disability and risk with respect to services offered to families and the potential barriers to service use. Clinicians and policy makers have a role in promoting accessible early childhood services.
在早期干预服务中，风险、恢复力、残疾以及难以接触到的家庭等几个概念，在诸多讨论和著述中有着多种表述方式。家庭压力理论可有效地用于系统地探讨这些问题。
风险与残疾之间的关系复杂，恢复力的作用尚未得到充分理解。“难以接触到的家庭”这一概念定义不明确，给服务提供者和政策制定者带来了挑战。思考：本文提出了风险、残疾与难以接触到的家庭模型，并运用该模型来：（1）界定高风险家庭群体和残疾儿童家庭群体，并探讨这些群体中的恢复力概念；（2）描述为这些群体提供的服务；（3）反思服务利用情况以及所谓的“难以接触到的家庭”。每个部分都为服务提供者提供了建议应用，这些建议可能会为与面临风险或残疾的幼儿及其家庭开展的工作提供参考。
服务提供者可以应用风险、残疾与难以接触到的家庭模型，来考量每个家庭独特的优势和挑战，并利用这些个体因素来影响服务建议并预测服务利用情况。对康复的启示风险、恢复力和难以接触到的家庭这些概念在文献中定义不明确，但对幼儿早期干预服务具有重要意义。家庭压力理论有助于识别高风险家庭并解释家庭恢复力。对于临床医生、研究人员和政策制定者而言，在为家庭提供的服务以及服务利用的潜在障碍方面，考虑残疾与风险之间的关系非常重要。临床医生和政策制定者在推广可及的幼儿服务方面发挥着作用。
