The Voice of Families: Perceptions of Family-Centred Practices and Natural Environments in Early Intervention in Spain

Abstract

Highlights What are the main findings? Coexistence of the traditional clinical model and the model based on routines and natural environments. Families' request for more personalized models, where decision-making responsibility is shared. What is the implication of the main finding? The need to modify the intervention model and gradually introduce models based on routines and natural environments. The need to involve families in the support and decision-making process.Highlights What are the main findings? Coexistence of the traditional clinical model and the model based on routines and natural environments. Families' request for more personalized models, where decision-making responsibility is shared. What is the implication of the main finding? The need to modify the intervention model and gradually introduce models based on routines and natural environments. The need to involve families in the support and decision-making process.Abstract The family-centred Early Intervention model based on routines and natural environments has been widely supported by international evidence in recent decades. Within this framework, Family-Centred Practices (FCP) and their development in natural environments have emerged as an evidence-based intervention model of reference, promoting parental empowerment, shared decision-making, and functional intervention through daily routines. However, its effective implementation in real contexts presents multiple challenges, especially from the perspective of families receiving the service. Background/Objectives: This study explores the experiences, meanings, and assessments of Spanish families with children who have disabilities or developmental difficulties in relation to the application of these professional practices. This study is carried out in the Spanish context, since Campus Capacitas (Campus Capacitas-Catholic University of Valencia, Spain) has been implementing, in recent years, the family-centred model as a model of early intervention. Methods: A qualitative, descriptive, and interpretative methodology was used. Data collection was carried out through semi-structured interviews and discussion groups with 30 families from the 17 Spanish autonomous communities. Data analysis was carried out through thematic coding following criteria of qualitative rigour such as triangulation and theoretical saturation. Results: The findings show a significant gap between the theoretical model of family-centred practices and their practical application. Families who have experienced a clinical model criticise the absence of personalised intervention, unidirectional communication, as well as lack of participation in decision-making. In that sense, it is the different specialists of the early intervention team who are responsible for making intervention decisions. Therefore, these families demand more emotional and educational support. On the other hand, other families report positive experiences associated with collaborative, transdisciplinary, and home-based models based on a family-centred model. Conclusions: The results highlight the urgent need to move towards early intervention that strengthens the active role of families, promotes professional co-responsibility, and adapts to real child development environments, in line with international recommendations. Regarding future lines of research, we are committed to the development of longitudinal studies on the sustainable effects of interventions centred on families and on the global development of children and families. To carry out comparative studies between autonomous communities, to assess the influence of regulatory factors and regional resources on the practices implemented, as well as to carry out triangulation studies of the professional practices implemented, incorporating the perspectives of professionals and other intervention agents to enrich the analysis.