Dialog, 16(1), 20-44 

Copyright © 2013 

ISSN: 1930-9325 

 

Leanne Whiteside-Mansell, Department of Family and Preventive Medicine, College of Medicine, University of 

Arkansas for Medical Sciences; Danya Johnson, Department of Family and Preventive Medicine, College of 

Medicine, University of Arkansas for Medical Sciences; Patti Bokony, Department of Psychiatry and Behavioral 

Sciences, College of Medicine, University of Arkansas for Medical Sciences; Lorraine McKelvey, Department of 

Family and Preventive Medicine, College of Medicine, University of Arkansas for Medical Sciences; Nicola 

Conners-Burrow, Department of Family and Preventive Medicine, College of Medicine, University of Arkansas for 

Medical Sciences; Taren Swindle, Department of Family and Preventive Medicine, College of Medicine, University 

of Arkansas for Medical Sciences. 

Correspondence concerning this article should be addressed to Leanne Whiteside—Mansell, Department of 

Family and Preventive Medicine, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, 

AR 72207. E-mail:WhitesideMansellLeanne@uams.edu. 

 

 

RESEARCH-ARTICLE 
 

 

 

Supporting Family Engagement with Parents of Infants and Toddlers 
 

Leanne Whiteside-Mansell, Danya Johnson, Patti Bokony, Lorraine McKelvey, Nicola Conners-

Burrow, and Taren Swindle 

University of Arkansas for Medical Sciences 

 

  

Engaging families of preschool children in partnerships with early childcare providers 

includes, among other activities, engaging in meaningful conversation, linking parents to 

needed services, and supporting parents as they capitalize on family protective factors. 

Early childhood programs struggle to implement systematic processes to support teachers 

in engaging families and documenting the interactions. This report summarizes the 

development and implementation of a tool designed to facilitate family engagement with 

childcare. The study targets a rural, multi-center agency serving Early Head Start families 

using an inventory called The Family Map. This report provides evidence of the 

feasibility of implementation, the reliability, and validity of the screening questions, and 

the range of risk and strengths identified in Early Head Start families served. 

 

 

The parenting environment is a key determinate in the healthy development of infants and 

toddlers (e.g., Bradley, 1999, 2007), even for children who are spending substantial time in 

center based care away from home (Shonkoff & Phillips, 2000). For over 30 years, research has 

identified key family and home characteristics that place young children at risk for achieving 

age-appropriate social, emotional, and cognitive skills (e.g., Evans, 2004; Bradley, 2002). Some 

risks to child development in the home and parenting environment are pervasive and difficult to 

change, (e.g. living in poverty, Bradley & Whiteside-Mansell, 1997; Votruba-Drzal, Coley, & 

Chase-Lansdale, 2004). Other risks are more malleable; making them amenable to services for 

the child, education for the parent, or support for the family. For example, children are thought to 

be at risk when they lack learning materials, experience harsh parenting, or lack supervision 



SUPPORTING FAMILY ENGAGEMENT – FAMILY MAP    21 
 

 

(Bradley, 2007). Regardless, high quality childcare programs can serve to protect children from 

risks found in the home environment (Shonkoff, & Phillips, 2000). Childcare providers may do 

this more effectively when the specific risks in the home are identified (Whiteside-Mansell, 

Bradley, McKelvey, & Lopez, 2009). In this paper, we describe the development of the Infant-

Toddler Family Map, an inventory designed to facilitate conversation between childcare 

providers and parents with the goals of identifying family risks and strengths specific for each 

family. We report on the use of the Infant-Toddler Family Map as part of a system imbedded into 

a multi-site Head Start program to engage families, document engagement, and support the 

family-childcare partnership. Below we briefly review the literature that points to the need for 

such a tool and then summarize the specific objectives of our study. 

 

 

Risk and Protective Factors in Families in Poverty 
 

The chance of harm to children substantially increases as children experience more risk factors. 

That is, while reductions in exposure to individual risks are important, the reduction in the 

number of risks present in a child’s environment is also important based on cumulative risk 

theory (Burchinal, Roberts, Hooper, & Zeisel, 2000). The Head Start Bureau’s Family and Child 

Experience Survey (FACES) found that parents from families with four or more risk factors were 

more depressed and reported less social support (U.S. Dept of Health and Human Services, 

2003). Children from these families were reported to have more problem behaviors and 

significantly lower scores on measures of early literacy and cognitive functioning. 

Positive parenting is important for children with multiple risk factors because it has been 

found to provide a buffering effect in the presence of risk. For example, research on child 

development during early childhood has also shown that when parents provide structure and 

routines, warm and nurturing care, and read with their children, they are setting the stage for 

successful learners (Bradley, 2007). These parenting actions serve as protective factors. Other 

known protective factors include (but are not limited to): two healthy parents; parenting 

characterized by warmth, responsiveness, engagement, support, consistency and stimulation; 

monitoring for child safety; and availability of learning materials in the home (Bradley, et.al, 

1994). Positive parenting is associated with the development of cognitive skills and positive 

behavior in children (e.g., Connell, & Prinz, 2002; Treyvaud, Anderson, Howard, et al, 2009).  

While positive parenting is seen in families of all income levels, parents living in poverty 

are more likely to face stressors that make parenting more challenging. Individuals in poverty 

face more negative life events and have fewer resources to cope. These stressors can create 

psychological distress and tap emotional resources. Parenting under these circumstances 

becomes difficult, and is associated with less protective parenting behaviors (see summary in 

Shonkoff & Phillips, 2000). Co-factors of poverty such as parental depression and other mental 

illness, high family conflict, low social support, and low education often result in chronic 

adversity and stress (Bradley & Whiteside-Mansell, 1997). Children in poverty are also less 

likely to experience a high quality home learning environment, and studies have shown this 

accounts for a major part of the gap in test scores for high and low income preschool children 

(Ackerman, Brown, & Kail, 2006). While parents in poverty face many challenges raising their 

children, it is also unfortunately a basic reality that they have less access to information specific 

to parenting. The same co-factors that make parenting difficult are likely to also impede the 



22    WHITESIDE-MANSELL ET AL.  

 

 

ability of parents to attend traditional parenting education classes or obtain information through 

other means. 

Supporting families to provide a high quality home environment is a hallmark objective 

of high quality early childcare programs (U.S. Department of Health and Human Services, 

2011). Helping families draw on their strengths and find support to improve areas that may put 

the child at risk for poor development is always a challenge and often strains the resources of 

provider agencies (Espe-Sherwindt, 2008). Key to this activity is the development of parent-

caregiver relationships so that productive partnerships are established and maintained (U.S. 

Department of Health and Human Services, 2011). However, developing these important 

relationships can be a challenge for all involved. 

 

 

The Challenge of Parent-Teacher Communication 
 

Parent-caregiver communication forms the foundation for the important link between home and 

childcare contexts to shape children’s development. This link is important for both parents and 

caregivers to provide supportive and sensitive care to the child (Elicker & Fortner-Wood, 1995). 

The need for a strong connection between the multiple contexts in which children function has 

long been considered important and this deficit has influenced standards of professional practice 

(Bronfenbrenner, 1979). 

Often the engagement of parents depends upon the degree of caregiver-initiation 

(Halgunseth & Peterson, 2009). The primary factor in quality parent communication is teacher 

outreach, even beyond parental socioeconomic status or race (Patrikakou & Weissberg, 2000). 

When teachers keep parents informed and provide parents with support to help their children, 

parents view teachers as partners (Patrikakou & Weissberg, 2000). However, teachers’ have 

consistently been found to give negative evaluations of parents’ competence (Manlove, 2001; 

Galinski, 1990). Further, most preschool teacher-parent communication is narrow in content 

(Shpancer, 2002) and avoids important topics such as child rearing practices and challenges the 

family may be facing. In general, the research suggests that teachers need both guidance and 

training to increase the frequency and quality of parent-teacher conversations to tackle sensitive 

child-rearing and family issues. 

Meeting the challenge of supporting families to reduce risks for children means that 

program staff must be able to efficiently and systematically assess the family and home 

environment in ways that can lead to successful engagement with the family. Specifically, 

teachers and parents must talk about the family needs so that teachers can link families with the 

resources, information, and services most important for their child and so that parents can 

identify meaningful family goals (Henderson, & Mapp, 2002). In general, teachers are hesitant to 

begin this conversation resulting in programs searching for a ‘form’ to begin the conversation 

(Shpancer, 2002). For most concerns in the home environment to be assessed, the problem is not 

one of a lack of reliable and valid evaluation tools. Rather the problem is one of too many tools 

that are deficit based, overlapping in content, and difficult to integrate into a meaningful protocol 

for early childhood teachers and family support staff to use. 

An effective system to facilitate meaningful family engagement would be one that a) 

systematically connects the parent and teacher on key aspects of the home environment, b) these 

aspects of the home are linked to healthy child development, c) guides the teacher to appropriate 

services, d) documents the past and current family goals and progress, and e) identifies potential 



SUPPORTING FAMILY ENGAGEMENT – FAMILY MAP    23 
 

 

protective factors in the home environment. This exchange should be bi-directional and 

encourage communication that is respectful, and focuses on key information about areas of 

family life critical to healthy child development. The bi-directional conversation should 

encourage staff to collaborate with parents to identify important goals with mutual respect. The 

system should recognize that family members have unique insight into the history of experiences 

and family challenges, while the childcare providers may have access to knowledge and 

resources that are not easily available to parents. Past models of family engagement viewed this 

partnership as primarily parent-initiated; however, many, including the Office of Head Start’s 

National Center on Parent, Family, and Community Engagement (NCPFCE), recognize the role 

of programs to engage and involve parents in partnership with childcare professionals (U.S. 

Department of Health and Human Services, 2011). 

 

 

The Family Map Inventories 
 

There are three Family Map Inventories: Prenatal, Infant Toddler (IT-FM, birth to 3 yrs.), and 

Early Childhood (EC-Family Map, 3 to 5 yrs.). As seen in Table 1, questions on the Infant 

Toddler Family Map, like the other versions, are clustered into three broad areas covering twelve 

domains: (1) physical and social conditions that children experience directly, (2) family 

climate/context, and (3) parental characteristics. The rational for the inclusion of construct 

domains in the EC-Family Map has been described in a previous study (Whiteside-Mansell, et 

al., 2007). The IT-FM builds on the EC-FAMILY Map with adjustments made for the younger 

target age. The Family Map questions are scored using structured, observation, and semi-

structured questions; although most information is obtained from structured interview. 

 

 
TABLE 1 

Percentage of Families at Risk and Validity Summary based on Infant Toddler Family Map 
Based on Teacher Interview 

Family Map Construct Initial Source
a
 # of Questions Risk α 

Area 1 Physical/Social Conditions 
 

 

N = 72 

 1) Basic Needs 

    Utilities Fragile Families 1 9.70% 

 Rent and other monthly bills & EHS 1 15.30% 

 Health Care Expenses “ 1 8.30% 

 Transportation “ 1 7.00% 

 Legal Involvement IT-Study 3 16.70% 

 Housing Instability EHS 2 18.10% 

 Expected Future Needs EC-Study 2 20.80% 

 Food Quantity Insecurity/Nord 2 12.50% 

 Infant Feeding Practices 
b
 IT-Study 2 42.30% 

 Food Quality 
b
 Head Start Intake 9 91.50% 

 Communication (ESL) 
b
 Ramos & Mendez 4 14.30% 

 Parent - Education EHSRE 4 37.10% 

 Parent - Employment “ 4 38.60% 

 Partner/Other - Education 
b
 “ 6 59.30% 

 



24    WHITESIDE-MANSELL ET AL.  

 

 

Partner/Other - Employment 
b
 “ 3 14.30% 

  
 

(Continue)

TABLE 1, cont'd. 

Percentage of Families at Risk and Validity Summary based on Infant Toddler Family Map 
Based on Teacher Interview 

Family Map Construct Initial Source
a
 # of Questions Risk α 

2) Safety - Home & Car 

    Vehicle Safety EHSRE 4 25.40% 

 Secondhand Smoke FACES, & 2 34.70% 

 Fire Safety HUD Healthy 2 13.90% 

 Lead Paint Screen  IT-Study 1 11.40% 

 Injury or Accident Homes Checklist 10 37.50% 

 Poison Accessibility “ 5 42.90% 

 Baby Sleep Safety IT-Study 5 40.30% 

 Baby Concerns 
c
 HOME 2 2.50%   

3) Physical Health 

    Pregnant EC-Study 1 2.90% 

 Child Health Care Use National Survey 3 7.00% 

 Health Care Access Children's Health 1 0.00% 

 Chronic Condition Exist “ 1 10.50% 

 Chronic Treatment Need “ 1 0.00% 

 Caregiver Care Access “ 1 39.40% 

 Chronic Condition Exist “ 1 9.20% 

 Chronic Treatment Need “ 1 0.00% 

 Lack of Sleep BRFSS 1 32.40% 

 Lack of Activity “ 1 47.20% 

 Other Adult Health EC-Study 1 4.40% 

 Other Adult Treatment Need “ 1 10.50%   

4) Early Learning 

    Availability Learning Materials HOME 6 34.80% 0.79 

Read to child FACES 3 7.30% 
 

Supportive Play “ 5 2.80% 0.69 

Supportive Learning HOME 4 52.10% 0.80 

Variety of Experience “ 8 1.40%   

5) Discipline Practices 

    Excessive Punishment EHSRE, 1 1.50% 
 

Inconsistent FACES, & 3 0.00% 
 

Harsh Discipline PDMI 4 37.70% 
 

Parental Warmth 
b,c

 PICCOLO 8 10.40% 0.90 

6) Routines 

    Nighttime Lodging Shifts EHSRE 2 13.00% 

 Daily Activities Brody & Flor 4 10.00% 

 Child Adequate Sleep Davis/Montgomery 2 76.20% 

 TV Content Conners et al. 4 62.90% 

 Amount of TV FACES 1 20.00% 

 Parent/other Separation IT-Study 4 12.00% 

 



SUPPORTING FAMILY ENGAGEMENT – FAMILY MAP    25 

 

Physical Organization
c 
 HOME 3 5.00%   

           (Continue)

TABLE 1, cont'd. 

Percentage of Families at Risk and Validity Summary based on Infant Toddler Family Map 
Based on Teacher Interview 

Family Map Construct Initial Source
a
 # of Questions Risk α 

7) Surveillance 

    Daily Monitoring EC-Study 4 71.80% 

 Childcare Needs “ 5 28.60%   

8) Social Integration  
Social Support MSSS 5 29.20% 0.68 

Social Integration IHDP 4 1.40% 

 Caregiver HS Integration EC-Study 3 2.80% 

 Father HS Integration “ 2 44.90%   

Area 2 Family Climate/Context 

    9) Exposure to Violence 
    

Neighborhood Safety FastTrack 5 26.40% 0.74 

Exposure EHSRE 4 2.80% 
 

10) Family Cohesion/Conflict 
    

Parenting Stress PSI, AAPI 7 21.10% 0.76 

Conflict w/ Co-Parent EC-Study 3 9.80% 
 

Family Conflict FES/FACES 2 7.30% 
 

Family Cohesion “ 2 21.70%   

Area 3 Parental Characteristics 
    

11) Alcohol/Drug Use 

   
 

Caregiver Use CAGE 5 1.40% 

 Friend/Family Use RAFFT 2 15.30% 

 Use Impact Parenting EC-Study 1 1.80%   

12) Caregiver Mental Health 
   

 Depression PHQ 9 2 18.10%  

Hostility BSI/GAD-7 2 38.90%  

Anxiety “ 3 11.10%  

Impact Parenting 
c
 EC-Study 1 5.40%   

 

a
 The sample size varies from 69 to 72 except where skip patterns reduced sample.

 b
 Skip pattern reduced sample for 

Infant Feeding (n = 26), Food Quality (n = 57), Communication Barriers (n = 14), Partner Education/Employment 

(n = 28), Warmth (n = 48). 
c 

Observational items 

Note: AAPI (Adult-Adolescent Parenting Inventory, Bavolek & Keene, 1999); BRFSS (Center for Disease Control 

and Prevention, Behavioral Risk Factor Surveillance System); Bavolek, & Keene (1999); Brody, & Flor (1997); BSI 

(Brief Symptom Inventory, Derogatis, 1992); CAGE (Bisson, Nadeau, & Demers, 1999; Ewing, 1984).; Conners, 

Tripathi, Clubb, & Bradley,2007); Davis, Parker & Montgomery, 2004); EHSRE - Early Head Start Research and 

Evaluation Project); FACES - Head Start Family and Child Experiences Survey (US DHHS, 2003); FastTrack: 

Neighborhood items used in FastTrack and NICHD Study of Early Childcare studies. (Greenberg & Lengua, 1995); 

FES (Family Environment Scale, Moos, & Moos, 1984); Food Security (Bickel, Nord, Price, Hamilton, & cook 

2000); Fragile Families and Child Wellbeing Study); GAD-7 (Spitzer, Williams, Kroenke, et al , 2006,); Healthy 

Homes Checklist; US DHHS, 1991); HOME (Home Observation for Measurement of the Environment; Bradley, 



26    WHITESIDE-MANSELL ET AL.  

 

 

Mundfrom, Whiteside, Casey, & Barrett, 1994; Caldwell, & Bradley, 1984); IHDP – Infant Health and Development 

Program, McCarton, et al, 1997; Jensen, James, Boyce, & Hartnett, 1983); MSSS (MOS Social Support Survey, 

Sherbourne, & Stewart,1991); National Survey of Children’s Health (Ogden, 1998); PDMI (Parental Discipline 

Methods Interview, Webster- Stratton, & Spitzer, 1991); PHQ 9 (Patient Health Questionnaire, Kroenke, Spitzer, & 

Williams, 2001); PICCOLO (Parenting Interactions with Children: Checklist of Observations Linked to Outcomes, 

Roggman, Innocenti, Cook, Jump, & Akers, 2007); PSI (Parenting Stress Index, Abidin, 1990); RAFFT (Relax, 

Alone, Family Friends, Trouble; Bastiaens, Francis, & Lewis, 2000); Ramos, & Mendez, 2004; EC-Study: Created 

in the development of the EC-Family Map; IT-Study: Created in the development of the IT-Family Map. 

 

 

The Family Map Inventories (FM Inventories) were designed to support teachers in the 

initiation of communication, screen the parenting environment for important risks to healthy 

child development and strengths the family can build on, and support the parent-teacher 

partnership with on-going high quality communication (Whiteside-Mansell, et al., 2007). The 

FM Inventories were developed to direct teachers into discussions with parents on topics relevant 

to the needs of the family. The FM Inventories may also help teachers identify critical risk areas 

that parents may not perceive as needs and to identify strengths that the family can build upon. 

Beyond facilitating communication between the teacher and parents, we designed the 

Family Map Inventories to support educators and early childcare programs in other ways 

(Whiteside-Mansell, et al., 2007). First, the results obtained from families can be used to identify 

areas appropriate for agency-wide intervention. For example, when a large number of parents 

report not using child safety seats routinely, the topic is a likely candidate for a center parent 

meeting or special event organized by the early childcare agency. Second, comparing results 

from multiple interviews over time can provide evaluative data to document areas in which the 

program has made impacts. Third, the Family Map Inventories results can be a useful tool in the 

self-assessment and monitoring process. The Family Map Inventories are directly linked and 

supportive of the framework put forth by NCPFCE and were developed with the Head Start 

performance standards as a guiding principle. 

As seen in Figure 1, the cut-points indicating “risk” are shown on the IT-FM using 

shading to alert the teacher of concerns. As with the EC-Family Map, we used a set of principles 

in establishing the cut scores. These are discussed in detail in the development of the EC-Family 

Map (Whiteside-Mansell, et al., 2007) and are summarized here. When there is literature to 

support a particular cut, we followed the guideline.  For example, the American Academy of 

Pediatrics provides guidance on the number of hours of screen time and sleep.  Other research 

based agencies provide guidance on nutritional intake, car safety practices, and fire safety. When 

there was doubt about the level exposure that would result in a risk for the child, we erred on the 

side of over-identification. Like other screening tools, the Family Map is designed to avoid 

missing risks. 

 

 



SUPPORTING FAMILY ENGAGEMENT – FAMILY MAP    27 

 

 
 

Figure 1. Family Map Screen for Secondhand Smoke, Fire Safety, Lead Screen, and Burns. 

   

 

The use of shading also communicates the healthiest response to the parent (i.e., shaded 

responses are not desired). While the use of shading suggests that there is a danger of socially 

acceptable responses, there are several reasons that the shading is preferred. First, by indicating 

the most optimal options to parents, the parent will become aware of recommended practices. 

Second, the non-shaded response communicates the social norm to the parent (e.g., using car 

seats) and may have impact on some behavior (Schultz, Nolan, Cialdini, Goldstei, & 

Griskevicius, 2007). For example, parents may become aware that it is not just recommended 

practice to use car seats but that most people use them (i.e., social norm). 

Third, when parents are interviewed on topics in which the appropriate response is 

obvious, reliability of parental response is increased when the parent perceives the response is 

linked to corrective assistance (Hatfield et al., 2006). For example, parents willing to use car 

seats may not know how to obtain one they can afford. Finally, if parents are not truthful, it may 

indicate they are not ready to address the issue. This may be similar to the response many people 

have to a physician’s query regarding regular exercise or diet habits. However, when the teacher 

asks the question, it signals the topic as one that is safe to discuss. Additionally, the question 

should suggest to the parent that the program might be able to offer services or support. 

The Family Map for Early Childhood (EC-Family Map) targeting parents of children 3 to 

5 years-of-age has been implemented in multiple sites including home visiting programs, school 

based early childhood programs, Head Start programs, and church- based early childhood 

programs. Several of the evaluation studies that we conducted have shown support for the 

feasibility of the implementation in large agencies serving preschool children. For example, in a 

multiyear study, EC-Family Map was successfully implemented in 28 classrooms (570 children) 

in school-based preschool programs (Bokony et al., 2008). Because the program was school-

based, the EC-Family Map was completed during classroom parent-teacher conferences. Teacher 

rating of support for the use of the EC-Family Map increased significantly each year. This 

supports focus group findings that teachers had a positive view of the usefulness of the EC-

Family Map which increased with experience. 

 

 



28    WHITESIDE-MANSELL ET AL.  

 

 

The Purpose of the Study 
 

This study reports on the development of the Family Map Inventory of the Parenting 

Environment of Infants and Toddlers (IT-FM). This report summarizes the development process 

and the implementation of the IT-FM in a rural Early Head Start (EHS) program. The basic 

structure of the IT-FM originated in the EC-Family Map.  In this study, we describe our review 

of the literature based on constructs and questions developed for the EC-Family Map. We 

provide evidence of face validity by pilot interviews with parents, input from EHS teachers and 

administrators, and a cyclical process of revisions. 

We examined the feasibility and the acceptability of the use of the IT-FM.  This included 

evaluations from teacher training and survey results from parents and teachers regarding their 

perceptions of the use of the Family Map. We also documented the time needed to conduct an 

interview using the Family Map. Next, we provided evidence of the reliability and validity of the 

questions and risk indicators as used by teachers. We show a summary of each risk area assessed 

by the IT-FM in this study. While evidence of reliability is limited, we supply estimates of 

internal consistency where appropriate. 

For evidence of validity, we provide five types of information. First, we detail 

comparisons with national estimates of risk. That is, we expect that the numbers of families 

identified using the Family Map should be similar to the levels identified in other studies of low-

income families. Second, we provide evidence of construct validity. For a subset of the risk areas 

identified on the Family Map, we assess the construct using a more in-depth assessment.  For 

example, using an established research tool for identifying depression risks (i.e., BSI), we 

compared parent scores of depression on the BSI with parent scores of depression as indicated 

with two questions on the IT-FM. 

Third, we examined criterion validity for a subset of constructs (e.g., increased risk of 

unintentional injury is expected to be associated with a parent’s belief in fate). Fourth, we 

compared risk levels identified by teachers with observational assessments by researchers for 

appropriate risks.  For example, researchers conducted safety checks in the home after the 

teacher interviewed the parent using the IT-FM.  We compared the researcher’s observations 

with the parent’s report to teachers.  Finally, we linked some of the IT-FM constructs with 

relevant published studies of EC-Family Map constructs found in both the IT-FM and the EC-

Family Map. 

 

 

METHOD  
 

Development of the Family Map Inventory for Infants and Toddlers 
 

The term, Family Map, was used as an organizing metaphor for the Family Map Inventories 

because the assessment process is thought to locate a comprehensive set of strengths and 

concerns in family life that can serve as targets of productive early childcare efforts (Whiteside-

Mansell et al., 2007). In our 2007 study, we provided a detailed rational for the inclusion of each 

area shown in Table 1. Areas were included in the EC-Family Map when there was substantial 

literature linking the area to healthy child development and the area was likely one in which 

early childcare programs would have expertise and resources to intervene. Identification of 

potential areas to include in the IT-FM started with the EC-Family Map and included a 



SUPPORTING FAMILY ENGAGEMENT – FAMILY MAP    29 

 

comprehensive repeat of the literature review considered from the perspective of the infant and 

toddler. 

The IT-FM constructs can be clustered into three broad areas:  (1) physical and social 

conditions that children experience directly, (2) family climate/context, and (3) parental 

characteristics. The first area consists primarily of experiences that are parent directed. The 

identification of constructs drew heavily on the framework of parenting tasks described by 

Bradley and colleagues (Bradley, 1999, 2002; Bradley, & Caldwell, 1995; Bradley, & Corwyn, 

2004). As seen in Table 1, these include the key parenting tasks that assure the survival and 

promote the optimal development of the child.  For example, parenting actions that provide 

nutrients, shelter, and health care were included.  Beyond basic survival, there is ample evidence 

that the actions of the parent to provide a stimulating environment lead to a greater likelihood of 

academic and even social success (Bradley, 1994; Bradley, & Corwyn, 2003). Based on 

substantial research, the Family Map also includes the parent’s ability to provide a healthy 

structure to the child’s environment (e.g., routines) and protect the child from harm with 

adequate supervision (Bradley, & Caldwell, 1976; Wachs, 2000). 

The second area, family climate/context, includes the background setting within the 

family environment. These family characteristics may be something the child is directly exposed 

to or they may impact the quality of the parenting by their impact on the parent. Constructs 

included here were selected for their significant impact on children and often on a wide variety 

of child outcomes impacted. For example, family conflict and exposure to violence has been 

associated with a wide range of negative outcomes of children many with sever impacts 

(Kitzmann, Gaylord, Holt, & Kenny, 2003).  Family climate characteristic also have a negative 

effect on the ability of the parent to be a nurturing, supportive parent (Krishnakumar, & Buehler, 

2000). 

Finally, research has consistently supported Belsky (1984) in linking characteristics of 

the parent such as parent history of substance abuse and mental illness to child outcomes. Both 

of these characteristics are often found in homes with other risk factors for children such as 

violence, poverty, and residential instability, all of which make it difficult to parent effectively 

(Conners, Bokony, Whiteside-Mansell, Bradley, & Liu, 2004; Osofsky, & Thompson, 2000; 

Tronick & Beeghly, 1999). 

Table 1 (column 2) shows the conceptual bases for the questions. Most were based on 

questions used with similar populations in the literature or from national studies. The 

development process included an extensive literature review to identify potential modifications 

to the EC-Family Map in consideration of the younger target age of children. A pilot IT-FM 

interview was conducted with a small number of families (10 families) by trained research 

assistants. After each interview, the researcher discussed the interview with families to identify 

areas of the interview that concerned parents. EHS teachers (n = 10) and administrators (n = 5) 

reviewed the pilot tool and suggested modifications. After revisions, trained data collectors 

conducted interviews with 56 families. Modifications were made in a cyclical process based on 

input from data collectors and families after groups of about 10 interviews.  Face validity of the 

final version was confirmed in a pre-implementation review of the inventory by EHS teachers 

and administrators. 

 

 

 
 



30    WHITESIDE-MANSELL ET AL.  

 

 

Implementation of the IT-Family Map 
 

Implementation Sites.    The study was conducted in 3 rural EHS centers with 25 teachers 

serving up to 4 children each. An additional 25 teachers were interviewed for comparison. 

Centers were selected to participate because they were administered by the same agency and 

were located within 50 miles of a central office. The IT-FM interview was conducted by teachers 

in the fall home visit and repeated at the spring home visit. 

In line with current Head Start standards, most teachers had at least two years of post-

high school education with 60% receiving a CDA or Associate Degree and 20% with a BA or 

more (i.e. Head Start Standards as described in Informational Memorandum ACF-IM-HS-11-

03). The majority of teachers had more than 3 years of experience (55%). Most parents had 

known the teacher for more than a year (52%) suggesting that parents had been involved with the 

EHS program for more than the study year. 

 

Teacher Training.    Teachers attended 6 hours of training on the use of the IT-FM prior 

to the fall home visit. The training described the project, the role of Head Start in strengthening 

families, non-judgmental interview techniques, the impact of the home and parenting 

environment on children’s ability to learn, and how to use the potential risks identified in the IT-

FM interview to suggest family goals. The training included discussion of individual questions 

and role play sessions of interviews. Before the second home visit, teachers met for 2 hours with 

the research team to address questions and review the procedures. 

 

 

Data Collection. 
 

Based on implementation of the EC-Family Map, our expectation was that, while the use of the 

Family Map to screen is straightforward, the effective use of the IT-FM to link to services would 

take experience (Bokony, 2010; Bokony, Whiteside-Mansell, & Swindle, 2010). Therefore, our 

design targeted the fall assessment for a baseline to compare with national statistics. The spring 

assessment was used to link validity constructs. 

 

Implementation Assessments.    Teachers rated the training and their perceptions of 

the IT-FM following the training. After the fall and spring (n = 72) home visits, all teachers were 

asked to complete an on-line survey. In the spring, a subset (n = 44) of Family Map interviews 

were selected to be conducted as joint home visits between teacher, parent, and research staff. 

During this visits, the length of the home visits was recorded by the researcher.  Joint visits were 

scheduled so that each a researcher would attend at least one visit with each teacher with an ideal 

target goal of 2 visits with each teacher. 

Input from parents was obtained from three different contacts with parents. First, in the 

fall, 58 parents were contacted by phone to obtain initial response to the use of the Family Map.  

Among other questions, parents were asked to rate the visit compared to past non-Family Map 

home visits. Of the 58 parents, 44 had been involved in past Head Start home visits. Second, in 

the spring, 72 parents received Family Map home visits using the IT-Family Map. Third, 38 

parents receive a home visit with just their teacher (excluding the research assistant) and were 

interviewed by phone after the home visit. This was done so that parent reports would not be 



SUPPORTING FAMILY ENGAGEMENT – FAMILY MAP    31 

 

influenced by the joint research visit. Of these 38 parents, 10 were involved in the Head Start 

program as prenatal enrollees and so are not included in Table 1 (n = 72). 

 

Validity Assessments.    At the end of the spring home visit (n = 44 of 72, 1 interview 

was 12 days after the home visit), a researcher conducted an additional interview with the parent. 

The assessment tools targeted key aspects of the IT-FM and are described below. 

 

Family Conflict.    Family conflict was assessed using two dimensions from the Family 

Environment Scale (Moos, & Moos, 2002). The family conflict scale (9 questions) measures the 

extent to which the open expression of anger, aggression, and generally conflictual interactions 

are characteristic of the family (e.g., “We fight a lot in our family”.). Parents responded True (1) 

or False (0) and questions summed so that high scores indicated conflict. Reliability was high 

with α = .73. 

 

Brief Symptom Inventory-18 (BSI-18).    The BSI-18 is a self-report inventory to 

screen for mental health symptoms (Derogatis, 1992, 2000). Respondents rated how bothered 

they had been by 18 psychological symptoms during the past 7-days on a 5- point scale (‘Not at 

all’ to ‘Extremely’). Scores included 6 questions each: Somatization (α = .59, e.g., ‘Faintness or 

dizziness’), Depression (α = .68, e.g., ‘Feeling blue’) and Anxiety (α = .61, e.g., ‘Feeling 

fearful’) and a total score (GSI). 

 

Food insecurity (FI).     FI was assessed with a 6 item reduction of the full Household 

Food Security Survey Module (HFSSM, α = .75 e.g., ‘We couldn’t afford to eat balanced 

meals’). This scale has been shown to demonstrate high specificity, sensitivity, and reliability 

(Blumberg, Bialostoski, Hamilton, & Briefel, 1999) and is designed to indicate households 

where hunger is likely for children. Sum scores of 2 and above were deemed as Food Insecure 

per scoring recommendations (Blumberg, et al., 1999). 

 

Parenting stress.    The Parent-Child Dysfunction (PSI-PCD, Abidin, 1990) subscale of 

the Parenting Stress Index Short Form (11 questions) administered using a card with response 

options (1 = Strongly Agree to 5 = Strongly Disagree) and a 12th item rating of parent perception 

of being a good parent from very good (1) to not very good (5). The subscale rates parents 

perceptions of the child (α = .76, e.g., child rarely does anything to make parent feel good). 

 

Observation of home and neighborhood safety.    A home inspection checklist was 

constructed based on other published observational assessments (e.g., Preschool Safety Practices, 

Hatfield et al., 2006). The short observational check was conducted with the parent at the end of 

the validity assessment interview by the trained researcher. Parents were informed of conditions 

that might put their child or family at risk (e.g., hot water could cause burns). 

 

Chaos in the home.    A 15-item survey of home confusion and disorganization 

(Confusion, Hubbub, and Order Scale — CHAOS; Matheny, Wachs, Ludwig, & Phillips, 1995) 

was used to measure the degree of disruption in the home. The true/false response (e.g., “It’s a 

real zoo in our home”) resulted in a total score (α = .58). 

 



32    WHITESIDE-MANSELL ET AL.  

 

 

Supervision attitudes.    Two scales were constructed from modification of the Parent 

Supervision Attributes Profile Questionnaire (PSAPQ; Morrongiello, Corbett, McCourt, & 

Johnston, 2006). Parent tolerance for risk (e.g., learn from her own mishaps) was assessed with 5 

questions (α = .72). Parent belief in fate related to injury (e.g., injured due to bad luck) was 

assessed with 3 questions (α = .67). 

 

 

RESULTS 

 

Implementation Evaluation 
 

After IT-FM training, teachers’ reports were positive in reactions to the IT-FM and related 

training. Most teachers rated the training 4.2 to 4.6 (SD .6 to .9) on a 5 point scale with 5 

representing ‘excellent’. For example, the overall presentation of the training was scored high (M 

= 4.5, SD = .6) and 94.0% of teacher rated the overall presentation in the highest two categories 

of ‘good’ or ‘excellent’. 

Regarding the perceptions of the inventory, 92.8% of teacher endorsed the statement: 

‘The information I will learn during the home visit using the Family Map will be helpful working 

with families’ (‘much’ or ‘very much’; M = 4.7, SD = .55).  All (99.9%) endorsed the statement: 

‘I am comfortable I can conduct home visits using the Family Map.’ (‘much’ or ‘very much’; M 

= 4.7, SD = .43).  As was reported in the development of the EC-Family Map, some teachers 

(16%) were concerned about how families would respond with these teachers feeling that 

families would not like the change in the home visits. 

After the spring home visits, 84.0% of teachers reported being comfortable with using the 

Family Map. Only 15.2% reported that it was ‘just more paper work’.  Most (84.1%) reported 

feeling that the Family Map was a useful tool to learn important information about families.  

Most (79.1%) reported the Family Map was helpful for the home visit for at least one of the (up 

to 4) families they interviewed.  Similar numbers (79.1%) indicated that they would recommend 

the Family Map to other programs. 

Parents (n = 58) were contacted by phone after the fall home visits. Most (68.9%) 

reported liking (‘liked it’ or ‘very much liked it’) the home visits and a similar number (68.9%) 

reported being comfortable with what was talked about during the home visit. Of parents that had 

had previous home visits (n = 44 of the 58), only 2 reported this visit was ‘worse’ than previous 

home visits. Most parents also reported that the length of the visit was ‘just right’ (70.6%). 

Parents (n = 38) were contacted at the end of the spring semester and interviewed by 

phone.  Parents reported on a 4-point likert scale. After two home visits using the Family Map, 

parents reported positive feeling regarding the home visits. All (100.0%) reported liking the 

home visit (‘agree’ or ‘strongly agree’; M = 3.5, SD = .5) and being comfortable about the 

content of the visit (‘agree’ or ‘strongly agree’; M = 3.6, SD = .5). Most (94.7%) indicated that 

they thought that the EHS teacher understood their family better after the visits (‘agree’ or 

‘strongly agree’; M = 3.4, SD = .5) and 89.5% felt the teacher knew more about the child’s life at 

home after the visit (‘agree’ or ‘strongly agree’; M = 3.4, SD = .7). 

A research assistant was present at the spring home visit and noted the length of the home 

visit between the teacher and the parent. IT-FM home visits lasted a little over an hour (n = 44, 

M = 68 min, SD = 28 min). 

 



SUPPORTING FAMILY ENGAGEMENT – FAMILY MAP    33 

 

 

Risk and Strength Assessment: IT-Family Map 
 

Table 1 shows the range of risk and service needs for infants and toddlers screened using 

the IT-FM. The table shows the rates for families interviewed in the spring by teachers (n = 72). 

Of the families interviewed with the IT-FM, 26.4% had children 12 months-of-age or less and 

33.3% had children over 24 months. Most children were white non-Hispanic (45.8%, 22.2% 

black, 23.6% Hispanic, and 8.4% bi-racial). Most (95.8%) were biological parents and (69.4%) 

had other children in the home. Half (48.6%) of children were male. Parents reported diversity in 

education (23% with GED or less, 27% with high school degree, and 50% with additional 

education). Most parents reported working (21% not working, 21% < 30 hours a week, 43% 

about 40 hours, and 15% more than 40 hours a week). 

A review of Table 1 suggested some key areas of interest. For example, 42.2% of infants 

were being fed cereal or juice in a bottle or being put to bed with a bottle. Of toddlers, almost 

none (8.5%) were receiving the recommendations for quality nutrition in the home (e.g., 5 

servings of fruits/vegetables a day).  About half (42.9%) of children were living in a home with 

access to poison, and 40.3% were sleeping in situations that had safety risks (e.g., co-sleeping, 

not on back, crib unsafe). Regarding the early learning environment, many parents (52.1%) had 

limited interactions with their children in ways that promote early learning such as pointing out 

letters, colors or shapes. Many young children (34.8%) also lacked materials to engage them in 

learning (e.g., age- appropriate toys, games, music). 

A lack of organization in the home and efforts to provide a routine and structured home 

were indicated. For example, 13.0% of children slept somewhere other than their own bed more 

than 2 nights a week and 76.2% received less hours of sleep than the recommended.  However, 

only 10.0% reported a weekday schedule that was not relatively routine (e.g., meals, bed time at 

about the same time). In terms of parental characteristics, problematic alcohol and drug use 

varied depending upon the focus of the problem (1.4% among primary caregivers and 15.3% 

among close family/friends); though problems in mental health were more prevalent (18.1% 

screened positive for depression and 39% for problems with hostility). 

While Table 1 is presented in terms of the level of risk, some questions should be 

interpreted as family strengths also. For example, in this sample of rural families, nearly all 

(93.0%) have secure transportation; most lived in homes built after the use of lead base paint 

(88.6%), and most (70.8%) reported good social support. In addition, some evidence of family 

strength is imbedded in the IT-FM but not represented in Table 1. For example, the interview 

included an item regarding child dental health. Access to early dental care is often difficult to 

obtain and often begun past the one-year recommended first check. The parent that is proactive 

in this area suggests an attentive parent in regard to health. In this study, 75.0% indicated they 

had a dentist they considered to be the child’s dentist. 

 

 

Reliability and Validity 
 

While reliability is an important aspect of an assessment tool, a meaningful assessment of 

reliability is difficult to obtain in this situation. Asking teachers to repeat the interview within a 

short time was not feasible. Estimates of internal consistency can support reliability; however, 

because many constructs on the Family Map are only 1 or 2 questions or checklists, the use of 



34    WHITESIDE-MANSELL ET AL.  

 

 

internal consistency is limited (Bollen, & Lennox, 1991). That is, when the Family Map contains 

multiple questions to assess a construct, it is often a check list (e.g., Social Integration is a set of 

activities the parent may participate in such as church, a hobby, or a club).  For constructs 

composed of multiple indicators representing an effect indicator, estimates of internal 

consistency were computed (Bollen, 1984). As seen in Table 1, internal consistency estimates 

(Cronbach’s alpha) were computed for seven sets of questions. These were supportive of 

adequate reliability with values generally high. 

In addition to the data presented in the results, other publications support the validity of 

the Family Map. These include comparisons with national averages presented for the EC-Family 

Map (Whiteside-Mansell et al., 2007). It also includes unpublished studies presented at national 

conferences or in review.  For example, in 2010, we presented a summary of validation studies 

of the EC- Family Map (Whiteside-Mansell, et al., 2010). This analysis was of 1,150 families 

and examined risk subgroups identified by EC-Family Map risk cuts (e.g., material depression 

and compared the risks experienced by families in the risk category with expectations. The 

findings suggested that the EC-Family Map identified meaningful subgroups. 

In this study, independent assessments were also conducted to evaluate validity of some 

constructs (n = 44). In addition, several studies using the EC-Family Map data have been 

published that support the validity of specific constructs assessed in the IT- FM. A full analysis 

of validity of each item is not feasible in one report; however, the following reports on key 

aspects. 

 

Basic Needs.    The IT-FM includes indicators of parents’ ability and efforts to provide 

adequate nutrition and basic needs, health care, and provisions for environmental safety. 

Children in 10% of all homes in the United States experienced food insecurity (Nord et al., 2009) 

in 2009 compared to 12.5% identified in this study. A comparison of the HSSFM short form and 

the two food insecurity questions suggests significant overlap (Swindle, Whiteside-Mansell, & 

McKelvey, in press).  In a study of infants receiving WIC benefits, 25% of mothers reported 

adding other foods or liquids into the bottle with formula by 3 months of age (Baydar, McCann, 

Williams, Vesper, & McKinney, 1997).  Recommendations for a healthy diet have several 

components; however, consumption of fruits and/or vegetables daily is a standard 

recommendation. The assessment of food intake for young children is difficult (Serdula, 

Alexander, Scanlon, & Bowman, 2001).  Fewer than 10% of infants and toddlers consumed dark 

green, leafy vegetables in a day and after 12 months 27% consumed no separate serving of 

vegetable in a day. 

Although difficult to count, 2009 national estimates for the homelessness among 

American poor is 10% (National Coalition for the Homeless, 2011). Housing instability is more 

prevalent and has been estimated at 21.8% (Suglia, Duarte, Chambers, & Boynton-Jarrett, 2012). 

These compare with the IT-FM estimate of housing instability of 18.1%. The evidence is clear 

that exposure to secondhand smoke is a serious health concern and children are at higher risk 

than others. In 2006, nearly 60% of children ages 3 to 11 years were thought to be exposed. This 

compares to 34.7% of the children identified in the IT-FM. 

 

Safety – Home and Car.    In 2001, 45% of all unintentional deaths occurred in and 

around the home with falls the leading cause of nonfatal injuries for children less than 4 years of 

age. More than 90% of  injuries in early childhood occur in or around the home (Borse, Gilchrist, 

Dellinger, Rudd, Ballesteros, & Sleet, 2008; National SAFE KIDS Campaign, 2004National 



SUPPORTING FAMILY ENGAGEMENT – FAMILY MAP    35 

 

Safety Council, 1991, Schwebel, & Gaines, 2007 ). The most common injuries in the home 

involving children under the age of 5 years include falls from suffocation, drowning, falls, fires, 

and poisonings (LeBlanc et al., 2006). The FACES study of low-income families found 31% of 

children with access to poisons while this study identified 42.9% (U.S. Dept of HHS, 2003). As 

predicted by research on unintentional injury, access to poisons was correlated with parents who 

report in their belief in fate (r = -.31, p = .04). 

Outside the home, riding in motorized vehicles is a common source of injury and death 

for young children. More children, particularly in rural areas, are killed in motor vehicle 

accidents than from any other source (Burgess 2005). While estimates vary, 29% is a reasonable 

estimate for the national number of preschool children who ride in cars without appropriate 

restraints (Taft, Mickalide, & Taft, 1999) compared to 25.4% in this study. 

Nationally smoke alarms are less common in households with incomes below the poverty 

line (10%); however, reports are typically overestimated because respondents tend to report 

smoke alarms even when they are not working (Ahrens, 2009). The IT-FM identified 13.9% at 

risk (Fire Safety) by assessing the existence of a working smoke detector and access to two clear 

fire exits. In the observational safety check, this data was confirmed with parent report of smoke 

detectors consistent with home safety inspection (phi = .63, p = .00). That is, a report by the 

parent in the interview was associated with the observational check.  However, like national 

studies, parents over- reported the existence of working smoke detectors (phi = .34, p = .11). 

That is, a ‘yes’ report by parents that the smoke detector worked did not predict the results of the 

observers test of the smoke detector in the home. 

A detailed examination of some of the questions used to identify risk for unintended 

injury (Injury/Accident) supported risk identified. For example, concordance in parent report and 

observer tests of hot running water in the home was high (phi = .48, p = .01). Research 

observations of the crib placement confirmed the parent report of placement (i.e., near cords or 

heating units, (phi = .49, p = .02) and the existence of risky material in the crib (phi = .71, p 

= .00). Finally, as predicted there was a correlation (r = -.34, p = .02) between the parent report 

for risk tolerance and the Injury/Accident risk category. 

 

Physical Health.    Few children were identified with health access, chronic conditions 

or treatment needs. This was likely due to their young age and related to the fact that children 

had been in EHS at least since the fall. That is, parents may have received support to prevent 

poor birth outcomes. Caregiver report of their own sleep was correlated with their report of chaos 

in the home (r = .45, p = .00) but not the number of hours of sleep reported for the child. 

 

Early Learning.    Academic gains are made by children whose parents read to them 

from infancy onward (Raikes, et al, 1994). Nationally, most (45%) European American, mothers 

of infant/toddlers living in poverty reported reading to their children less than three times per 

week (Bradley et al., 2001). Based on the IT-FM, a child is considered at risk if no adult reads to 

the child this often (only 7% of children); however, for comparison (with the 45%), based on the 

IT-FM 21% of mothers reported reading this often. Many (55%) parents, similar to those in this 

study (48%), reported teaching basic concepts to their children (Bradley et al., 2001). 

 

Discipline Practices.    To function well within social groups (and society at large), 

children must not only learn how to regulate their emotions but to control their behavior as well 

(Bronson, 2000). Accordingly, parents must provide the kind of productive discipline that 



36    WHITESIDE-MANSELL ET AL.  

 

 

facilitates behavioral control. There is also evidence that children benefit from positive 

affirmation of worth (Roberts, 1983). Spanking is generally low before 12 months of age (15%) 

and increases as children age with about 50% of children 20 months of age in low-income 

studies being spanked (MacKenzie, Nicklas, Brooks- Gunn, & Waldfogel, 2011). These statistics 

compare with 37.7% across the infant to 36 month range of the IT-FM study. 

 

Routines.    The reorganization needed to adjust to the transition into parenthood or the 

addition of a child often makes establishing a routine difficult (Fiese, Tomcho, Douglas, Josephs, 

Poltrock, & Baker, 2002). In general, an organized home with established routines has been 

shown to be linked to psychological health (Fiese, et al., 2002). Three questions on the IT-FM 

were coded from teacher observations of the physical organization of the home (e.g., 

crowdedness, clutter). Risk identified with this set of questions was correlated with FES conflict 

scale (r =.60, p = .00) and BSI Total (r = .58, p = .00). However, it was not statistically 

significantly related to parent report of chaos (r = .18, p = .30). 

Two key areas related to establishing routines are infant sleep patterns and the use of 

electronic media. Based on the IT-FM interview, children slept 11.4 hours (SD = 1.02) the day 

before the interview compared to the 12-18 recommended by experts (Centers for Disease 

Control and Prevention, n.d.). Other studies report average sleep times of 11.7 for toddlers to 

12.7 for infants (Carskadon, 2004). 

The overuse of TV has been associated with a variety of problems for young children 

including weight gain, health problems, later academic performance, and exposure to poor 

parenting (AAP, Committee on Public Education, 2001; Pagani, Fitzpatrick, Barnett, & Dubow, 

2010). Further, the exposure to inappropriate TV programming has been associated with the 

development of behavior problems (Conners-Burrow, McKelvey, & Fussell, 2011). The America 

Academy of Pediatrics recommends no television for children under 2 years and only 2 hours a 

day for children over 2 (Brown, 2011). Estimates of TV use for young children range 17% for 

children less than a year (Certain &Kahn, 2002), to 11% at 29 months (Pagani, Fitzpatrick, 

Barnett, & Dubow, 2010) to 41% of 24-35 month-olds (Certain &Kahn, 2001). The IT- FM 

identified 20.0% of children with over 2 hours a day. 

 

Surveillance.    A significant proportion of accidental or unintentional injury occurs 

because of parental failure to adequately monitor and supervise children (Garbarino, 1988; 

Saluja, Brenner, Morrongiello, Haynie, Revera, & Chen, 2004). The level of child monitoring is 

connected to parental perceptions about controllability of the hazards (Greaves, Glik, 

Kronenfeld, & Jackson, 1994) and parental mental health (Elgar, Mills, McGrath, Waschbusch, 

& Brownridge, 2007). In this study, monitoring was correlated with the BSI Total (r = -.38, p 

= .01); however it was not statistically significantly correlated with parent report of Risk 

Tolerance (r = .18, p = .24) or belief in fate (r = .22, p = .16). 

 

Exposure to violence.    While the negative impacts of exposure to violence on children 

is well known (e.g., Fitzgerald, McKelvey, Schiffman, & Montanez, 2006; McKelvey, et al., 

2011), the study of the impact of the neighborhood on child development has dramatically 

increased in the 20 years (Sampson, Morenoff, & Gannon-Rowley, 2002). The IT-FM assesses 

children’s exposure to inadequate neighborhood resources somewhat more broadly than the 

Head Start FACES 2002 report and therefore identified more children at potential risk 

(Neighborhood: 26.4% with IT-FM compared to 19% FACES). 



SUPPORTING FAMILY ENGAGEMENT – FAMILY MAP    37 

 

Risks in these areas were expected to be related to parental mental health and parental 

concern for their own and child’s safety (Margolin, & Gordis, 2000; Hughes, 1988). 

Neighborhood Safety risk was correlated with the BSI Total (r = .40, p = .01) and increased 

monitoring (r = -.23, p = .05). Parent report of exposure to violence was associated with parental 

physical activity (r = -.25, p = .04). 

 

Family Cohesion/Conflict.    Families living in poverty often experience elevated levels 

of stress both from the difficulties of managing life with fewer resources and from exposure to 

stressful life events (Conger, & Donnellan, 2007). Stress related to economic hardship can lead 

to conflicts between parents (Belle, 1990). Parenting stress has been implicated in less positive 

interactions between parents and children (Coyl, Roggman, & Newland, 2002), in a higher 

likelihood of child maltreatment and abuse (Rodriguez & Green, 1997), and in higher conflict 

between family members (Almeida, Wethington, & Chandler, 1999). 

National estimates indicate that 13% of children live in households with high parenting 

stress (Raphael, Zhang, Liu, & Giardino, 2010) compared to 21.0% identified with the IT-FM. 

Parents identified with the IT-FM screen for high parenting stress scored higher on the PSI-PCD 

subscale (t(42) = 2.63, p < .05) and the FES conflict scale (t(42) = 2.77, p < .09). Further, the 

parenting stress risk score was significantly correlated with each (r = -.38, p = .012 for PSI-PCD 

and r = .39, p = .008 for FES conflict). 

Based on the National Household Survey on Drug Abuse (NHSDA), it has been 

estimated that 10% of children (more than 6 million) age five and younger have at least one 

parent who is dependent on alcohol or illicit drugs (AOD, Office of Applied Studies, 2003). 

While an assessment of parent substance use is included on the IT-FM, nearly all parents 

indicated it was not a problem for them.  However, the IT-FM screens for homes at risk for AOD 

use expanding the question to include other adults (close family or friends) and includes an 

observation questions (15.0%). Children identified with this definition were more likely to be at 

risk on 10 of 11 additional areas assessed (Conners-Burrow, Johnson, Whiteside-Mansell, 

McKelvey, Bokony, & Bradley, 2011). That is, these questions on the IT-FM identified a high-

risk group of families. 

 

Caregiver Mental Health.    Data from the Head Start FACES 2000 study indicated that 

25% of Head Start parents are moderately or severely depressed (U.S. Dept of HHS, 2003). This 

compares to 18.1% identified using the IT-FM. When the BSI-18 was examined in relation to the 

IT-FM screen, meaningful associations were seen. IT-FM depression risk was correlated with the 

BSI depression (r = .43, p = .002) and families identified as depressed scored higher on the BSI 

Total (t(41) = 3.61, p < .045). BSI Somatization scale was correlated with IT-FM anxiety (r 

= .72, p = .00). The 2 questions used to screen for hostility identified 38.9% of the sample and 

this cut score was correlated with BSI depression (r = .39, p = .01). 

In a study of depressive symptoms identified using the EC-Family Map, Conners- 

Burrow and colleagues (in press), using a series of logistic regression analyses (controlling for 

demographics), found that when mothers reported either low or high levels of depressive 

symptoms, their children were significantly more likely to experience safety risks in the home in 

6 of 7 areas assessed. 

 

 

 



38    WHITESIDE-MANSELL ET AL.  

 

 

DISCUSSION 

 

The recognition of the role of the family and impact of the home environment for child 

outcomes has been acknowledged in quality early childcare programs including Head Start for 

many years. The evaluation of the role of Head Start programs and a useful definition for parent 

involvement has evolved since the beginning of Head Start in 1965. The difficulty has been 

identifying the process to efficiently identify the needs and strengths of families and build 

productive parent-teacher partnerships to address the needs. The Family Map Inventories were 

developed to address this problem. This study examined the feasibility of implementation and the 

reliability and validity of the Family Map for the Parenting Environments of Infants and 

Toddlers. 

The Family Map Inventories were designed to be used as part of the required twice yearly 

home visits as in this study. However, the EC-Family Map has been implemented in the field in a 

variety of ways (e.g., parent-teacher conferences) and settings (e.g., home visit programs). 

Program enrollment, parent-teacher conferences, or home visits are ideal opportunities for 

parents and teachers to discuss issues regarding their joint interest in the child; however, in a 

typical parent-teacher visit this opportunity is often missed. The EC-Family Map has also been 

shown to provide data to improve programs (Conners-Burrow, Johnson, Whiteside-Mansell, 

McKelvey, & Bradley, 2010) and document the impact of quality programs like Head Start 

(Whiteside-Mansell, Johnson, Aitken, Bokony, Conners-Burrow, & McKelvey, 2010). 

Results evaluating the feasibility of implementation were consistent with the EC- Family 

Map implementation and generally positive. Families and educators were at least as positive 

about the home visit with the Family Map as without it. As in past studies (Whiteside-Mansell, et 

al, 2007), we found that a small group of teachers were resistant to the implementation. 

Anecdotal reports suggested that educators were concerned about the potential reaction by 

parents. However, at least some part of educator hesitancy was likely the natural resistance to 

change often seen in some individuals. In other studies of the EC-Family Map, qualitative 

evidence suggested that teachers became more comfortable with the experience with the EC-

Family Map as they become more skilled at using the interview (McKelvey, Swindle, Bokony, & 

Patrick, 2011). 

This study supported the reliability of the IT-FM. Unfortunately; few constructs consisted 

of questions appropriate for evaluation using internal consistency. However, of those assessed, 

internal consistency estimates were generally greater than .7. Given the small number of 

questions for each construct, this was noteworthy (i.e., the fewer the questions the lower the 

expected reliability). In addition, the evidence of validity provided implicit support for reliability 

(i.e., reliability is required for validity). 

Evidence of validity was provided in multiple ways. Rates of families/children identified 

as experiencing specific conditions were compared to national studies. The rates in this study 

should be interpreted with caution because of the relatively small numbers (i.e., N = 72 means 

that 10% is only 7 participants); however, in general, similar rates were observed suggesting that 

the short screening questions on the IT-FM were consistent with other studies and national 

estimates. While rates of some concerns were lower than was likely for the general population 

(e.g. substance abuse problems), anecdotal reports from the use of the EC-Family Map indicated 

parents do return to teachers and request help with more sensitive topics (e.g., exposure to 

violence) even when not reporting problems at the initial contact. It is possible that when the 



SUPPORTING FAMILY ENGAGEMENT – FAMILY MAP    39 

 

parent is willing to address the topic, the Family Map has opened the doorway for 

communication. 

Validity was also supported by construct validity for a subset of key measures and direct 

observation confirmed several questions. As predicted, most key measures were related to 

theorized constructs as expected. This is remarkable in that the risk indicators were dichotomous 

(risk/not) and, therefore, the power to observe significant relationships is limited. A strength of 

the validity examination was the confirmation of the home environment using the observational 

measure by trained researchers. Several key indicators of safety were confirmed using 

observational assessments after the educator conducted the Family Map interview. 

The Family Map is scored to identify risk during the home visit (i.e., shaded areas of 

interview). The tradeoff for this quick scoring system is that it was not possible in the 

paper/pencil implementation to bring family strengths to the attention of the dyad. That is, the 

Family Map includes assessments of strength that are sometimes the opposite of risk, but not 

always. Training included an in-depth discussion linking risk and resilience, strategies for 

educators to help families build upon strengths, the role of protective factors, and how to identify 

family strengths from the Family Map interview. For example, parents that provide a warm, 

supportive parenting environment may be protecting their children from a variety of potential 

risks including health related risks (Landry, Smith, Swank, Assel, & Vellett, 2001). 

When conducted as a home visit, the Family Map along with other Head Start activities 

requires a full hour to complete. This is longer than typical screening instruments; however, the 

Family Map is atypical in the comprehensive nature of the screen. When fully integrated, the 

Family Map may replace other program-generated efforts to document parent partnership 

agreements and the related service recommendations. However, it is likely that full integration 

into a program and teacher practice would result in shorter home visits than those reported here. 

This study, in conjunction with the previous study of the EC-Family Map, provides 

empirical evidence of the feasibility and usefulness of the Family Map Inventories in high 

quality childcare programs. This study focused on the implementation and psychometrics and 

found support for the Inventory for parents of infants and toddlers. In addition, the Inventory 

may prove useful in documenting and supporting educators in their efforts to engage families and 

link to critical services to protect children. 

 

 

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