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Experiences of parents of children with special needs at school entry: a mixed method approach

A. Siddiqua*† and M. Janus*†

*Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada, and †Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada

Accepted for publication 4 December 2016

Keywords children with special needs, family-centred services, linkages, quality of services, transition to school

Correspondence: Ayesha Siddiqua, Department of Clinical Epidemiology and Biostatistics, McMaster Uni- versity, 1280 Main Street West, Hamilton ON L8S 4L8, Canada. E-mail: ayesha.summer@gmail. com

Abstract Background The transition from pre-school to kindergarten can be complex for children who need

special assistance due to mental or physical disabilities (children with ‘special needs’). We used a

convergent mixed method approach to explore parents’ experiences with service provision as their

children transitioned to school.

Methods Parents (including one grandparent) of 37 children aged 4 to 6 years completed measures

assessing their perceptions of and satisfaction with services. Semi-structured interviews were also

conducted with 10 parents to understand their experience with services.

Results Post transition, parents reported lower perceptions of services and decreased satisfaction

than pre-transition. The following themes emerged from the qualitative data: qualities of services

and service providers, communication and information transfer, parent advocacy, uncertainty about

services, and contrasts and contradictions in satisfaction. The qualitative findings indicate that

parents were both satisfied and concerned with aspects of the post-transition service provision.

Conclusions While the quantitative results suggested that parents’ experience with services

became less positive after their children entered school, the qualitative findings illustrated the

variability in parents’ experiences and components of service provision that require improvements

to facilitate a successful school entry.

Introduction

Facilitating successful transition to school is crucial for

establishing the foundation of children’s future development

(Bowes et al. 2009). Positive transition is associated with

favourable academic and social outcomes (Berlin et al. 2011).

Children who experience social and behavioural problems

early in their school careers are more likely to continue facing

these problems as they progress through their schooling

(Margetts 2002). Negative academic and social trajectories are

more difficult to alter by mid-elementary school years,

highlighting the importance of supporting successful transition

to kindergarten (Wildenger & McIntyre 2012).

Transition to kindergarten can be particularly challenging

for children who need assistance with developmental or

physical disabilities (children with ‘special needs’; Janus &

Siddiqua 2015). Every year, approximately 3.7% of all children

entering kindergarten in Canada have special needs that

prevent optimal development (Statistics Canada 2008). While

children’s special needs may be identified prior to school entry,

an Identification, Placement, and Review Committee (IPRC)

within the school board decides whether a student should be

identified as an exceptional pupil requiring special education

(Ministry of Education 2001). By law, the IPRC reviews all

relevant information available for the child, including an

education assessment as well as health and psychological

assessments and decides whether the student should be placed

in a special education class or in a regular class with

appropriate special education services (Ministry of Education

2001). During transition, these children and their families may

Original Article doi:10.1111/cch.12443

bs_bs_banner Child: care, health and development

experience changes in the services they receive, as well as

changes in providers, locations and frequency of these services

(Daley et al. 2011). The services are often inadequate to

support transition to school among children with special needs

(Janus et al. 2007). In a US study, parents identified child-

centred transitions to be effective and communication between

school and home as a vital link for successful transitions

(Stoner et al. 2007). Currently, there is a lack of research

evidence on factors contributing to a successful process of

transition to school for Canadian children with special needs.

The objectives of this study are (i) to quantitatively examine

parents’ perceptions of and satisfaction with their child’s

services before and after their children with special needs are

enrolled in school and (ii) to examine how qualitative data

help us gain a more nuanced understanding of parents’

perceptions of and satisfaction with services during transition.

Methods

Study design

A convergent approach was selected because it is the most

appropriate design given the parallel objectives of this study,

exploring parents’ experience with services using both

quantitative and qualitative data (Creswell & Plano-Clark

2011) to develop a more complete understanding of parents’

experiences.

Procedure

Data were collected in a prospective longitudinal cohort study

which focused on the process of transition to school for

children with special needs in Ontario (Janus et al. 2008) from

prior to school entry until the end of the first school year.

Before school entry, parents participated in a semi-structured

interview and completed a set of questionnaires. In the fall,

questionnaire and interview data were collected on the child’s

health, functional status, service history (at intake) and the

experience of transition to school.

Study sample

The sample included 37 children with identified special needs

(ages 4 to 6 years) and their families. These were children whose

‘behavioural, communicational, intellectual, physical or multi-

ple exceptionalities are such that (they are) considered to need

placement in a special education program’ (Ontario Ministry of

Education 2006). Parents who were unable to read and speak

English and those with a cognitive impairment were excluded

from the primary study. As per ethics requirements, families

were requested to contact us in response to information and

flyers; thus, it is impossible to provide an accurate recruitment

rate. Families were approached through several channels:

preschools/daycare centres, early identification agencies, early

year rehabilitation programmes, community centres and the

school boards from three cities in Southern Ontario.

Participants were selected for the qualitative phase by using

extreme case sampling. Among all interviewed participants, 10

participants who had the largest decline in satisfaction, as

measured by the scores on the Client Satisfaction Question-

naire (Larsen et al. 1979), obtained prior to school entry and

were selected at the end of the first school year.

Measurement strategy

Prior to school entry and at the end of the first school year,

parents completed the Measure of Processes of Care (MPOC)

assessing their perceptions of services and the Client

Satisfaction Questionnaire (CSQ) evaluating their satisfaction

with services. For the period prior to school, these measures

assessed experience with services received outside of school,

whereas at the end of the first school year, they measured

perceptions of school-based services.

Measure of processes of care

Responses on the MPOC were used to measure parents’

perceptions of whether the services their children receive were

family-centred (King et al. 1995; King et al. 1997). MPOC is a

self-report measure with questions in five scales: enabling and

partnership, providing general information, providing specific

information about the child, coordinated and comprehensive

care for the child and family, and respectful and supportive

care. We used the shorter, 20-item version of the MPOC,

which is a well-established instrument with good psychometric

properties (King et al. 2004).

Client Satisfaction Questionnaire

The CSQ was used to measure parents’ satisfaction with their

experiences with a target situation or service (Larsen et al.

1979). This is a generic eight-item questionnaire that correlates

strongly (up to 0.60) with MPOC scale scores (King et al. 1997)

but is not redundant. The pilot study conducted for the

primary study showed that this measure had high internal

consistency (Cronbach’s coefficient alpha: 0.97) and good test–

retest reliability (intraclass correlation coefficient: 0.88).

Experiences of parents of children with special needs at school entry 567

Semi-structured interviews

For the qualitative phase, a qualitative description study

(Neergaard et al. 2009) was conducted to explore parents’

perceptions of and satisfaction with service provision as their

children with special needs entered school. During the semi-

structured interviews, the parents were asked about the child’s

diagnosis, health and functional status and about service

history at intake and the experience of transition to school.

This paralleled the data collected in the quantitative phase,

where the parents indicated their perceptions of and

satisfaction with services.

Analyses

Quantitative data analysis was conducted by using statistical

software SPSS v20. Paired t-tests were conducted to compare

the parents’ MPOC and CSQ responses in the two time

points.

Qualitative analysis of the interview data was conducted by

using NVIVO 10 software. Principles of conventional content

analysis (Hsieh & Shannon 2005) guided the coding and

analysis. The analytic steps included deriving initial codes from

exact words in the data that appeared to represent key concepts

of interest, development of new codes to categorize text that

did not fit into initial codes and sorting related codes into

categories that reflected parents’ perceptions of and satisfaction

with services (Hsieh & Shannon 2005). The preliminary coding

scheme was revised as the analysis progressed to incorporate

new insights arising from the data.

For the mixed method data analysis, data from all MPOC

scales were selected as they evaluate the parents’ perceptions of

services. Then, the interview transcripts were read multiple

times to identify illustrative comments highlighting the

parents’ experience with services in relation to the MPOC

components of service provision.

A merged analysis display approach was taken to compare

the quantitative results and qualitative findings (O’Cathain

et al. 2010). A 5 × 5 merged data analysis table was created,

where the qualitative themes were arrayed with the five MPOC

scales. The display presents qualitative quotes representing

major themes across MPOC scales to assess how the qualitative

data provided a more complete understanding of parents’

perceptions of and satisfaction with services.

Ethics

Ethics approval for this study was obtained from the Hamilton

Integrated Research Ethics Board.

Results

Quantitative phase study participants

In total, 37 children and their families met the eligibility

criteria for this study. Overall, 33 (89%) children had a

diagnosis at intake and 12 (32.4%) received updates to their

diagnosis post transition (Table 1). The two most common

diagnoses were autism spectrum disorder (27%) and develop-

mental delay (19%; Table 2). Children with no diagnosis (8%)

were also included because they were suspected to have a

diagnosis, although it not confirmed at the time of the study.

Parents’ perceptions of and satisfaction with services before and after school entry

The parents’ perceptions of family-centredness of services

differed before and after their children entered school

Table 1. Demographic profiles of study participants in the quantitative and qualitative phases of the study

Quantitative phase (n = 37)

Qualitative phase (n = 10)

Characteristics No. of participants (%)

No. of participants (%)

Diagnosis at intake 33 (89%) 10 (100.0) Updates to diagnosis 12 (32.4) 3 (30.0) Child’s gender

Female 11 (29.7) 1 (10.0) Male 26 (70.3) 9 (90.0)

Parent ethnicity Aboriginal 2 (5.4) 1 (10.0) Black 2 (5.4) South Asian 1 (2.7) White/Caucasian 31 (83.8) 9 (90.0) Other 1 (2.7)

Parent educational level Some secondary/high school 2 (5.4) Completed secondary/high

school 10 (27.0) 4 (40.0)

Some community college 1 (2.7) 1 (10.0) Completed community college 11 (29.7) 2 (20.0) Some university 3 (8.1) Completed university 4 (10.8) Graduate degree 6 (16.2) 3 (30.0)

Family income (Cdn $) 0–9999 1 (2.7) 30–39 999 4 (10.8) 2 (20.0) 40–49 999 9 (24.3) 1 (10.0) 50–59 999 4 (10.8) 2 (20.0) 60–69 999 1 (2.7) 70–79 999 1 (2.7) 80–89 999 8 (21.6) 3 (30.0) 90–99 999 2 (5.4) More than 100 000 7 (18.9) 2 (20.0)

568 A. Siddiqua and M. Janus

(Table 3). The parents reported that significantly more general

information was provided prior to school entry than post

transition. The effect size of this difference was 0.37. While the

majority of the differences did not reach statistical significance,

the parents had consistently more positive perceptions of

services pre-transition. The effect sizes of these differences

were generally small/moderate: With the exception of the

enabling and partnership scale, they ranged from 0.25 to 0.28.

The parents’ satisfaction with services was higher prior to

school entry than post transition, although this difference did

not reach statistical significance, with the effect size of 0.21

(Table 4).

Qualitative phase study participants

All children had a diagnosis at intake, while three received

updates to diagnosis post transition (Table 1). The two most

common diagnoses were developmental delay (50%) and

autism spectrum disorder (30%; Table 2).

Qualitative themes

Five themes emerged from the data pertaining to the parents’

perceptions of and satisfaction with services after their children

with special needs were enrolled in school. Each theme and

relevant subthemes are described in the succeeding texts,

accompanied by illustrative quotes where the use of ‘I’ refers to

the interviewer’s voice and ‘P’ to the parent’s voice.

Theme I: qualities of services and service providers

The first major theme pertained to parents’ perceptions of the

qualities of services and service providers. This theme,

composed of six subthemes, reflects the parents’ views

regarding the positive traits of school staff and negative

notions about school and timeliness and individualization of

services. Furthermore, the parents described the cooperative-

ness of service providers. The parents also commented on the

disorganization of information during transition.

Positive traits of school staff

The parents generally had positive perceptions about their

child’s schoolteacher and educational assistant (EA). The

parents described the teacher by using terms such as ‘caring’,

‘supportive’ and ‘competent’. Some parents reported that they

found that the EA was ‘relaxed’, ‘understanding’ and ‘positive’

with their child, and that the EA did not overwhelm the child

in supporting their learning in class.

P: …I know in class he’s [child] doing very well. He has his

EA with him but I don’t think she’s you know glued to him

Table 2. Diagnoses of children participating in the study

Quantitative phase (n = 37)

Qualitative phase (n = 10)

No. of participants (%)

Diagnosis Angelman syndrome 1(3%)

Attention deficit hyperactivity disorder

2 (5%)

Autism spectrum disorder 10 (27%) 3 (30%) Coffin–Lowry syndrome 2 (5%) Developmental delay 7 (19%) 5 (50%) Fetal alcohol spectrum disorder 1 (3%) Nonverbal learning disability 1 (3%) Pervasive developmental disorder 2 (5%) Rett syndrome 1 (3%) Speech delay 3 (8%) No diagnosis 4 (8%) Multiple diagnoses 3 (8%) 2 (20%)

Table 3. Means, standard deviations and effect sizes of difference between families’ pre-transition and post-transition judgments on the Measure of Processes of Care (MPOC) scales

MPOC domains Pre-transition Mean (SD)

Post-transition Mean (SD) Effect size P-value

Enabling and partnership 5.1 (1.53) 4.9 (1.86) 0.12 0.486 Providing general information 4.0 (1.93) 3.3 (1.90) 0.37 0.020 Providing specific information 5.5 (1.25) 5.1 (1.63) 0.28 0.134 Coordinated and comprehensive care 5.5 (1.26) 5.1 (1.61) 0.28 0.124 Respectful and supportive care 5.7 (0.91) 5.4 (1.46) 0.25 0.171

Table 4. Mean, standard deviation and effect size of difference between families’ pre-transition and post-transition judgments on the total score of the Client Satisfaction Questionnaire (CSQ)

Pre-transition Mean (SD)

Post-transition Mean (SD) Effect size P-value

CSQ total 26.0 (4.60) 24.7 (7.51) 0.21 0.293

Experiences of parents of children with special needs at school entry 569

and you know helping him with every single thing. He’s

doing a lot on his own.

The parents described many examples of service providers

taking the initiative to support their child. The parents

reported that the school was proactive in noticing the child’s

problems. One parent indicated that the school initiated a

communication book to facilitate communication between the

school and themselves. Another parent reported that the

teacher and principal pushed the Board of Education to

provide an EA for the child. However, several parents also

reported that the school did not take initiatives to serve the

child and their families.

Negative notions about school

All parents expressed negative perceptions about service

provision by the school system. Some parents felt that the

school offered inadequate services for the child, while others

described the school as not being helpful for the child and

wasting the child’s time.

P: …the autism team from the school happened to go into

his [child] kindergarten class, not for him but for somebody

else and noticed him and said how come that child’s not

signed up, and the teacher said well he should be. And he

wasn’t…but you think that they would try and fix that.

They’re like well we’re going to put him in special class

anyway so let’s have meetings about special class…in the

meantime he’s wasted a year of school time going there…

Timeliness of services

Issues of timeliness in service provision ranged from early

availability to long wait times. One parent indicated that the

Individual Education Plan was completed before the IPRC

meeting. The parents reported that the occupational therapist

(OT) and physician were available in a timely manner based on

the child’s needs. However, the parents also provided examples

of delay in service provision in relation to the child’s

programming at school, with long waitlist for services being

a common complaint among parents post-transition.

I: …has the ASD team been involved at all in the school?

P: [Laughs] They haven’t come to see him [child] at all. He

doesn’t have any kind of programming…What he does

have is the one-on-one EA…his programming from my

understanding has not been modified. Like there’s nothing,

no one has come in…But I’m not really sure why they

haven’t come in yet. I mean it’s December you know.

Individualization of services

Several parents reported that their child was receiving

individualized services, whereas some parents indicated the

need for modified services to meet their child’s needs. Many

parents reported that there was a designated EA for their child

at school. Some also described the staff’s awareness of the

child’s needs and working to meet them: ‘…I think [the

principal] certainly has been very much aware of [child’s] needs

and tried to do everything necessary’.

For individualizing services, the parents expressed the

perceived need for tailored accommodation. The parents

commonly indicated that there was a need for the EA to

modify care to help their child.

P: …it’s very common for EAs to hover too much when they

don’t know the kids and their abilities very well… [Child] is a

very head strong and very determined child…you have to

many times push and push…but once he knows he can’t get

away with it, he’ll do it…

P: …if he thinks he can get away with it, he will…she’s [EA]

a really sweet woman…she’s always very positive with

him…

P: But I keep saying to her you need to push him…Make

him do it…

Cooperativeness of service providers

The parents described a spectrum of cooperativeness demon-

strated by service providers. In terms of cooperation between

service providers and parents, the parents reported both

positive and negative examples. Some parents described how

the EA and school responded to the parents’ suggestions and

requests, with one parent reporting that the school argued with

her instead of providing her child with the needed services.

P: …the school has done nothing, absolutely nothing…

I: So what kinds of things would he have lost from the

daycare once he went into school?

P: …PT, OT, speech – everything…They have done

nothing but argue with me.

The parents provided examples of varying cooperation

among school and other service providers. One parent indicated

that the school did not cooperate with Intensive Behavioural

Intervention staff. Another reported that while school initially

was not open to Intensive Behavioural Intervention staff, they

eventually welcomed them to the school system.

570 A. Siddiqua and M. Janus

Disorganization of information

Several parents described situations where information related

to their child’s diagnosis was not organized within the school

system.

P: …I think in October or November, they [school] sent me

a letter saying do you think maybe we could have a

diagnosis on [child]? I couldn’t believe it…They were given

his complete medical history. He’s diagnosed with autism…

they just accepted him being autistic about a week ago.

I: So what does the school say happened?

P: They say that they never got a diagnosis on him, which is

b—t because we had a preschool meeting in April before he

started school in September.

Not transferring diagnosis information to the right individ-

uals within the school system resulted in a lack of needed

support for the child as well as dissatisfaction among

caregivers. One parent described the need to complete the

same paperwork multiple times for school. The parents

reported that disorganization of information was an issue for

early intervention service providers as well, as they lost the

child’s paperwork.

Theme II: communication and information transfer

The second major theme, composed of two subthemes,

reflected the parents’ perceptions regarding communication

and information transfer between service providers and

families, as well as among service providers themselves.

Communication and information transfer between service providers and families

The parents described a spectrum of communication and

information sharing between service providers and families.

The parents’ perceptions of pre-transition service providers

were largely positive. Many parents described that the daycare

shared information with them and that they had good

conversations with daycare teachers. Post transition, the

parents reported having ongoing communication with the

school. Some parents indicated that they used a communica-

tion book with the school and teacher to stay up to date with

their child’s progress in school.

Despite giving examples of regular communication with

school, many parents reported that there was lack of

information sharing by the school and teacher with parents.

Several parents described having little communication with the

principal. Some parents also mentioned lack of interaction

with the teacher and a paucity of feedback received from them.

P: …the teacher sometimes will send emails out but they’re

just like general emails to all the families, right? …there’s no

actual one-on-one communication with her…if there were

a concern I would assume that they would be contacting

me, right? Or they may you know mention something

through my nurses but you know you’re not really

supposed to go that way. They’re supposed to be

communicating with me directly…

Communication and information transfer between service providers

Although the parents described some communication and

information transfer taking place between service providers,

they provided many more examples of limited interaction

between service providers. Some parents reported that the

school communicated with the daycare and that reports

were shared between the daycare and teacher at school.

However, in many cases, the parents reported a lack of

communication taking place between service providers.

Several parents indicated that there was a disconnect in

communication between daycares and schools.

P: …I also really, really like the teachers he [child] has in

the daycare, the ECE he has there and then I quite like his

teacher…although funny enough, there’s a disconnect

between those two groups. It’s almost like when the

daycare teachers come to pick them up when it’s dismissal

time at school, there’s never any time or there’s never sort

of a lot of information passed back and forth…

One parent described several situations where the teacher

did not receive important information from the school to

support the child with transition.

P: She [teacher] gave me papers to fill out while I sat down

and talked to her… then she had said to me ‘okay, and what

are your expectations for the year’? and I said to her ‘well,

hoping that we can make sure that he [child] doesn’t have

any issues with being behind…’ She goes ‘does he have any

other issues besides for that’? and I said ‘well yah, but that is

all in the report…’ and she just sort of looked at me funny

and said ‘what report?’ and I said ‘we did an intake meeting in

March I believe it was’…and she goes ‘I don’t have any of

that’ and I’m like ‘pardon, what do you mean you don’t have

it’ and I said ‘it should be in his records…’ and I told her what

the principal had written down and it was requested that be

put in that class so that he can built on his strengths that way.

Experiences of parents of children with special needs at school entry 571

Theme III: parent advocacy

The third major theme, composed of two subthemes, reflected

the parents’ perceived need for parental advocacy and parental

advocacy for accessing services.

Perceived need for parental advocacy

Many parents described the perceived need to advocate for

their child. One parent explained that it was very important

to get involved in school council to ‘have some say’.

P: …I’m also on the school council. Put my foot in there so

that I have some say, [Laughs] which I think is really

important for parents with children of special needs. You

need to get on to the school council…You can present

problems if there are some…

Many parents addressed the need to follow up with service

providers.

P: …[husband] and I both remember sitting in the school

before [child] even started, introducing everyone to [child]

and his challenges and there were all of the representatives

like resource teachers…we were told that they would be

contacting us…And we have never, ever gotten that phone

call…I think I need to go back…figure out what’s

happened.

Parental advocacy for accessing services

The parents described taking initiative to find services and

resources for their child after school entry. This included

arranging special equipment for the child in class, transpor-

tation to school, funding to attend daycare and private therapy.

They also indicated inquiring about the child’s status on the

waitlists for various therapies, potential testing for child and

working to arrange visits by school staff to the daycare.

Many parents described their effort to maintain continuity

of services post transition, including making up for the loss

of services after school began. Not surprisingly, one parent

reported feeling overwhelmed by having to arrange different

services post transition.

P: …I would be really surprised if we saw funding before

July so I think in terms of this academic year it won’t be an

issue. I think the issue is going to be next September –

what do we do? …I have no idea…I just can’t go there

right now, I just feel so overwhelmed trying to deal with

like the really pressing issues like let’s find an OT and let’s

get a speech plan in place for the New Year when our

coverage renews…

Theme IV: uncertainty about services

The fourth major theme, composed of two subthemes,

reflected the parents’ uncertainty in knowledge pertaining to

service provision and information management.

Uncertainty about service provision

Many parents described uncertainty about the services their

child received or could receive after school entry.

I: …What would the ASD team at school do, do you know?

P: I have no idea. I know the school called the ASD team,

the Board ASD team and said do you have [child] on your

list? And they said we didn’t but we do now. Now what that

means and what’s going to happen I have no idea.

The parents commonly expressed uncertainty about where

services came from and how services were provided, as well as

uncertainty regarding the continuity of services post transition.

The issues included decisions made regarding the type of service,

benefits of services, length of waitlists, paperwork needed to

obtain services at school and activities that take place at school

Uncertainty about information management

Several parents expressed concerns about information sharing

between service providers.

P: The only thing of reports, the only thing I did was

provide the book that I had done…so that we could go

through it as a group together and I could talk about all the

challenges and strategies and give them some ideas of how

he [child] is…there was no other information shared or

reports…Whether or not the school got reports from, I’m

sure from [early intervention service provider (a)] and

[early intervention service provider (b)], I’m imagining that

they would…I: That’s what I was wondering…P: I mean he

has I guess a file now on him so I don’t know.

Some parents also described their uncertainty about

organization of information pertaining to the child, while

others expressed uncertainty regarding sources of information

and the school’s information keeping practice.

Theme V: contrasts and contradictions in satisfaction

The fifth major theme, composed of two subthemes,

reflected the parents’ satisfaction with services and service

providers, as well as dissatisfaction with services and service

providers. In many cases, the same parents expressed

feelings in both subthemes.

572 A. Siddiqua and M. Janus

Satisfaction with services and service providers

The parents expressed satisfaction with many services provided

to their child. They were pleased with the child care preparing

the child for transition by visiting the school before entry.

Some parents were satisfied with the one-on-one support

provided to their child by the EA, as well as the special meal

accommodation made by the principal to include their child in

the lunch programme.

The parents were also pleased with many service providers

who served their child prior to school entry and post transition,

including preschool, child care and school teachers: ‘…we have

hit good [school] teachers…The teachers that genuinely love doing

what they do and care about the kids…’ Many parents were also

satisfied with the school, EA, principal, vice principal, physician,

physician’s staff and speech pathologist.

Dissatisfaction with services and service providers

Some parents were disappointed with the lack of diagnosis for

their child and the delay in service provision as a result. Some

parents expressed strong dissatisfaction with the school system.

I: Really? Is the waitlist [for OT, PT, and speech] that long?

P: Yeah…

P: …when they talk their tongue is split right down the

middle. Oh the best years are 0-6, we got to help them…

Wait, you know. So very, very discouraged with the school

system.

The parents were frustrated with the unavailability of an aide

for their child in school and with disorganization of services

despite good intentions of service providers. One parent was

frustrated with the school seeking answers from them when

there were challenges with their child.

P: …the teacher, I’ve spoken to her a few times on the

phone. I appreciated her calling me at home on the one

Friday…she said I needed to tell you [child] had a very

difficult day and these are the challenges…I get frustrated

with ‘Well what’s changed? What’s different?’ I wish I could

have something…This has happened and this is why [child]

is being that way. But I don’t know.

Mixed method findings

The appendix presents the mixed method findings by using a

merged analysis display approach. The qualitative findings

pertaining to each of the MPOC scales show.

• Enabling and partnership (scale 1): Service providers were

both responsive to parents’ requests and inclusive in their

decision-making practices by involving parents.

• Providing general information (scale 2): There was evidence

that the service providers were both proactive and late in

relation to information sharing with parents; there was lack of

information shared, need for parent advocacy to access

information, uncertainty about services and satisfaction and

lack of satisfaction with information received.

• Providing specific information (scale 3): Parents received

information pertaining to their child from service providers,

although there were sometimes delays in receiving such

information, need for parent advocacy to access child-specific

information and uncertainty about child-specific information.

• Co-ordinated and comprehensive care (scale 4): Parents

were frustrated with disorganized services.

• Respectful and supportive care (scale 5): Service providers

listened to parents and welcomed parent advocacy.

The mixed method findings show that while some aspects of

the MPOC service components are working well, there is need

for improvement in other aspects.

Discussion

Our study highlights the value of using a mixed method

approach to generate a nuanced understanding of the process

of transition to school for children with special needs, due to

ambiguity of experiences. For example, while the quantitative

results indicated that the parents received less general and

child-specific information from service providers after school

entry, the qualitative findings highlighted the wide range of

communication and information sharing that took place

during transition. The qualitative findings showed that

information sharing routinely took place between parents

and pre-transition service providers. In contrast, the school

was only occasionally proactive in sharing information with

parents (e.g. by initiating a communication book). Echoing

findings of other studies, although some parents received

information from the school teacher through the communi-

cation book, there was a decrease in parent–teacher commu-

nication in kindergarten in comparison with preschool

(Anderson 2009; Applequist 2009; Quintero & McIntyre

2011; Stoner et al. 2007).

Poor exchange and organization of information have been

identified as significant barriers to successful transition for

children with special needs, as they often lead to gaps in service

Experiences of parents of children with special needs at school entry 573

availability, duplication of procedures and cost inefficiencies

(Freedman & Boyer 2000; Janus et al. 2008). Our qualitative

findings show both occasional information sharing and a

disconnect in communication between institutions, demon-

strating the duality of relationships, while disorganization of

information within institutions was a consistent challenge for

parents during the transition process. Earlier studies demon-

strated that lack of linkages between school and agencies that

care for children in the preschool year resulted in repeated

assessments and completion of large volumes of paperwork by

parents (Janus et al. 2007; Janus et al. 2008). Our current study

expands these findings to indicate that it is often lack of

internal communication within agencies that may contribute

to parents’ frustrating experiences.

Partnerships among service providers and between

providers and families are integral elements of an effective

educational system for children with special needs. Previous

evidence documents that parents and professionals often fail to

successfully collaborate (Janus et al. 2008; Kohler 1999; Stoner

et al. 2007; Stormont et al. 2005). Through its mixed method

design, our study provides a new perspective on this

phenomenon. The parents acknowledge positive initiatives

on the part of the school, as well as good will of service

providers, even though the quantitative measurement reflects

mostly decline in relationships. This is particularly important

because higher perception of services is associated with

children’s adjustment at school (Janus & Siddiqua 2015).

Our findings make it clear that there are many positive capital

on which system-wide improvements can be built. A first step

in such improvement should give parents an opportunity to

identify their most pressing needs and concerns.

Post transition, the parents seemed to believe that schools did

not consider it problematic to delay special education service

availability to students in need. Long waitlists, lack of delivery of

promised services, uncertainty about them and inadequacy once

they were provided were also commonly reported in ours as well

as previous studies (Hamblin-Wilson & Thurman 1990; Leiter &

Krauss 2004). In terms of timeliness of services, because in some

instances services were offered and delivered on time, we believe

that a combination of lack of resources and overly bureaucratic

administrative process is responsible for the variation in

fulfilling the timely delivery (Lutenbacher et al. 2005).

While schools sometimes took the initiative to meet the

children’s and their families needs, the need for parent

advocacy emerged as a prominent theme in the qualitative

data. The mixed method findings highlighted that it appeared

greater post transition than pre-transition. Themes related to

the need and importance of individually tailored services are

common in literature (Applequist 2009; Rous et al. 2007).

While some services are provided in school according to

children’s needs, parents usually have to take the initiative to

seek necessary and additional services (Floyd & Gallangher

1997). Negative feelings have been commonly expressed by

parents while advocating for their child given the amount of

time, energy and personal resources needed to ensure their

child’s needs were fulfilled at school (Anderson 2009;

Lutenbacher et al. 2005).

Generally, parents were less satisfied with service provision

after school entry than pre-transition as they received more

support from their early intervention service providers than

from the public schools (Hamblin-Wilson & Thurman 1990;

La Paro et al. 2000). Although the quantitative results show an

overall decline in satisfaction with services post transition, the

mixed method findings put them in context: Parents were also

pleased with many of the school staff and services, often at the

same time, which can also explain small effect sizes in

quantitative results.

The small sample size of this study increased the risk of

committing a type II error in the quantitative analyses. While it

may not be representative of other populations, the common-

alities we found with previous evidence suggest a degree of

generalizability. It is likely that parents’ reported perceptions of

and satisfaction with services depended on the degree to which

their expectations were met. To develop a more comprehensive

understanding of services from parents’ perspectives, future

studies can assess both expectations and perceptions of services

concurrently in larger and more diverse samples.

Because all qualitative interviews had been completed as part

of the primary study, there was no opportunity to probe

parents to gather more information on areas that were deemed

relevant for the current study. Member checking also could not

be conducted. Although the quantitative and qualitative phases

of the primary study were conducted in parallel and focused on

parents’ experiences with services, the themes arising from the

qualitative interviews did not include information pertaining

to every component of family-centred services considered in

the MPOC. This limited the level of content convergence

achieved in the mixed method analysis. Future convergent

mixed method studies should collect data on the same content

areas in the quantitative and qualitative phases, as this will

likely lead to greater content convergence.

Conclusion

This mixed method study contributed to the school

transition literature for children with special needs. The

574 A. Siddiqua and M. Janus

quantitative results showed that parents’ perceptions of and

satisfaction with services declined post transition. While the

qualitative findings illustrated the variation in parents’

experiences with services during transition, there were some

overarching themes that reflected the common challenges

parents faced during this process.

Key messages

• There is limited evidence on experience of parents of

children with special needs at school entry in Canada.

• Mixed method research develops a nuanced understanding

of parents’ experiences of services during children’s

transition to school.

• There are several components of early year service

provision that require improvements to facilitate a

successful school entry.

Acknowledgements

This article describes research carried out by the first author

for her MSc degree under the supervision of the second

author. We would like to express our thanks to Dr Peter

Rosenbaum and Dr Wendy Sword for useful discussions

that greatly contributed to clarification of ideas presented in

this article.

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