Perceived Parent Needs for Improving Parent Participation in School-Based Therapies for Children with Disabilities Using the Parent-Therapist Partnership Survey
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| Title: | Perceived Parent Needs for Improving Parent Participation in School-Based Therapies for Children with Disabilities Using the Parent-Therapist Partnership Survey |
|---|---|
| Language: | English |
| Authors: | Ashley N. Murphy (ORCID |
| Source: | Journal of Autism and Developmental Disorders. 2025 55(4):1254-1273. |
| Availability: | Springer. Available from: Springer Nature. One New York Plaza, Suite 4600, New York, NY 10004. Tel: 800-777-4643; Tel: 212-460-1500; Fax: 212-460-1700; e-mail: customerservice@springernature.com; Web site: https://link.springer.com/ |
| Peer Reviewed: | Y |
| Page Count: | 20 |
| Publication Date: | 2025 |
| Sponsoring Agency: | National Center for Advancing Translational Sciences (NCATS) (DHHS/NIH), Clinical and Translational Science Awards (CTSA) Program |
| Contract Number: | UL1TR000445 U24TR001579 |
| Document Type: | Journal Articles Reports - Research |
| Descriptors: | Parents, Needs, Parent Participation, Children, Students with Disabilities, Family School Relationship, Allied Health Personnel, Rehabilitation |
| DOI: | 10.1007/s10803-024-06282-w |
| ISSN: | 0162-3257 1573-3432 |
| Abstract: | Rehabilitative and habilitative therapies can help children with disabilities increase independence and overall wellbeing. However, children and their caregivers face many barriers to accessing these therapies and often rely on the school for therapy access. Given the limited resources available within the special education system, increasing parent involvement in special education therapies could improve service delivery. However, providers must first understand what parents need to participate in therapies before attempting to engage families. 217 parents completed an online survey consisting of the Parent-Therapist Partnership Survey and demographic questionnaires about their families and their child[ren] with disabilities. The percentage of needs parents endorsed as important and the percentage of important needs endorsed as unmet were calculated. Differences across demographic variables were assessed. Overall, parents reported an average of 75% of needs as important with significantly more needs endorsed as important regarding being an informed, engaged member of the child's care team (M = 83%) than needs related to support and guidance (M = 65%, p < 0.001). Furthermore, parents reported an average of 58% of important needs as unmet, with no significant differences in subscale averages. Significant associations were found for race/ethnicity, education, income, partner availability, number of children with disabilities in the household, transportation access, neighborhood opportunities, parent efficacy and social, emotional, and behavioral concerns. Parents reported a high percentage of needs as important, but a large percentage of these important needs were considered unmet. Significant disparities based on racial/ethnic identities and access to resources were found. In order to successfully engage parents in special education therapy activities, providers must work to understand and address parents' engagement needs, paying special attention to each family's unique circumstances to optimize engagement. |
| Abstractor: | As Provided |
| Entry Date: | 2025 |
| Accession Number: | EJ1464147 |
| Database: | ERIC |
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| FullText | Links: – Type: pdflink Url: https://content.ebscohost.com/cds/retrieve?content=AQICAHj0k_4E0hTGH8RJwT4gCJyBsGNe_WN95AvKlDbXJGqwxwHD5oXN--QbYqLBp0U-ItpKAAAA4TCB3gYJKoZIhvcNAQcGoIHQMIHNAgEAMIHHBgkqhkiG9w0BBwEwHgYJYIZIAWUDBAEuMBEEDFx6_xsaLhpZkx1hzgIBEICBmRwExIJzsdNSeHEcxCmG3qKqOgKwRPjqOU08g6pCOwiEoZNkzVeZaNpes9Gv51qaTmXAq-ZGQnDiMIBTxrJLHLHJ7-GyXp1Ea5L6kHoYbHYREaYsby0hjZ60kwegmmZ8HKAxqOyCSRSc6G2yGydZ51zROpdDPrMJTpqbk_IuPhGTKdxrVNImTXGOj1AGgHXwhj9TYiMHAHb3Zw== Text: Availability: 1 Value: <anid>AN0183973028;aut01apr.25;2025Mar26.05:27;v2.2.500</anid> <title id="AN0183973028-1">Perceived Parent Needs for Improving Parent Participation in School-Based Therapies for Children with Disabilities Using the Parent-Therapist Partnership Survey </title> <p>Rehabilitative and habilitative therapies can help children with disabilities increase independence and overall wellbeing. However, children and their caregivers face many barriers to accessing these therapies and often rely on the school for therapy access. Given the limited resources available within the special education system, increasing parent involvement in special education therapies could improve service delivery. However, providers must first understand what parents need to participate in therapies before attempting to engage families. 217 parents completed an online survey consisting of the Parent-Therapist Partnership Survey and demographic questionnaires about theirfamiliesand their child[ren] with disabilities. The percentage of needs parents endorsed as important and thepercentageofimportantneedsendorsedasunmetwere calculated. Differences across demographic variables were assessed. Overall, parents reported an average of 75% of needs as important with significantly more needs endorsed as important regarding being an informed, engaged member of the child's care team (M = 83%) than needs related to support and guidance (M = 65%, p &lt; 0.001). Furthermore, parentsreportedan average of 58% of important needs as unmet, with no significant differences in subscale averages. Significant associations were found for race/ethnicity, education, income, partner availability, number of children with disabilities in the household, transportation access, neighborhood opportunities, parent efficacy and social, emotional, and behavioral concerns. Parents reported a high percentage of needs as important, but a large percentage of these important needs were considered unmet. Significant disparities based on racial/ethnic identities and access to resources were found. In order to successfully engage parents in special education therapy activities, providers must work to understand and address parents' engagement needs, paying special attention to each family's unique circumstances to optimize engagement.</p> <p>Keywords: Parent Involvement; Special Education; Parent Needs; Therapy; Disparities; Related Services; Psychology and Cognitive Sciences Psychology Studies in Human Society Sociology</p> <p>Copyright comment Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</p> <p>Within the U.S., 1 in 6 children are diagnosed with a developmental condition that impacts their physical, language, learning, intellectual, and behavioral functioning (Zablotsky et al., [<reflink idref="bib98" id="ref1">98</reflink>]). For these children, rehabilitative and habilitative therapies (such as physical, occupational, behavioral, or speech therapies and therapies focused on social, emotional, and behavioral concerns) help build new skills, increase independence, and improve their ability to navigate their daily environments (Houtrow et al., [<reflink idref="bib36" id="ref2">36</reflink>]; Myers et al., [<reflink idref="bib59" id="ref3">59</reflink>]; Novak &amp; Honan, [<reflink idref="bib62" id="ref4">62</reflink>]). U.S. therapy services for children with disabilities are available through different modalities depending on a child's age, access to insurance, and needs. The most common modalities are early intervention services for young children (typically ages 0–2 years, with some states allowing access beyond a child's 3rd birthday), special education services for children and young adults ages 3–21 years, and outpatient therapies available to children of all ages with qualifying insurance. This study will discuss the rehabilitative and habilitative services (regardless of specific therapy type) delivered through special education programming.</p> <hd id="AN0183973028-2">Special Education Therapies</hd> <p>Recognizing the imperative nature of therapies on children's outcomes, Part B of the Individuals with Disabilities Education Act (IDEA, [<reflink idref="bib37" id="ref5">37</reflink>]) provides free, school-based therapy services (referred to as related services) as part of special education services for eligible individuals ages 3–21 years. Any relevant therapy service can be included in a child's special education plan (known as an Individual Education Program, or IEP) if it is "required to assist a child with a disability to benefit from special education" (§ 300.34, IDEA, [<reflink idref="bib37" id="ref6">37</reflink>]). Given the accessibility of these services (e.g., delivered in the school during the school day) and the many barriers (such as high costs, limited time and resources, and provider shortages) that limit access to outpatient therapies, many families ultimately rely on the special education system for therapies for their children. Relying on special education therapies presents three problems.</p> <hd id="AN0183973028-3">Limited Parent Participation in Special Education Therapies</hd> <p>For children with intellectual and developmental disabilities, family involvement is often an important component of therapies, particularly for therapies delivered during early childhood where intervention is thought to have the greatest developmental impact (Trivette et al., [<reflink idref="bib89" id="ref7">89</reflink>]; Ziviani et al., [<reflink idref="bib99" id="ref8">99</reflink>]). By involving caregivers in practicing therapy skills outside of therapy sessions, children can practice skills more frequently and in different settings, increasing maintenance and generalizability of skills. These principles are core tenants of Part C of IDEA, which authorizes early intervention services for children ages 0–2 years – as stated in the legislation, "Early intervention is most effective when parents are respected and empowered as consumers and as team members collaborating with professionals" (20 U.S.C. § 1431(a), IDEA, [<reflink idref="bib37" id="ref9">37</reflink>]). Noting the value of building strong parent-therapist partnerships, much work has been done to promote family participation and empowerment in early childhood therapies. This includes the development of family coaching and engagement models produced by the Early Childhood Technical Assistance Center (Frank Porter Graham Child Development Institute, [<reflink idref="bib24" id="ref10">24</reflink>]), the implementation of parent coaching models intended to build parent capacity to practice interventions within the family's daily routine (Rush and Shelden, [<reflink idref="bib73" id="ref11">73</reflink>]), and the rise of parent-mediated interventions (Wetherby et al., [<reflink idref="bib93" id="ref12">93</reflink>]; Wong et al., [<reflink idref="bib96" id="ref13">96</reflink>]; Steinbrenner et al., [<reflink idref="bib83" id="ref14">83</reflink>]).</p> <p>However, when children enter special education, covered under Part B of IDEA, the focus on parent participation in therapy delivery decreases, despite parents still being identified as a member of the child's team, as the focus of services shifts from the family to the child. A special education team can opt to provide parent training as a related service in a child's IEP (§ 1401 (<reflink idref="bib26" id="ref15">26</reflink>)(A), IDEA, [<reflink idref="bib37" id="ref16">37</reflink>]), but parent training and capacity building are not explicitly built into the foundation of special education services in the manner they are for early intervention. Recognizing that parents are still a critical member of the child's special education team, much work has been done around parent engagement in academic work for school-aged children with disabilities (§ 1431(d) (<reflink idref="bib1" id="ref17">1</reflink>) (b), IDEA, [<reflink idref="bib37" id="ref18">37</reflink>]) (Collier et al., [<reflink idref="bib13" id="ref19">13</reflink>]; Francis et al., [<reflink idref="bib23" id="ref20">23</reflink>]; Goldman et al., [<reflink idref="bib28" id="ref21">28</reflink>]). However, the literature has given little attention specifically to parent engagement in special education therapies, particularly for older children. Existing research has mainly focused on parents' perceptions of therapist partnerships when transitioning into special education from early intervention (Douglas et al., [<reflink idref="bib18" id="ref22">18</reflink>]; Podvey, [<reflink idref="bib69" id="ref23">69</reflink>]). The limited work that broadly looks at families with children of all ages in special education therapies indicates high parent dissatisfaction and large numbers of parents' engagement needs as unmet, with these challenges exacerbated by service access challenges during the COVID-19 pandemic (Murphy et al, [<reflink idref="bib57" id="ref24">57</reflink>]; Murphy &amp; Risser, [<reflink idref="bib55" id="ref25">55</reflink>]). While families who transitioned into special education therapies from IDEA Part C early intervention (EI) therapies were in theory taught how to support therapy goals at home, these strategies are often not reinforced in special education services as parents report high unmet needs related to being taught how to support therapies at home (Murphy &amp; Risser, [<reflink idref="bib55" id="ref26">55</reflink>]; Murphy et al, [<reflink idref="bib57" id="ref27">57</reflink>]). Furthermore, many parents report confusion, stress, and minimal collaboration when first working with their child's special education therapists, which further undermines parents' abilities to use previously learned skills (Podvey et al., [<reflink idref="bib69" id="ref28">69</reflink>]; Pinkerton et al, [<reflink idref="bib68" id="ref29">68</reflink>] Moreover, many children do not receive early intervention services due to receiving diagnoses after the EI age cutoff or due to difficulties accessing timely early intervention services (Knopf, [<reflink idref="bib41" id="ref30">41</reflink>]; Nahmias et al., [<reflink idref="bib60" id="ref31">60</reflink>]; Shenouda et al., [<reflink idref="bib76" id="ref32">76</reflink>]; Zuckerman et al., [<reflink idref="bib100" id="ref33">100</reflink>]). Thus, special education providers cannot assume families are appropriately trained to support special education therapies at home prior to entering special education. Additionally, parents' involvement often decreases as children get older and prepare to exit the school system. Co-occurring at this time, special education services begin to shift towards focusing on building the child's independence during transition planning; this shift further limits opportunities for and focus on parent involvement in interventions, even though consistent intervention across settings and parent intervention support can still positively benefit children's development (Defur et al., [<reflink idref="bib16" id="ref34">16</reflink>]; Geenan et al., [<reflink idref="bib26" id="ref35">26</reflink>]; Landmark et al., [<reflink idref="bib44" id="ref36">44</reflink>]). Overall, parents ultimately have limited involvement in special education therapies. Their absence limits the intervention efficacy of school-based therapies—the therapy delivery setting that is often the most accessible to families.</p> <hd id="AN0183973028-4">Limited Special Education Funding</hd> <p>Limited funding, resources, and providers often results in special education therapies inadequately meeting children's needs (Houtrow et al., [<reflink idref="bib36" id="ref37">36</reflink>]; Lindly et al., [<reflink idref="bib46" id="ref38">46</reflink>]; Majnemer et al., [<reflink idref="bib50" id="ref39">50</reflink>]; Montes et al., [<reflink idref="bib53" id="ref40">53</reflink>]; Murphy &amp; Risser, [<reflink idref="bib55" id="ref41">55</reflink>]; Russell &amp; McCloskey, [<reflink idref="bib74" id="ref42">74</reflink>]). Given restricted resources, many children receive limited-service minutes, providing less therapy dosage than what is actually needed for children to make meaningful gains. These disparities are further exacerbated for children of color, who do not speak English as a primary language, who live in poverty, or who live in low-resourced communities where school funding and resources are more limited (Ali et al., [<reflink idref="bib3" id="ref43">3</reflink>]; Blue Banning et al., [<reflink idref="bib9" id="ref44">9</reflink>]; Harry, [<reflink idref="bib34" id="ref45">34</reflink>]; Stein &amp; Silver, [<reflink idref="bib82" id="ref46">82</reflink>]). This issue becomes even more significant and inequitable for children who cannot access therapies outside of special education as they must rely on the limited services provided to them in their IEP by the school. Given the long history of underfunding and limited resources in the special education system, a solution to increase the dosage of special education therapies will require addressing policy and implementation that restrict school resources (Kolbe et al., [<reflink idref="bib42" id="ref47">42</reflink>]; Losen &amp; Orfield, [<reflink idref="bib48" id="ref48">48</reflink>]; Morgan et al., [<reflink idref="bib54" id="ref49">54</reflink>]). However, creative solutions to improve therapy quality, such as increasing intervention dosage through practice outside of therapy sessions, are also warranted (Murphy et al, [<reflink idref="bib57" id="ref50">57</reflink>]; Murphy &amp; Risser, [<reflink idref="bib55" id="ref51">55</reflink>]).</p> <hd id="AN0183973028-5">Special Education Philosophy</hd> <p>As stated in IDEA, early intervention seeks "to enhance the development of infants and toddlers with disabilities, to minimize their potential for developmental delay, and to recognize the significant brain development that occurs during a child's first 3 years of life" (§ 1431(a), IDEA, [<reflink idref="bib37" id="ref52">37</reflink>]). In contrast, while special education services are required to take into consideration "the academic, developmental, and functional needs of the child" (§ 1414(d)(<reflink idref="bib3" id="ref53">3</reflink>)(a)(iv), IDEA, [<reflink idref="bib37" id="ref54">37</reflink>]), the primary focus of special education is to help children achieve a free and appropriate public education. Thus, special education and its related therapies do not necessarily seek to holistically support a child's development outside of needs related to school functioning. Given limited school resources, this discrepancy prevents schools from prioritizing holistic developmental outcomes, despite the important role developmental skills taught in therapies play in facilitating long-term academic and functional abilities. Instead, schools only focus on providing the bare minimum therapies to improve a specific domain of school functioning.</p> <p>Given the importance of consistent, long-term therapy skills practice for children with developmental disabilities, using special education therapies only as a mechanism to improve academic functioning instead of as a critical tool to improve long-term developmental outcomes limits the efficacy of these services and can decrease the slope of the trajectory of a child's developmental progress. These limitations ultimately limit the number of and degree to which individuals with disabilities can develop critical skills that increase their independence and sense of autonomy throughout life. Given the limited resources available in the special education system, policy changes are needed to require that therapies address developmental outcomes beyond the limited scope of specific academic tasks. Building parent capacity and involvement can also help increase the scope of therapies, as families will likely be able to bring a perspective of how therapy skills can impact a child's functioning across settings and across the lifespan.</p> <hd id="AN0183973028-6">Parent Therapy Involvement</hd> <p>Given limited resources available in the special education system, including parents in reinforcing special education therapy skills, as outlined by a child's IEP goals for each therapy type, can serve as a cost-effective, equitable mechanism to increase the dosage and efficacy of therapies. COVID-19 pandemic stay-at-home orders further elucidated parents' interest in participating in school-based therapies as many families suddenly had to take on intervention practice at home. Despite the increased effort required from the family, many parents reported enjoying the increased involvement with therapy practice and wanting support around how to facilitate therapeutic progress at home (Murphy et al., [<reflink idref="bib57" id="ref55">57</reflink>]; Pinkerton et al., [<reflink idref="bib68" id="ref56">68</reflink>]).</p> <p>In general, parental therapy involvement, ranging in scope from practicing exercises at home to fully parent-mediated interventions, has a host of benefits for treatment quality and therapeutic outcomes (Green et al., [<reflink idref="bib30" id="ref57">30</reflink>]; Haine-Schlagel &amp; Walsh, [<reflink idref="bib32" id="ref58">32</reflink>]; Haine-Schlagel et al., [<reflink idref="bib33" id="ref59">33</reflink>]; Shire et al., [<reflink idref="bib77" id="ref60">77</reflink>]; Trembath et al., [<reflink idref="bib88" id="ref61">88</reflink>]). By supporting parents to reinforce therapy skills practice outside of therapy sessions, parents increase the dosage of therapy intervention across multiple settings, further promoting the maintenance and generalization of skills beyond the limited number of services minutes provided within a school therapy session (Gunning et al., [<reflink idref="bib31" id="ref62">31</reflink>]). Furthermore, parent therapy participation improves parent stress, competence, sense of efficacy, and their relationship with the child, all of which could further benefit the child's development (Leadbitter et al., [<reflink idref="bib45" id="ref63">45</reflink>]; Ollendick et al., [<reflink idref="bib66" id="ref64">66</reflink>]; Stuttard et al., [<reflink idref="bib84" id="ref65">84</reflink>], [<reflink idref="bib85" id="ref66">85</reflink>]; Weiss et al., [<reflink idref="bib92" id="ref67">92</reflink>]).</p> <p>However, in contrast to other therapy modalities with rich bodies of literature on parent involvement and coaching, significant work is still needed to determine exactly how parent involvement in special education therapies should look. Currently, minimal research has examined current parent involvement, engagement, and capacity-building in school-based therapies as well as how therapy involvement skills could feasibly and sustainably be cultivated. Other service modalities that incorporate varying levels of parent involvement (including early intervention and family-centered outpatient services) can provide general frameworks for adaption specifically for the unique constraints of the special education system. For example, evidence-based, parent-mediated therapies used in other service modalities—such as naturalistic developmental behavioral interventions (Schreibman et al., [<reflink idref="bib75" id="ref68">75</reflink>]) and positive parenting interventions to decrease challenging behaviors (for example, Triple P and the RUBI Framework) — can provide a starting point for identifying key parent-focused skills and knowledge that can feasibly be implemented within special education services. Additionally, these programs can also highlight policy and practice changes needed to facilitate opportunities for parent involvement and capacity building in special education therapies to align with best practices in other service modalities. However, an arguably even more important first step to increasing parent involvement in school-based therapies involves understanding what is needed for both schools and parents to feasibly implement and engage in interventions, as many families relying on the special education system for therapies already face cultural, linguistic, information and resource barriers that prevent their engagement and participation in special education and its associated therapies (Alegria et al., [<reflink idref="bib1" id="ref69">1</reflink>]; Olivos et al., [<reflink idref="bib65" id="ref70">65</reflink>]; Williams, [<reflink idref="bib94" id="ref71">94</reflink>]). For example, parents have reported feeling excluded from special education therapies due to confusion about special education terminology and services, frustration with limited service offerings, and lack of parent inclusion by the child's special education team— barriers which are exacerbated for families who come from culturally and linguistically diverse backgrounds (Douglas et al., [<reflink idref="bib18" id="ref72">18</reflink>]; Harry, [<reflink idref="bib34" id="ref73">34</reflink>]; Podvey, [<reflink idref="bib69" id="ref74">69</reflink>]). Parents also face practical barriers to engaging with school-based therapies such as limited time, inability to take off work, or a lack of childcare. Thus, to be able to feasibly engage parents in interventions that allow parents to more actively engage in school-based therapy services, schools and providers must understand parents' most significant engagement needs and plan around these needs.</p> <hd id="AN0183973028-7">Current Study</hd> <p>This study examines parents' responses to the Parent-Therapist Partnership Survey (PTPS; Murphy et al, [<reflink idref="bib58" id="ref75">58</reflink>]) regarding what needs they believe are important to support parent engagement in special education therapies, as well as if parents perceive these needs as being met. Furthermore, this study seeks to examine how sociodemographic factors impact parent ratings of needs endorsed as important, as well as unmet, to inform the individualization of support based on families' unique circumstances. In pilot studies, parents reported an average of 83% of items on the PTPS as important but endorsed 51% of their important needs as unmet. Additionally, preliminary disparities were identified for parents with multiple children with disabilities, as well as for parents of color (Murphy &amp; Risser, [<reflink idref="bib55" id="ref76">55</reflink>]). However, this pilot study presents multiple limitations: only 41 parents were included, the sample had limited diversity, and the measure utilized had not undergone psychometric evaluation.</p> <p>The current study assesses PTPS needs in a larger and more diverse sample while considering a wider range of sociodemographic factors that could impact a parent's ability to engage with special education therapies. In particular, this study assesses child, family, and community level-factors within a socioecological framework, as parent involvement and engagement in school-based services can be influenced by factors across systems and levels. (Bronfrenbrenner, [<reflink idref="bib10" id="ref77">10</reflink>]) Additionally, a socioecological framework allows practitioners, policymakers, and researchers to identify disparities and potential interventions targeted within the specific systems in which they interact, allowing for more targeted and impactful efforts.</p> <p>This study examines two overarching research questions. First, what needs do parents consider important, and do they consider their important needs as met? Second, how are sociodemographic factors across child, family, community, and systems levels associated with the percent of needs reported as important and the percent of important needs endorsed as unmet? Together, these aims seek to provide foundational findings regarding what needs parents and families view as important as well as unmet regarding their ability to participate in special education therapies. Moreover, these findings aim to provide insight into unique family factors that impact perceived needs to support providers in tailoring engagement interventions to best meet each family's needs.</p> <hd id="AN0183973028-8">Methods</hd> <p></p> <hd id="AN0183973028-9">Procedure</hd> <p>This study was first reviewed and approved by Northwestern University's IRB (STU00210386). A waiver of signature was requested and granted due to this survey collecting minimal identifying information and being completed completely online. The study was first advertised to U.S. caregivers and parents who were legal guardians (referred to as parents) of individuals with disabilities ages 3–21 years receiving special education therapies were contacted through Facebook groups, local community organizations, Researchmatch.org, and Facebook Ads. Inclusion criteria allowed caregivers of young adults to participate, as eligible individuals can receive special education services (and thus, special education therapies) until their 22nd birthday. Parents could have children with any disability who received any therapies so long as they were receiving therapies through special education. Exclusion criteria consisted of parents outside of the U.S. and parents of children who were not receiving any form of special education therapy.</p> <p>Respondents first completed an online consent form then completed a REDCap survey with a battery of questionnaires that took a median time of 18 min to complete. The mean time was 45 min, although 8 responses had completion times 3.5 h or longer which skewed this finding. With these outliers removed, the mean completion time was 22 min. Only part of the battery findings are discussed in this study, as the qualitative findings will be discussed elsewhere. No identifying information, including IP addresses, was collected unless parents indicated they would like to receive a copy of the study's findings via email. Parents had the option to receive a report of the study results via email as well as to enter a raffle for one of three $25 visa gift cards upon survey completion by providing contact information in a separate, unlinked survey. Data was collected from July 8, 2020, to February 5, 2021. Given that data was collected during the COVID-19 pandemic, parents were asked to provide responses based on their lives prior to the pandemic. To allow parents the opportunity to share their experiences during the pandemic and to clearly delineate experiences before and during the pandemic, parents were given the option to share their experiences with parent-therapist partnerships and service delivery during the pandemic in a separate set of questions that were not analyzed.</p> <p>Following data collection, responses from respondents who did not have at least one child with a disability ages 3–21 years were removed. In addition, responses from respondents that did not indicate at least one child was receiving at least one special education therapy were removed. Data cleaning occurred using the programming software R.</p> <hd id="AN0183973028-10">Survey Design</hd> <p>Respondents answered a survey battery consisting of parent, child, and family demographic questions aligned to the variables listed in Table 1. They also provided information about each of their children with a disability including what special education therapies each child received, any outpatient therapies, and what disabilities each child had. Parents also completed validated measures of child impairment by domain (ABILITIES Index), the Efficacy subscale of the Parent Sense of Competence scale, and the Parent-Therapist Partnership Survey. The survey was designed using a branching logic, so parents only completed questions relevant to them and to each of their children with a disability. Parents could provide information on up to four children with disabilities (demographics, ABILITIES Index, therapies) providing information in descending age order.</p> <p>Table 1 Variables assessed and corresponding ecological system level</p> <p> <ephtml> &lt;table frame="hsides" rules="groups"&gt;&lt;thead&gt;&lt;tr&gt;&lt;th align="left"&gt;&lt;p&gt;Ecological System Level&lt;/p&gt;&lt;/th&gt;&lt;th align="left" /&gt;&lt;th align="left"&gt;&lt;p&gt;Variable Assessed&lt;/p&gt;&lt;/th&gt;&lt;/tr&gt;&lt;/thead&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td align="left" rowspan="10"&gt;&lt;p&gt;Individual&lt;/p&gt;&lt;/td&gt;&lt;td align="left" rowspan="6"&gt;&lt;p&gt;Child&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;Age&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;School Setting&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Race and Ethnicity&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Disability Type&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Domain of Impairment (ABILITIES Index)&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Receipt of Outpatient Therapies&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" rowspan="4"&gt;&lt;p&gt;Parent&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;Race and ethnicity&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Employment Status&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Having a spouse or partner at home&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Parent Self-Efficacy&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" rowspan="4" colspan="2"&gt;&lt;p&gt;Family and Household&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;Household income&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Number of Total Children&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Number of Children with a Disability&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Transportation Barriers&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" rowspan="2" colspan="2"&gt;&lt;p&gt;Community&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;Community Setting&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Rural-Urban Codes&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" colspan="2"&gt;&lt;p&gt;Systemic&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;Childhood Community Index&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt; </ephtml> </p> <p>Note. This table provides a multi-level overview of the variables under consideration for an association with parent-reported important needs and unmet needs</p> <hd id="AN0183973028-11">Measures</hd> <p></p> <hd id="AN0183973028-12">Parent, Child, and Family Demographic Questionnaires</hd> <p>Respondents completed a series of open and closed questions about their demographic characteristics, their access to resources, and their family composition. For respondents with spouses and partners, respondents provided basic demographic information on their partners. Parents also indicated how many children in the household had a disability. For the four oldest children with disabilities, parents provided information on each child's demographic profile, information on the types and severities of the child's disabilities, and the types and quantities of therapies the child received in school and outpatient settings. Parents were asked to answer all responses in terms of their experience prior to the start of the pandemic.</p> <hd id="AN0183973028-13">ABILITIES Index</hd> <p>The ABILITIES Index is an instrument designed for practitioners and caregivers to document the nature and severity of childhood disability across 9 functional domains (Simeonsson et al., [<reflink idref="bib80" id="ref78">80</reflink>]). Respondents were asked to make ratings of their child's level of impairment in each domain, as compared to children of the same age. The ABILITIES Index assess the following nine domains: (<reflink idref="bib1" id="ref79">1</reflink>) Audition (Hearing), (<reflink idref="bib2" id="ref80">2</reflink>) Behavior &amp; Social Skills (divided into Social Skills and Inappropriate Behaviors), (<reflink idref="bib3" id="ref81">3</reflink>) Intellectual Functioning (Thinking &amp; Reasoning), (<reflink idref="bib4" id="ref82">4</reflink>) Limbs (Use of Hands, Arms, &amp; Legs), (<reflink idref="bib5" id="ref83">5</reflink>) Intentional Communication (Divided into Understanding Others &amp; Communicating with Others), (<reflink idref="bib6" id="ref84">6</reflink>) Tonicity (Muscle Tone), (<reflink idref="bib7" id="ref85">7</reflink>) Integrity of Physical Health (Overall Health), (<reflink idref="bib8" id="ref86">8</reflink>) Eyes (Vision), and (<reflink idref="bib9" id="ref87">9</reflink>) Structural Status (Shape, Body Form &amp; Structure) (Simeonsson &amp; Bailey, [<reflink idref="bib79" id="ref88">79</reflink>]). Respondents rated their perception of their child's level of functioning on a Likert scale ranging from 1 = Normal to 6 = Profound/Extreme Impairment. Adequate reliability and validity have been established (Bailey et al., [<reflink idref="bib7" id="ref89">7</reflink>]; Buysse et al., [<reflink idref="bib12" id="ref90">12</reflink>]; Lollar et al., [<reflink idref="bib47" id="ref91">47</reflink>]).</p> <hd id="AN0183973028-14">Parent Sense of Competence Scale (PSOC)</hd> <p>The PSOC is a commonly used measure of perceived parenting satisfaction and self-efficacy (Gilmore &amp; Cuskelly, [<reflink idref="bib27" id="ref92">27</reflink>]; Johnston &amp; Mash, [<reflink idref="bib39" id="ref93">39</reflink>]). The PSOC consists of 17 items across Satisfaction and Efficacy subscales (Ohan et al., [<reflink idref="bib64" id="ref94">64</reflink>]). Respondents indicate their level of agreement on a 5-point Likert scale (ranging from "Strongly Disagree" to "Strongly Agree"), and higher total scores indicate higher levels of satisfaction and efficacy. For the purposes of this study, the authors only used the 7-item Efficacy subscale. Several studies have reported acceptable levels of internal consistency for the PSOC (Johnston &amp; Marsh, [<reflink idref="bib39" id="ref95">39</reflink>]; Lovejoy et al., [<reflink idref="bib49" id="ref96">49</reflink>]; Ohan et al., [<reflink idref="bib64" id="ref97">64</reflink>]).</p> <hd id="AN0183973028-15">Parent-Therapist Partnership Scale (PTPS)</hd> <p>The PTPS is a parent report measure that includes 36 items that are related to needs parents might have to be able to engage and participate in their children's school-based therapies. Examples of needs assessed on the PTPS include "That I am needed in helping with my child's therapies" and "That I be informed about all therapeutic interventions my child will receive." The PTPS consists of two sub-scales: (a) Parent's needs for support and guidance (Support and Guidance); and (b) Parent's need to be informed, engaged members of their child's care team (Care Team Members). The measure asks parents to rate the importance of each item on a five-point Likert scale (ranging from "Does Not Concern Me" to "Very Important"). In addition, respondents were asked to rate "How well, and to what extent, do [they] feel [each need] is being met" on a five-point Likert scale (ranging from "Not at All" to "Fully") for all items endorsed as at least somewhat important. To score the PTPS, items endorsed as important are summed, and a percent of needs endorsed as important is calculated. For unmet needs, important items endorsed as unmet are summed, and a percent of important needs endorsed as unmet is calculated. Psychometric studies of the PTPS found adequate internal consistency (α = 0.93) and good face reliability when reviewed by caregivers (Murphy et al., [<reflink idref="bib58" id="ref98">58</reflink>]).</p> <p>More broad assessments exist to assess the needs of parents of children with developmental disabilities in early intervention settings, hospital settings, and in general day-to-day settings as well as satisfaction with parent-provider relationships (Algood et al., [<reflink idref="bib2" id="ref99">2</reflink>]; Alsem et al., [<reflink idref="bib4" id="ref100">4</reflink>]; Bailey &amp; Simeonsson, [<reflink idref="bib5" id="ref101">5</reflink>]; Dunst, [<reflink idref="bib19" id="ref102">19</reflink>]; Siebes et al., [<reflink idref="bib78" id="ref103">78</reflink>]; Wang et al., [<reflink idref="bib91" id="ref104">91</reflink>]). The PTPS is the only measure that specifically assesses the importance and degree unmet of parent needs specifically related to the special education therapies. This measure was initially adapted from the Needs of Parents Questionnaire (Kristjánsdóttir, [<reflink idref="bib43" id="ref105">43</reflink>]) and through a review of broader measures of parent needs, including the Family-Professional Partnership Scale (Summers et al., [<reflink idref="bib86" id="ref106">86</reflink>]), based on a multidisciplinary literature review of important needs for parents in school settings, pilot tested with parents of children ages 3–21 years receiving special education therapies, refined with parent input, and psychometrically tested.</p> <hd id="AN0183973028-16">Childhood Opportunity Index 2.0 (COI)</hd> <p>The COI is a comprehensive measurement tool that assesses the opportunities available to children in different zip codes. The standardized index accounts for 29 indicators involved in child development that assess education, health and environment, and social and economic opportunities (Noelke et al., [<reflink idref="bib61" id="ref107">61</reflink>]). The COI is either reported as a standardized score out of 100, or it is reported in 5 categories ranging from Very Low to Very High opportunity.</p> <hd id="AN0183973028-17">Primary Rural Urban Community Codes (RUCA)</hd> <p>Developed by the U.S. Department of Agriculture (USDA), primary RUCA codes classify U.S. zip codes into standardized levels of urbanicity and rurality, ranging from ratings of "Metropolitan area core: primary flow within an urbanized area" (<reflink idref="bib1" id="ref108">1</reflink>) to "Rural areas: primary flow to a tract outside an urban area or urban cluster (<reflink idref="bib10" id="ref109">10</reflink>). RUCA codes account for population density, urbanization, and daily commuting flows. Ratings are based on the data from the 2010 U.S. Census and 2006–2010 American Community Survey (USDA Economic Research Service, [<reflink idref="bib90" id="ref110">90</reflink>]). Data was used from 2010 RUCA codes, last updated in August 2020, which are the most recently available codes.</p> <hd id="AN0183973028-18">Data Analysis</hd> <p>Data was pulled from REDcap and analyzed using the programming software R. Prior to analyses, data was reviewed for completeness, and responses with extensive missing values were removed. To ensure that results only examined families with children receiving related services, responses where the oldest child was under 3 or there was no reported related service provision for any of the children with disabilities were removed.</p> <p>Percentages of total needs indicated as important and unmet for the overall measure as well as for subscales were calculated for each participant. Using Murphy &amp; Risser's ([<reflink idref="bib55" id="ref111">55</reflink>]) previous methodology, an item was considered important of responder rated it as "Important" or "Very Important". Items were considered unmet if responders rated it as "Not at All", "Seldom", or "To Some Extent" met.</p> <p>Differences in percentages of needs endorsed as important and unmet were examined for all relevant parent demographics. To examine child demographics, only responses from parents with one child with a disability were used to more clearly assess the association with PTPS scores. Differences were assessed for the measure's overall percentages of needs endorsed as important and overall percentage of important needs endorsed as unmet.</p> <p>Regarding specific statistical procedures, homogeneity of variance was assessed for each categorical variable using Levene's Test. For variables with two categories, T-tests were used to assess statistically significant differences if assumptions were met. If assumptions were not met, Wilcoxon rank sum tests were used. For variables with more than two categories, one-way ANOVAs were conducted, with group comparisons being conducted with post-hoc analyses with Tukey's Honest Significant Difference Test used if assumptions were met. If not, a Kruskal Wallace ANOVA was conducted, with group comparisons being conducted with post-hoc analyses conducted using Dunn's Test. For continuous and integer variables, correlations were assessed by calculating the Pearson correlation coefficient. For comparisons of integer variables and ordinal variables (e.g., ratings on the ABILITIES Index), Kendall's Tau Correlation test was used.</p> <hd id="AN0183973028-19">Results</hd> <p></p> <hd id="AN0183973028-20">Respondent Demographics</hd> <p>The survey was opened 656 times, 400 parents consented, and 241 parents completed the battery of measures. In total, 217 responses remained after removing ineligible responses.</p> <p>Respondents were on average 41 years old (<emph>SD</emph> = 7.1, range: 22–60) and had 2.2 (<emph>SD</emph> = 1.2, range 1–8) children. They were also predominantly female (89%) and married (69%). 90% were biological parents, 8% adoptive parents, and 1% foster parents. Eighty (37%) respondents reported parenting their child[ren] with a disability equally with a partner, and 135 (62%) respondents reported being the primary caregiver. Of respondents with partners, 78 respondents (36%) reported having "a lot of support" in parenting from their partners, 40 (18%) reported "a fair amount of support", 31 (14%) reported "some support," and 17 respondents (8%) reporting having "no support or minimal support". Thirty-seven (17%) respondents reported additional parenting support from other adults besides their partner.</p> <p>Regarding transportation access, most respondents (84%) reported easily being able to get where they need to go with 92% having access to a car and 72% having access to public transportation. Respondents who did experience transportation challenges reported access to childcare, cost, location, time, safety, and mobility as the most common barriers.</p> <p>Respondents had 248 children with IEPs who were on average 10 years old (<emph>SD</emph> = 4.6, range 3–21). Children had an average of 2.9 (<emph>SD</emph> = 1.9, range: 0–10) respondent-reported diagnoses. Children received an average of 2.3 therapies through special education (<emph>SD</emph> = 1.1, range: 1–6). Children who received therapies in outpatient settings received an average of 1.1 outpatient therapies (<emph>SD</emph> = 1.27, range 0–6). In total, children received an average of 3.4 therapies (<emph>SD</emph> = 1.9, range: 1–10). Additional demographic data for both children and caregivers are found in Tables 2 and 3.</p> <p>Table 2 Sociodemographic characteristics of parent respondents</p> <p> <ephtml> &lt;table frame="hsides" rules="groups"&gt;&lt;thead&gt;&lt;tr&gt;&lt;th align="left"&gt;&lt;p&gt;Sample Characteristics&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;&lt;italic&gt;n&lt;/italic&gt;&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;%&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;M&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;SD&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;Range&lt;/p&gt;&lt;/th&gt;&lt;/tr&gt;&lt;/thead&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Parent Age&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;41.3&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;7.1&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;22&amp;#8211;60&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Race/Ethnicity&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; American Indian/Alaskan Native&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;5&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;2%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Asian&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;8&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;4%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Black or African American&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;25&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;11%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Hispanic or Latino&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;19&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;9%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; White&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;142&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;65%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Other&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;4&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;2%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Multiple&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;11&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;5%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Prefer Not to Say&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;3&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Marital Status&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Single&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;36&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;17%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Living with a Partner&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;13&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;6%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Married&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;149&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;69%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Divorced/Separated&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;19&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;9%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Highest Household Education&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Some High School&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;3&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; High School/GED&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;19&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;9%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Some College&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;18&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;8%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Associate or Vocational Program&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;25&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;12%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Bachelor's Degree&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;67&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;31%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Master's Degree&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;66&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;30%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Professional Degree&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;19&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;9%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Income&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Below $50,000&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;55&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;25%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; $50,000 - $99,999&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;62&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;29%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; $100,000 - $149,999&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;37&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;17%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; $150,000 and Above&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;42&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;20%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Prefer Not to Say&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;17&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;8%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Community Setting&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Rural&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;28&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;13%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Suburban&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;136&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;63%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Urban&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;51&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;24%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Prefer not to Say&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;2&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Children with a Disability&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 1&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;169&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;78%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 2&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;39&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;18%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 3&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;4&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;2%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 4+&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;5&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;2%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt; </ephtml> </p> <p>Note. Table displays parent respondents (<emph>N</emph> = 217) self-reported sociodemographic data</p> <p>Table 3 Sociodemographic characteristics of children</p> <p> <ephtml> &lt;table frame="hsides" rules="groups"&gt;&lt;thead&gt;&lt;tr&gt;&lt;th align="left"&gt;&lt;p&gt;Sample Characteristics&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;&lt;italic&gt;n&lt;/italic&gt;&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;%&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;M&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;SD&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;Range&lt;/p&gt;&lt;/th&gt;&lt;/tr&gt;&lt;/thead&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Child Age&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;10&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;4.6&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;3&amp;#8211;21&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Race/Ethnicity&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; American Indian/Alaskan Native&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;3&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Asian&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;4&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;2%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Black or African American&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;25&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;11%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Hispanic or Latino&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;15&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;7%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; White&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;145&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;64%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Other&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;7&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;3%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Multiple&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;25&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;11%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Prefer Not to Say&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;3&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Disability Type&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; ADHD&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;93&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;38%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; ASD&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;113&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;46%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Cognitive/Intellectual Impairment&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;45&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;18%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Deafness&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;4&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;2%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Developmental Delay&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;100&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;40%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Emotional/Behavioral Disorder&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;44&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;18%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Hearing Impairment&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;23&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;9%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Motor/Physical Impairment&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;48&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;19%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Medical (Other Health) Impairment&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;49&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;20%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Specific Learning Disability&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;35&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;14%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Speech/Language Impairment&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;106&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;43%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Traumatic Brain Injury&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;10&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;4%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Visual Impairment&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;25&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;10%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;School-Based Therapy&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;2.2&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1.1&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1&amp;#8211;6&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Physical Therapy&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;74&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;30%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Occupational Therapy&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;143&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;58%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Psychological Services&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;60&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;24%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Speech/Language Therapy&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;189&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;76%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Social Work&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;89&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;36%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Vision Services&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;7&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;3%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Hearing Services&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;3&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;2%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; Nursing Services&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;2&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Receipt of Outpatient Services&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;139&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;56%&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Average Outpatient Services&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;1.1&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1.3&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0&amp;#8211;6&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Average Total Services&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;3.4&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;2.0&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1&amp;#8211;10&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Total Reported Disabilities&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;2.9&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;2.0&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1&amp;#8211;10&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;ABILITIES Score&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;26.3&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;9.7&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;11&amp;#8211;56&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt; </ephtml> </p> <p>Note. Sociodemographic data for children (<emph>N</emph> = 248) was collected from parent respondents</p> <hd id="AN0183973028-21">Research Question 1: What Needs Do Parents Consider Important, and Do They Consider Their Imp...</hd> <p>Regarding needs endorsed as important, respondents endorsed an overall average of 74.6% (<emph>SD</emph> = 19.5%, range: 16.7–100%) items as important. All but two of the 36 items were endorsed as important by over 50% of caregivers (Table 4). Parents endorsed an average of 64.8% of items as important on the Support and Guidance scale (<emph>SD</emph> = 25.9%, range: 5.9–100%) and 83.3% of items as important on the Care Team Member subscale (<emph>SD</emph> = 17.4, range: 15.8–100%), with a significantly higher percentage of important needs on the Care Team Member subscale than the Support and Guidance subscale (<emph>W</emph> = 13,079, <emph>p</emph> &lt; 0.001).</p> <p>Table 4 Parent-Therapist partnership survey item analysis</p> <p> <ephtml> &lt;table frame="hsides" rules="groups"&gt;&lt;thead&gt;&lt;tr&gt;&lt;th align="left" /&gt;&lt;th align="left"&gt;&lt;p&gt;Needs Endorsed as Important&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;Important Needs Endorsed as Unmet&lt;/p&gt;&lt;/th&gt;&lt;/tr&gt;&lt;/thead&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td align="left" colspan="3"&gt;&lt;p&gt;&lt;bold&gt;Parents' Need for Support and Guidance&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 1. That school-based clinicians recognize the feelings of parents.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;87%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;48%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 2. To feel I am important in helping with my child's needs and services.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;79%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;42%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 3. That there is flexibility in the interventions that school-based clinicians provide based on my family's needs.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;77%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;63%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 4. To have a person at the school especially assigned to respond to parents' needs.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;76%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;59%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 5. That I get information on how to handle my child's behavior.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;75%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;55%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 6. That I do not feel judgement from school-based clinicians that I am not doing enough to help my child.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;69%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;34%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 7. That I get the chance to speak with school-based clinicians alone about my own feelings/worries.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;65%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;54%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 8. That I feel less anxious about the needs my child has.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;63%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;62%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 9. To feel that I am needed in helping with my child's therapies.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;63%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;36%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 10. Recognize cultural differences.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;63%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;31%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 11. To be able to talk to other parents who have children with needs like my child.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;63%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;73%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 12. To feel that I am needed in helping with my child's therapies.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;63%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;36%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 13. To talk to school-based clinicians about how to explain my child's needs and therapies to my child.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;60%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;56%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 14. To know I can contact school-based clinicians after my child is done with their services. For example, when my child moves schools or graduates.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;60%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;52%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 15. To feel I am not blamed for the special needs my child has.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;56%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;21%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 16. That I get support to recognize and understand my own needs. For example, when I am feeling anxious or tired.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;54%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;55%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 17. To get advice from school-based clinicians about how to get support from family and friends regarding my child's needs.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;47%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;53%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 18. To have a planned meeting with other parents to discuss the experience of our children receiving school-based therapies.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;47%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;55%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" colspan="3"&gt;&lt;p&gt;&lt;bold&gt;Parents' Need to Be Informed, Engaged Members of the Child's Care Team&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 19. That I be informed about all therapeutic interventions my child will receive.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;96%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;44%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 20. To be told what therapies my child needs and what therapies the school can actually provide.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;94%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;54%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 21. That I get specific information about my child's unique needs.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;94%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;53%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 22. That clinicians consult me about the school-based therapies my child needs.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;93%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;46%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 23. To learn about how my child's needs and therapies affect their growth and development.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;91%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;51%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 24. That I be allowed to make the final decision about the therapeutic interventions my child will get, after school-based clinicians tell me about what interventions they are proposing for my child.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;91%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;47%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 25. That I get advice about the services my child will need in preparation for when my child moves to a new grade or a new school.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;88%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;63%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 26. That I learn how to recognize my child's therapeutic needs.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;87%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;58%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 27. That I be told as soon as possible about results from tests done on my child by school-based clinicians.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;85%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;49%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 28. To be told why each therapeutic intervention is being used with my child.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;85%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;50%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 29. That school-based clinicians encourage parents to ask questions.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;85%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;46%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 30. That I regularly receive written information about my child's needs that I can review later.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;84%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;54%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 31. That I get specific information about my child's diagnosis.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;84%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;48%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 32. That school-based clinicians help me understand my child's special education rights.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;83%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;58%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 33. To be able to implement therapeutic strategies at home.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;82%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;59%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 34. That I am taught by school-based clinicians how to help with my child's needs and therapies.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;77%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;65%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 35. That my child's opinion is taken into account when deciding what specific therapeutic interventions my child will receive.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;63%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;55%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 36. To be able to come to the school to observe my child's therapy sessions.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;61%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;53%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt; 37. That I can explain my child's needs and services to friends, family, and other children.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;57%&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;46%&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt; </ephtml> </p> <p>Of items endorsed as important, respondents endorsed an overall average of 57.9% of items as unmet (<emph>SD</emph> = 32.6, range: 0-100%). Overall, 28 of the 36 items were marked as unmet by 50% or more of the caregivers who had endorsed the items as important (Table 4). Parents endorsed an average of 60.6% of important items as unmet (<emph>SD</emph> = 32.0%, range: 0-100%) on the Support and Guidance subscale and 56.1% (<emph>SD</emph> = 34.6%, range: 0-100%) of items on the Care Team Member subscale, with no significant differences between subscales. Figure 1 depicts overall and subscale percentages for both needs endorsed as important and needs endorsed as met.</p> <p>Graph: Fig. 1 Parent respondents endorsement of needs as important and met Note. Figure one displays the percent of needs endorsed as important and percent of needs endorsed as important and met across the entire sample</p> <hd id="AN0183973028-22">Research Question 2: How Are Sociodemographic Factors Across Child, Family, Community, and Sy...</hd> <p>Table 5 lists how participant needs differed by child, parent, family, and community factors. Table 6 lists how needs were associated with parent-reported diagnoses and ABILITIES indices. Tables 3 and 4 list the average percentage, standard deviation, and/or or correlation coefficient for needs endorsed as important or as unmet (descriptive), the statistical findings (statistic), and <emph>p</emph>-values for all tests (<emph>p</emph>-value). For tests where post-hoc comparisons were conducted, the comparison variable is listed with significant post-hoc comparison <emph>p</emph>-values listed. For each level of factor below, needs endorsed as important are discussed first, and important needs endorsed as unmet are discussed second.</p> <p>Table 5 PTPS survey results: differences based on sociodemographic factors</p> <p> <ephtml> &lt;table frame="hsides" rules="groups"&gt;&lt;thead&gt;&lt;tr&gt;&lt;th align="left" rowspan="2" /&gt;&lt;th align="left" rowspan="2" /&gt;&lt;th align="left" rowspan="2" /&gt;&lt;th align="left" colspan="3"&gt;&lt;p&gt;Important Needs&lt;/p&gt;&lt;/th&gt;&lt;th align="left" colspan="3"&gt;&lt;p&gt;Unmet Needs&lt;/p&gt;&lt;/th&gt;&lt;/tr&gt;&lt;tr&gt;&lt;th align="left"&gt;&lt;p&gt;Descriptive,&lt;/p&gt;&lt;p&gt;&lt;italic&gt;M(SD) or R&lt;/italic&gt;&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;Statistic&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;&lt;italic&gt;P&lt;/italic&gt;-Value&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;Descriptive,&lt;/p&gt;&lt;p&gt;&lt;italic&gt;M(SD) or R&lt;/italic&gt;&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;Statistic&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;&lt;italic&gt;P&lt;/italic&gt;-Value&lt;/p&gt;&lt;/th&gt;&lt;/tr&gt;&lt;/thead&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td align="left" rowspan="5"&gt;&lt;p&gt;Child Factors&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;ABILITIES Index&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;R&lt;/italic&gt; = 0.08&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;&lt;italic&gt;R = 0.20&lt;/italic&gt;&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;t(157)=&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;2.49&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;0.01&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Total Disabilities&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;R&lt;/italic&gt; = &lt;italic&gt;0.15&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;&lt;italic&gt;T(167) = 2.0&lt;/italic&gt;&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;p = 0.05^&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;R&lt;/italic&gt; = 0.08&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Age&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;R&lt;/italic&gt; = 0.03&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;&lt;italic&gt;R = -0.18&lt;/italic&gt;&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;t(161)=&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;-2.28&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;0.02&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Public School&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;No&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;Yes&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;74.02 (20.0)&lt;/p&gt;&lt;p&gt;72.7 (19.7&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;50.9 (35.7)&lt;/p&gt;&lt;p&gt;59.7 (32.4)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Outpatient Therapies&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;No&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;Yes&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;70.3 (19.8)&lt;/p&gt;&lt;p&gt;75.0 (19.6)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;49.3 (33.7)&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;64.3 (31.7)&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;t(154.24) =&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;2.93&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;0.004&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" rowspan="13"&gt;&lt;p&gt;Parent and Family Factors&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;Primary Race/Ethnicity&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;Black&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;Hispanic&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;White&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;81.6 (20.0)&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;85.6 (16.8)&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;71.6 (18.6)&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;F(2)=&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;6.94&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;&lt;italic&gt;p = 0.001&lt;/italic&gt;&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;0.04&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;0.007&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;Comparison&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;45.3 (33.1)&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;61.8 (32.5)&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;61.9 (31.8)&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;F(2) = 2.92&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;p = 0.06&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;N.S.&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;0.05&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;Comparison&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Respondent Age&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;R&lt;/italic&gt; = -0.09&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;R&lt;/italic&gt; = 0.07&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Respondent Employed&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;No&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;Yes&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;77.7 (18.02)&lt;/p&gt;&lt;p&gt;73.5 (20.0)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;57.9 (32.2)&lt;/p&gt;&lt;p&gt;57.9 (33.7)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Partner Employed&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;No&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;Yes&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;78.5 (17.5)&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;73.4 (20.0)&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;T(93.56) = 1.76&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;0.08^&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;48.9 (32.8)&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;60.7 (32.1)&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;t(81.44)=&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;2.25&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;0.03&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Respondent Education&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;&amp;#60; Bachelors&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;Bachelors&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;Advanced&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;79.4 (17.5)&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;73.5 (19.9)&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;71.7 (20.2)&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;F(2,214) = 3.08&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;p&lt;/italic&gt; = 0.048&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;0.04&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;N.S.&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;Comparison&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;52.4 (33.7)&lt;/p&gt;&lt;p&gt;61.6 (33.0)&lt;/p&gt;&lt;p&gt;59.3 (31.1)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Household Income&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;&amp;#60; 50 K&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;$50-$100K&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;$100K-$150K&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;&amp;#62;$150k&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;80.3 (17.2)&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;75.0 (20.4)&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;73.3 (18.4)&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;69.5 (20.4)&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;F(3,192) = 2.63&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;p&lt;/italic&gt; = 0.05&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;0.03&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;N.S.&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;N.S.&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;Comparison&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;52.3 (34.9)&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;67.7 (26.8)&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;61.0 (34.9)&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;49.7 (31.9)&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;&lt;italic&gt;X&lt;/italic&gt;&lt;/bold&gt;&lt;sup&gt;&lt;bold&gt;2&lt;/bold&gt;&lt;/sup&gt;&lt;bold&gt;(3) =&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;9.52&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;p&lt;/italic&gt; = 0.02&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;0.01&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;Comparison&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;N.S.&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;0.003&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Efficacy (PSOC)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;R&lt;/italic&gt; = 0.08&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;&lt;italic&gt;R = -0.20&lt;/italic&gt;&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;t(191)=&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;2.78&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;0.006&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Total Children&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;r&lt;/italic&gt; = 0.07&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;R&lt;/italic&gt; = 0.05&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Living with a Partner&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;No&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;Yes&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;80.0 (18.1)&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;72.7 (19.7)&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;t(100.47) = 2.51&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;0.01&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;52.5 (35.5)&lt;/p&gt;&lt;p&gt;59.8 (31.4)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Parent Equally with partner&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;Primary&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;Equal&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;76.6 (19.6)&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;71.1 (19.1)&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;t(169.2) = 2.02&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;0.04&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;57.3 (34.4)&lt;/p&gt;&lt;p&gt;58.9 (29.4)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Children with Disabilities&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;One&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;Multiple&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;73 (19.7)&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;80.1 (18.1)&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;t(81.19) = 2.36&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;0.02&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;57.6 (33.3)&lt;/p&gt;&lt;p&gt;59.0 (30.2)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Transportation&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;Reliable&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;Barriers&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;73.0 (19.6)&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;83.0 (17.3)&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;W = 2142.5&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;0.002&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;57.0 (32.9)&lt;/p&gt;&lt;p&gt;62.8 (30.5)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Access to Childcare&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;No&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;Yes&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;75.9 (18.8)&lt;/p&gt;&lt;p&gt;72.6 (20.5)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;58.0 (33.4)&lt;/p&gt;&lt;p&gt;57.8 (32.1)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" rowspan="2"&gt;&lt;p&gt;Community Factors&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;Childhood Opportunity Index&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;Very Low&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;Low&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;Moderate&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;High&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;Very High&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;86.6 (12.8)&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;76.1 (18.6)&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;73.4 (22.3)&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;68.5 (18.1)&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;73.0 (19.8)&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;F(4,212) = 4.82&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;p&lt;/italic&gt; &amp;#60; 0.001&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;Comparison&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;N.S.&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;N.S.&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;0.0003&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;0.005&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;55.6 (34.7)&lt;/p&gt;&lt;p&gt;65.7 (35.9)&lt;/p&gt;&lt;p&gt;52.3 (33.7)&lt;/p&gt;&lt;p&gt;54.2 (31.5)&lt;/p&gt;&lt;p&gt;61.2 (30.9)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Rural-Urban Commuting Area Codes&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;R&lt;/italic&gt; = 0.02&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;R&lt;/italic&gt; = -0.01&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt; </ephtml> </p> <p>Note. The significance of differences between demographic factors endorsed as important and/or unmet for the overall measure. For variables with significant differences, subscale comparisons are reported in the text</p> <p>Table 6 PTPS survey results: differences based on disability diagnosis and ABILITIES indices</p> <p> <ephtml> &lt;table frame="hsides" rules="groups"&gt;&lt;thead&gt;&lt;tr&gt;&lt;th align="left" rowspan="2" /&gt;&lt;th align="left" rowspan="2" /&gt;&lt;th align="left" rowspan="2" /&gt;&lt;th align="left" colspan="3"&gt;&lt;p&gt;Important Needs&lt;/p&gt;&lt;/th&gt;&lt;th align="left" colspan="3"&gt;&lt;p&gt;Unmet Needs&lt;/p&gt;&lt;/th&gt;&lt;/tr&gt;&lt;tr&gt;&lt;th align="left"&gt;&lt;p&gt;Descriptive,&lt;italic&gt;M(SD) or T&lt;/italic&gt;&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;Statistic&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;&lt;italic&gt;P&lt;/italic&gt;-Value&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;Descriptive,&lt;italic&gt;M(SD) or T&lt;/italic&gt;&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;Statistic&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;&lt;italic&gt;P&lt;/italic&gt;-Value&lt;/p&gt;&lt;/th&gt;&lt;/tr&gt;&lt;/thead&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td align="left" rowspan="5"&gt;&lt;p&gt;Parent-Reported Disabilities&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;ADHD&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;No&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;Yes&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;72.7 (19.9)&lt;/p&gt;&lt;p&gt;73.5 (19.4)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;57.1 (33.4)&lt;/p&gt;&lt;p&gt;58.6 (33.2)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Autism&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;No&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;Yes&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;71.1 (19.7)&lt;/p&gt;&lt;p&gt;75.4 (19.6)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;59.2 (32.2)&lt;/p&gt;&lt;p&gt;55.6 (34.7)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Cognitive Impairment&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;No&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;Yes&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;72.6 (20.0)&lt;/p&gt;&lt;p&gt;74.7 (18.1)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;57.7 (33.9)&lt;/p&gt;&lt;p&gt;57.1 (30.6)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Developmental Delay&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;No&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;Yes&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;69.5 (20.7)&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;77.4 (17.5)&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;t(169.89)=-2.68&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;0.008&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;56.3 (34.2)&lt;/p&gt;&lt;p&gt;59.3 (32.2)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Emotional/Behavioral Disorder&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;No&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;Yes&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;71.7 (20.0)&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;79.4 (17.0)&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;t(43.28)=-2.11&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;0.04&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;55.5 (33.1)&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;68.4 (32.6)&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;T(38.85)=-1.91&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;0.06^&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;Hearing Impairment&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;No&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;Yes&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;73.4 (20.0)&lt;/p&gt;&lt;p&gt;69.7 (16.8)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;58.2 (33.1)&lt;/p&gt;&lt;p&gt;52.9 (34.9)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;Motor Disability&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;No&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;Yes&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;72.8 (19.8)&lt;/p&gt;&lt;p&gt;73.7 (19.6)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;56.8 (33.9)&lt;/p&gt;&lt;p&gt;61.0 (30.8)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;Other Health Impairment&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;No&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;Yes&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;73.3 (20.1)&lt;/p&gt;&lt;p&gt;72.1 (18.4)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;57.6 (33.5)&lt;/p&gt;&lt;p&gt;57.6 (32.8)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;Specific Learning Disability&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;No&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;Yes&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;72.5 (20.1)&lt;/p&gt;&lt;p&gt;76.6 (16.6)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;55.7 (33.7)&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;70.7 (27.6)&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;t(31.20)=-2.32&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;0.03&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;Speech&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;No&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;Yes&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;71.8 (20.0)&lt;/p&gt;&lt;p&gt;74.7 (19.2)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;59.1 (34.2)&lt;/p&gt;&lt;p&gt;55.4 (32.0)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;Sensory Processing Disorder&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;No&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;Yes&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;71.3 (20.4)&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;79.4 (15.4)&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;W = 1811.5&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;0.04&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;55.2 (33.1)&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;66.9 (32.8)&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;T(53.48)=-1.88&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;0.07^&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;Visual Impairment&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;No&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;Yes&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;72.8 (20.3)&lt;/p&gt;&lt;p&gt;74.7 (14.3)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;57.0 (33.2)&lt;/p&gt;&lt;p&gt;62.4 (34.5)&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" rowspan="9"&gt;&lt;p&gt;ABILITIES&lt;/p&gt;&lt;p&gt;Index&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;Audition&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;T = -0.11&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;Z = -1.80&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;0.07^&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;T = -0.01&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Behavior &amp; Social Skills&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;Social Skills&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;Inappropriate Behavior&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;T = 0.15&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;T = 0.10&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;Z = 1.96&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;Z = 1.78&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;&lt;italic&gt;0.05^&lt;/italic&gt;&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;&lt;italic&gt;0.07^&lt;/italic&gt;&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;T = 0.16&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;T = 0.17&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;Z = 2.82&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;Z = 2.93&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;0.005&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;&lt;bold&gt;0.003&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Intellectual Function&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;T = 0.12&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;Z = 2.01&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;0.04&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;T = 0.11&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;Z = 1.82&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;0.07^&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Limbs&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;T = &amp;#8722; 0.02&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;T = 0.07&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Intentional Communication&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;italic&gt;Understanding&lt;/italic&gt;&lt;/p&gt;&lt;p&gt;&lt;italic&gt;Communicating&lt;/italic&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;T = 0.11&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;T = 0.05&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;Z = 1.85&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;0.06^&lt;/bold&gt;&lt;/p&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;T = 0.07&lt;/p&gt;&lt;p&gt;&lt;bold&gt;T = 0.11&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;p&gt;&lt;bold&gt;Z = 1.88&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;p&gt;&lt;bold&gt;0.06^&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Tonicity&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;T = -0.04&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;T = 0.10&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;Z = 1.67&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;0.09^&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Integrity of Physical Health&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;T = 0.03&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;T = 0.07&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Eyes&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;T = -0.03&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;T = 0.11&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;Z = 1.87&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&lt;bold&gt;&lt;italic&gt;0.06^&lt;/italic&gt;&lt;/bold&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Structural Status&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;T = -0.01&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;T = 0.02&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;N.S.&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt; </ephtml> </p> <p>Note. The significance of differences between parent-reported diagnoses and ABILITIES Indices endorsed as important and/or unmet for the overall measure. For variables with significant differences, subscale comparisons are reported in the text. Differences for children diagnosed with traumatic brain injury (<emph>n</emph> = 7) and deafness (<emph>n</emph> = 4) are not reported due to small sample sizes</p> <hd id="AN0183973028-23">Child Factors</hd> <p>Regarding needs endorsed as important in terms of parent-reported diagnoses, having a child diagnosed with a developmental delay (<emph>p</emph> = 0.008), emotional/behavioral disorder (<emph>p</emph> = 0.04), or sensory processing disorder (<emph>p</emph> = 0.04) was associated with reporting a significantly higher percent of needs endorsed as important (average percentages with standard deviations are reported in Table 6). Total number of parent-reported disabilities approached a significant positive correlation with needs endorsed as important (<emph>p</emph> = 0.05). Regarding parent-reported severity of impairments across domains on the ABILITIES Index, higher severity ratings of Intellectual Functioning impairments (<emph>p</emph> = 0.04) were associated with higher percentages of needs as endorsed as important. Higher ratings of impairments in audition (<emph>p</emph> = 0.07), social skills (<emph>p</emph> = 0.05), inappropriate behavior (0.07), and understanding others (<emph>p</emph> = 0.06) approached significant positive associations with the percentages of needs endorsed as important. No other sociodemographic factors were associated with needs endorsed as important.</p> <p>Regarding needs endorsed as unmet, the sum of ABILITIES indices scores (<emph>p</emph> = 0.01) and receipt of outpatient therapies (<emph>p</emph> = 0.004) were positively associated with the percent of important needs endorsed as unmet. In contrast, child age was negatively associated with percentage of needs endorsed as unmet, suggesting that respondents who had younger children reported a higher percentage of needs endorsed as unmet (<emph>p</emph> = 0.02). In terms of parent-reported diagnoses, having a child diagnosed with a specific learning disability was significantly associated with higher percentages of needs endorsed as unmet (<emph>p</emph> = 0.03). Having a child with an emotional/behavioral disorder approached a significant association (<emph>p</emph> = 0.06). Regarding the ABILITIES Index, higher ratings of impairments on Social Skills (<emph>p</emph> = 0.005) and Inappropriate Behavior (<emph>p</emph> = 0.003) indices were significantly correlated with the percentages of needs endorsed as unmet. Higher severity ratings for intellectual functioning (<emph>p</emph> = 0.07), communicating with others (0.06), muscle tone (<emph>p</emph> = 0.09), and visual impairments (<emph>p</emph> = 0.06) all approached significantly positive associations with needs endorsed as met.</p> <hd id="AN0183973028-24">Parent and Family Factors</hd> <p>Regarding needs endorsed as important, significantly higher percentages of needs endorsed as important were found for respondents who identified only as Black (<emph>p</emph> = 0.04) or Hispanic (<emph>p</emph> = 0.007) (as compared to only White), who reported having less than a bachelor's degree (<emph>p</emph> = 0.04) (as compared to those with advanced degrees), who reported a household income below $50,000 (<emph>p</emph> = 0.03) (as compared to over $150,000), who reported living with a spouse or a partner (<emph>p</emph> = 0.01), who were the primary caregiver for their child[ren] with a disabilities (<emph>p</emph> = 0.04), who had multiple children with disabilities (<emph>p</emph> = 0.02), and who experienced transportation barriers (0.002). As a follow up exploration regarding income, families whose household incomes fell below the federal poverty line (M = 79.39) approached a significant difference from families above the poverty line (M = 73.58, <emph>p</emph> = 0.06).</p> <p>In terms of needs endorsed as unmet, having an employed partner (<emph>p</emph> = 0.03), having a household income between $50,000-$100,000 (<emph>p</emph> = 0.01 as compared to &lt;$50,000 and <emph>p</emph> = 0.003 as compared to &gt;$150,000), and lower parent-rated efficacy (<emph>p</emph> = 0.006) were all significantly associated with higher percentages of needs endorsed as important. Differences in race and/or ethnicity approached a significant association with needs endorsed as unmet regarding group comparisons of respondents identifying as only black, only Hispanic, or only white (<emph>p</emph> = 0.06, with post-hoc tests suggesting the difference between White and Hispanic respondence approaching significance, <emph>p</emph> = 0.05). When further exploring the utility of childcare resources for respondents who had access to childcare via ratings on a scale of 0% (does not fit my needs at all) to 100% (fits my needs perfectly), lower ratings of childcare resources meeting the respondents' needs were associated with higher percentages of important needs being unmet (<emph>r</emph>= -0.29, t(<reflink idref="bib69" id="ref112">69</reflink>) =-2.53, <emph>p</emph> = 0.01).</p> <hd id="AN0183973028-25">Community and Systems Factors</hd> <p>Group differences in regard to needs endorsed as important were found when comparing different ranges for the Childhood Opportunity Index, with post hoc tests revealing a significant difference between a Very Low rating as compared to ratings of High (<emph>p</emph> = 0.0003) and Very High (<emph>p</emph> = 0.005) ratings for zip codes, as measured by the Childhood Opportunity Index. No significant associations were observed between RUCA codes and needs endorsed as unmet.</p> <p>Regarding needs endorsed as unmet, no significant associations were found between parent ratings and Childhood Opportunity Index ratings or RUCA codes.</p> <hd id="AN0183973028-26">Discussion</hd> <p>Parent involvement in therapy interventions for children with disabilities has been shown to have significant benefits for children's outcomes, parents' well-being, and service delivery (Bailey &amp; Wolery, [<reflink idref="bib6" id="ref113">6</reflink>]; Gunning et al., [<reflink idref="bib31" id="ref114">31</reflink>]). While family involvement in intervention practices is common in early intervention and family-centered, care-focused outpatient settings, the special education system often underutilizes parents, despite mandates for equal parent participation in all special education services. Increasing parents' involvement in special education therapies can improve services in a cost-effective manner, especially for children reliant on the special education system for therapies. However, practitioners, policymakers, and researchers must first understand the specific needs parents and family members have to be involved in their child's special education therapies to successfully implement interventions that increase parent therapy involvement, This study is a first step in understanding how different families engage with their child's special education therapies. Additionally, this study assesses how demographic factors are associated with what parents view as important for their ability to engage in school-based therapies as well as if these important needs are being met. This study indicates that a high average percent of overall needs was viewed by parents and other caregivers (referred to as parents) as being important. However, on average of over half of important needs were viewed as unmet by parents. Furthermore, given that interactions with school services are influenced by a variety of socioecological factors across parent, child, family, and community levels, suggesting that future intervention to increase parent involvement must consider families' unique identities and circumstances for optimal implementation.</p> <hd id="AN0183973028-27">Overall Findings</hd> <p>Aligning with research question 1, parents endorsed an average of 75% of needs as important but that an average of 58% of important needs were considered unmet. Furthermore, parents reported a significantly higher percent of needs related to being informed, engaged members of their child's care team than their percent of needs related to support and guidance. These results are consistent with previous literature, as parents consistently report higher ratings of unmet needs related to their children's needs as opposed to their own needs (Colombet et al., [<reflink idref="bib14" id="ref115">14</reflink>]; Ellis et al., [<reflink idref="bib21" id="ref116">21</reflink>]; Granlund &amp; Roll-Pettersson, [<reflink idref="bib29" id="ref117">29</reflink>]; McLennan et al., [<reflink idref="bib51" id="ref118">51</reflink>]; Pickard &amp; Ingersoll, [<reflink idref="bib67" id="ref119">67</reflink>]; Resch et al., [<reflink idref="bib70" id="ref120">70</reflink>]). This difference yields two considerations. First, parents want to be active and informed members of their child's team, including receiving information on their child's therapies as well as how to support therapies at home – yet they do not feel as if they are receiving the needed information and capacity building support to fulfill this interest. As an example, 96% of respondents indicated that being informed about all therapeutic interventions their child will receive was important to them, yet 44% of parents who indicated this need was important felt the need was unmet. Improving communication with parents and other family members could improve parent-provider collaboration, family buy-in, and active participation in special education goals and decision-making, which could ultimately improve treatment outcomes. Furthermore, providing parents with the information and skills they need to support therapies at home, as is done in EI and outpatient therapies, could further increase parent involvement in therapy goals while promoting the generalization and maintenance of skills in the child's daily settings. According to this study, 77% of respondents indicated that being taught by school-based clinicians how to help with their child's needs and therapies was important, yet 65% of those respondents indicated that that need was not met. Thus, given the resource limitations experienced within the special education system, developing interventions that equip parents with the skills and knowledge to support therapy goals at home would not only be valued by parents but could provide a cost-effective mechanism to improve therapy service delivery for children who rely on the special education system for therapies. Second, parents likely underreport their own needs for support and guidance in favor of focusing on their child's needs. This prioritization of their child's needs over their own likely contributes to the higher rates of anxiety, depression, and stress parents of children with disabilities experience as compared to parents of typically developing children, which in turn could impact the parent-child relationship and parenting practices (Eisenhower et al., [<reflink idref="bib20" id="ref121">20</reflink>]; Estes et al., [<reflink idref="bib22" id="ref122">22</reflink>]; Hauser-Cram et al., [<reflink idref="bib35" id="ref123">35</reflink>]; Oelofsen &amp; Richardson, [<reflink idref="bib63" id="ref124">63</reflink>]; Rodrigue et al., [<reflink idref="bib71" id="ref125">71</reflink>]). To fully facilitate parent and family member participation in their children's services as well as to maximize the efficacy of services, efforts must be made to ensure parents have appropriate support for their own needs and the needs of the family unit. While caring for parents' needs is outside of the scope of the school, special education does require equal parent participation in services. Thus, exploring how to embed parent supports, or create a mechanism to connect parents to supports, is necessary for facilitating parent-provider partnerships and parent engagement in special education services.</p> <hd id="AN0183973028-28">Child Level Factors</hd> <p>Aligning with research question 2, when looking at children's specific demographic factors, parents who reported their child had social, emotional, or behavioral concerns had significantly higher needs endorsed as important and/or unmet. As reported by parents, 75% of respondents indicated that getting information on how to handle their child's behavior was important to them, yet 55% of these respondents indicated that this need was unmet. Previous literature has shown that behavioral problems contribute to parenting-related stress, especially for parents of children with disabilities (Estes et al., [<reflink idref="bib22" id="ref126">22</reflink>]). In addition, many families rely on the school for mental health services, given the paucity of outpatient services available in many communities (Baller &amp; Barry, [<reflink idref="bib8" id="ref127">8</reflink>]; Garland et al., [<reflink idref="bib25" id="ref128">25</reflink>]; Murphy &amp; Ruble, [<reflink idref="bib56" id="ref129">56</reflink>]). Parents of children with social, emotional, and behavioral needs may especially benefit from increased support from service providers to participate in interventions, understand their child's complex needs, and, if needed, locate outside sources to increase therapy dosage to promote psychosocial well-being at home (Murphy &amp; Risser, [<reflink idref="bib55" id="ref130">55</reflink>]). For parents of children with social, emotional, and behavioral needs, providers should be especially cognizant of starting strong communication at the beginning of the school year, so the family, the school-based provider, and any outside mental health providers can collaborate on what strategies work well for the child while also developing consistent supports across settings so skills are reinforced. Furthermore, parent capacity building for increased involvement in current school-based mental health interventions could further enhance the efficacy of these services.</p> <p>Additionally, parents of children with developmental delay and sensory processing disorder diagnoses reported more needs as unmet as compared to parents of children with other diagnoses. Given the vagueness of these terms and the disability-specific focus of many interventions, families and providers may lack a clear understanding of their child's needs, required supports, and available interventions. Thus, children with more general developmental concerns could benefit even further from enhanced parent involvement in therapy interventions to more clearly elucidate for families their child's needs as well as what services and supports are needed to allow that child to thrive. Indeed, 94% of respondents indicated that getting information on their child's unique needs was important to them, yet 53% of these parents reported this need was unmet. Providers can support parents by providing specific information on what the child's unique needs are, ensuring parent understanding of the planned interventions, and supporting parent understanding of how special education therapy goals will help support the child's academic, developmental, and functional outcomes.</p> <p>Additionally, younger child age was associated with higher reported unmet needs, suggesting that parents of younger children or children who are first entering the special education system might benefit the most from targeted supports to increase parent capacity for involvement and parent-provider collaboration. While parent involvement is extensively prioritized in EI services (IDEA, [<reflink idref="bib37" id="ref131">37</reflink>]), parents and families likely would benefit from specific training on parent participation when transitioning and first entering the special education system – particularly because parents report feeling excluded and lacking needed information during the transition from EI to special education (Podvey et al., [<reflink idref="bib69" id="ref132">69</reflink>]).</p> <p>Finally, parents whose children receive outpatient therapies reported a higher number of unmet needs compared to parents whose children only receive school services. This distinction could be attributed to parents having greater involvement in or more personalized interventions in outpatient therapies and, consequently, having greater expectations for what parent involvement in therapies should look like. Thus, when they directly compare school-based services to outpatient services, they are more easily able to identify gaps in ideal parent involvement. In other words, parents whose children receive outpatient therapies might have higher parent activation, or the knowledge, ability, and confidence to manage their child's disability-related care (Mizra et al., [<reflink idref="bib52" id="ref133">52</reflink>]; Ruble et al., [<reflink idref="bib72" id="ref134">72</reflink>]; Yu et al., [<reflink idref="bib97" id="ref135">97</reflink>]). School providers could support families by assessing access to services outside of the school, and for families who can only access special education therapies, providing supports to increase parent activation. The Parent Activation Measure for children with developmental disabilities (PAM-DD; Ruble et al., [<reflink idref="bib72" id="ref136">72</reflink>]; Yu et al., [<reflink idref="bib97" id="ref137">97</reflink>]) could be a useful tool, in addition to assessing parent needs, for providers understand areas where they can support the development of parent activation prior to attempting to increase parent involvement in special education therapies as well as in parent-provider partnerships.</p> <hd id="AN0183973028-29">Parent and Family Level Factors</hd> <p>Multiple sociodemographic factors significantly impacted the percentage of needs endorsed as important and/or unmet. Regarding respondent demographic factors, parents who identified primarily as Black or Hispanic reported significantly higher percentages of needs endorsed as important than White parents, with percentages reported of important needs endorsed as unmet approaching significance. These findings align with existing research that suggest culturally diverse families experience additional barriers when interacting with school-based services, such as differences in expectations for parent-provider roles, varying cultural understandings of disability, and a lack of trust in the educational system due to historical marginalization (Brotman et al., [<reflink idref="bib11" id="ref138">11</reflink>]; Harry, [<reflink idref="bib34" id="ref139">34</reflink>]; Olivos et al., [<reflink idref="bib65" id="ref140">65</reflink>]; Skiba et al., [<reflink idref="bib81" id="ref141">81</reflink>]). School-based providers would benefit from exploring cultural perceptions of parent roles in services as well as how different cultures view disability to best involve families in therapy interventions (Blue-Banning et al., [<reflink idref="bib9" id="ref142">9</reflink>]; Darling &amp; Gallager, [<reflink idref="bib15" id="ref143">15</reflink>]; Harry, [<reflink idref="bib34" id="ref144">34</reflink>]; Jung, [<reflink idref="bib40" id="ref145">40</reflink>]).</p> <p>Moreover, respondents with less than a bachelor's degree reported significantly more needs as important than parents with an advanced degree, and families whose annual household income was less than $50,000 reported significantly more needs than families whose annual household income was greater than $150,000. These findings suggest that disparities in reliance on the school for supports exist between the families in the lowest and highest socioeconomic strata. Families who experienced transportation barriers also reported significantly more needs as important than those with easy access to transportation. These findings align with previous work suggesting parents with limited education and financial resources may face barriers in accessing information on therapy best practices while having limited knowledge regarding their child's disability, advocacy and their rights to services. Conversely, parents who have advanced education and more financial resources could be more easily able to locate information and resources on how to best support their children with disabilities, seek and advocate for needed services, and outsource supports to outpatient settings (Olivos et al., [<reflink idref="bib65" id="ref146">65</reflink>]; Pickard &amp; Ingersoll, [<reflink idref="bib67" id="ref147">67</reflink>]). Thus, families in lower socioeconomic strata appear to rely more heavily on the school for information on the family's role in therapies whereas families in higher socioeconomic strata can outsource their needs to other providers. Increasing involvement supports for families in the lower socioeconomic strata might thus be an effective target for intervention, as these families are most likely to rely on the school system for services, due to barriers with accessing outpatient services. Furthermore, interventions that increase parent activation within parents in lower socioeconomic strata could help equip these families to best manage their child's developmental care throughout childhood and adolescence.</p> <p>Family structure also appeared to influence the percentage of parent-reported needs as important and unmet, as significant differences were observed in parents of multiple children with disabilities, single-parent households, having an employed partner, and being the primary caregiver for a child or children with disabilities. This trend appears to be similar for parents who report a lower sense of parenting efficacy. These findings suggest that having more caregivers actively available to participate in caregiving activities for children with disabilities decreases the importance of school-based providers to provide parent-focused information and supports as well as to support families in understanding how they can more actively participate in therapies. Conversely, households where one caregiver is predominantly responsible for the care of a child or children with disabilities or who lack confidence in their parenting efficacy may have increased responsibilities, greater resource limitations, and less time to dedicate to service engagement, resulting in a heavier reliance on the school and school-based services to meet their child's therapeutic needs (Murphy &amp; Risser, [<reflink idref="bib55" id="ref148">55</reflink>]). They may also rely more heavily on providers to communicate vital information regarding their child's services and expectations for involvements. Supportive interactions between providers and parents also can enhance self-efficacy, parental engagement, and positive outcomes for children with disabilities (Ingersoll &amp; Wainer, [<reflink idref="bib38" id="ref149">38</reflink>]; Murphy et al., [<reflink idref="bib58" id="ref150">58</reflink>]; Tonge et al., [<reflink idref="bib87" id="ref151">87</reflink>]). Thus, providers would benefit from taking time at the start of the school year, or when first interacting with a student to understand family dynamics and beliefs about family involvement in school services, as parents who rely on the school for therapeutic supports might have higher expectations for information shared by providers than those who have more caregiver support available.</p> <hd id="AN0183973028-30">Community Level Factors</hd> <p>Families who lived in a zip code categorized as having "Very Low" childhood opportunity, as determined by the Child Opportunity Index (COI), endorsed significantly more needs as important than families who live in a "High" or "Very High" childhood opportunity zip code. The COI measures the quality of resources within a child's community that influence child development, including educational opportunities that directly affect the types of services accessible to families (Diversitydatakids.org, [<reflink idref="bib17" id="ref152">17</reflink>]). These findings suggest that families living in neighborhoods with greater childhood opportunity place less importance on school-based clinicians and services to meet parents' involvement needs while also furthering the argument for increased school-based parent supports in historically minoritized and marginalized communities.</p> <hd id="AN0183973028-31">Limitations and Future Directions</hd> <p>There are several limitations to the current study. First, while this study sample was more diverse and larger than its precursor (Murphy &amp; Risser, [<reflink idref="bib55" id="ref153">55</reflink>]), it still consisted of a majority of white, educated, and/or married parents. Sampling a more diverse sample continues to be needed to understand how parent-reported needs more fully are impacted by sociodemographic factors. Second, this study only examined if needs were unmet if they were endorsed as at least somewhat important to the respondent. It may be useful for future studies to determine needs unmet for all questions, as recommended in (Murphy et al, [<reflink idref="bib58" id="ref154">58</reflink>]). Third, this study omitted additional variables that likely play a role in parent-reported engagement needs, such as other sources of caregiving aside from the respondents' partners, Medicaid coverage, and provider-related variables. To fully understand how to improve parent involvement in therapies, further research is needed that more comprehensively assess parent variables as well as provider and school perspectives. Fourth, measures used to assess child disability and impairment are not widely standardized to compare responses to a sample group. Additional work is needed looking at more objective measures of child ability, such as IQ, using standardized measures instead of relying on parent report. Fifth, due to space limitations, differences in associations with subscale scores and demographics are not reported. More research is needed to inform specifically what needs are significant to inform future intervention planning. Sixth, this study asked parents to recall their past experience regarding their needs multiple months back prior to the start of the Coronavirus pandemic. Thus, these results could be subject to parents' recall bias. Seventh, this study does not explore specific levels or settings of special education supports, which could influence parent perception. Finally, this study does not explore the mechanisms that underly the relationship between parent-reported needs and child, parent, or family factors. Further work is needed to examine why parents and families with specific demographic identities report more needs as important or unmet to further inform intervention planning.</p> <hd id="AN0183973028-32">Conclusions</hd> <p>Increasing opportunities to partner and collaborate with parents and families in special education therapies, including building parent capacity to be involved in therapy interventions, presents a huge opportunity to improve service delivery and address disparities in access to high-quality care for children with disabilities relying on the school for therapy services. Furthermore, the findings of this study suggest that while most respondents reported high percentages of needs as important to them and high rates of important needs being unmet, disparities in parent-reported needs exist for families with the least and the most resources. Given the limitations presented by the special education system, more research is needed to understand how to feasibly involve parents and families in therapies specifically delivered as part of special education services. Specifically, practitioners and researchers must understand what parents need to be able to participate in these therapies before implement interventions to more fully involve parents in special education therapies. Specifically, efforts to address parents' involvement needs need to carefully consider the increased needs of families with limited education, financial, and caregiving resources, families who have historically been marginalized from school-based partnerships, and children whose diagnoses do not provide clear intervention goals, given these families often rely on the school for therapy access more frequently (Witt et al., [<reflink idref="bib95" id="ref155">95</reflink>]).</p> <p>Teaching families to build intervention practice into daily routines, as is often done in early intervention programs, can be an effective method to maximize parental involvement without excessively consuming parents' time or resources. These strategies, when developed collaboratively with families and clinicians, can effectively increase the dosage of therapeutic interventions, enhance skill generalizability, and build parental sense of efficacy.</p> <hd id="AN0183973028-33">Funding</hd> <p>This research utilized grant-funded research tools. ResearchMatch is funded in part by the National Institutes of Health (NIH) Clinical and Translational Science Award (CTSA) program (grants UL1TR000445, U24TR00157 9, and 5 U24 TR001579-02). REDCap is funded through Northwestern University Clinical and Translational Science Institute, which is funded in part by a Clinical and Translational Science Award (CTSA) grant from the National Institutes of Health (UL1TR001422).</p> <hd id="AN0183973028-34">Declarations</hd> <p></p> <hd id="AN0183973028-35">Conflict of Interest</hd> <p>The authors report no financial conflicts of interest.</p> <hd id="AN0183973028-36">Publisher's Note</hd> <p>Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.</p> <ref id="AN0183973028-37"> <title> References </title> <blist> <bibl id="bib1" idref="ref17" type="bt">1</bibl> <bibtext> Alegria M, Vallas M, Pumariega AJ. Racial and Ethnic Disparities in Pediatric Mental Health. 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| Header | DbId: eric DbLabel: ERIC An: EJ1464147 AccessLevel: 3 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
| IllustrationInfo | |
| Items | – Name: Title Label: Title Group: Ti Data: Perceived Parent Needs for Improving Parent Participation in School-Based Therapies for Children with Disabilities Using the Parent-Therapist Partnership Survey – Name: Language Label: Language Group: Lang Data: English – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Ashley+N%2E+Murphy%22">Ashley N. Murphy</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0001-6973-0966">0000-0001-6973-0966</externalLink>)<br /><searchLink fieldCode="AR" term="%22Kathleen+Moskowitz%22">Kathleen Moskowitz</searchLink><br /><searchLink fieldCode="AR" term="%22Francesca+Fernandez%22">Francesca Fernandez</searchLink><br /><searchLink fieldCode="AR" term="%22Heather+J%2E+Risser%22">Heather J. Risser</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0003-4789-0111">0000-0003-4789-0111</externalLink>) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="SO" term="%22Journal+of+Autism+and+Developmental+Disorders%22"><i>Journal of Autism and Developmental Disorders</i></searchLink>. 2025 55(4):1254-1273. – Name: Avail Label: Availability Group: Avail Data: Springer. Available from: Springer Nature. One New York Plaza, Suite 4600, New York, NY 10004. Tel: 800-777-4643; Tel: 212-460-1500; Fax: 212-460-1700; e-mail: customerservice@springernature.com; Web site: https://link.springer.com/ – Name: PeerReviewed Label: Peer Reviewed Group: SrcInfo Data: Y – Name: Pages Label: Page Count Group: Src Data: 20 – Name: DatePubCY Label: Publication Date Group: Date Data: 2025 – Name: SourceSuprt Label: Sponsoring Agency Group: SrcSuprt Data: National Center for Advancing Translational Sciences (NCATS) (DHHS/NIH), Clinical and Translational Science Awards (CTSA) Program – Name: NumberContract Label: Contract Number Group: NumCntrct Data: UL1TR000445<br />U24TR001579 – Name: TypeDocument Label: Document Type Group: TypDoc Data: Journal Articles<br />Reports - Research – Name: Subject Label: Descriptors Group: Su Data: <searchLink fieldCode="DE" term="%22Parents%22">Parents</searchLink><br /><searchLink fieldCode="DE" term="%22Needs%22">Needs</searchLink><br /><searchLink fieldCode="DE" term="%22Parent+Participation%22">Parent Participation</searchLink><br /><searchLink fieldCode="DE" term="%22Children%22">Children</searchLink><br /><searchLink fieldCode="DE" term="%22Students+with+Disabilities%22">Students with Disabilities</searchLink><br /><searchLink fieldCode="DE" term="%22Family+School+Relationship%22">Family School Relationship</searchLink><br /><searchLink fieldCode="DE" term="%22Allied+Health+Personnel%22">Allied Health Personnel</searchLink><br /><searchLink fieldCode="DE" term="%22Rehabilitation%22">Rehabilitation</searchLink> – Name: DOI Label: DOI Group: ID Data: 10.1007/s10803-024-06282-w – Name: ISSN Label: ISSN Group: ISSN Data: 0162-3257<br />1573-3432 – Name: Abstract Label: Abstract Group: Ab Data: Rehabilitative and habilitative therapies can help children with disabilities increase independence and overall wellbeing. However, children and their caregivers face many barriers to accessing these therapies and often rely on the school for therapy access. Given the limited resources available within the special education system, increasing parent involvement in special education therapies could improve service delivery. However, providers must first understand what parents need to participate in therapies before attempting to engage families. 217 parents completed an online survey consisting of the Parent-Therapist Partnership Survey and demographic questionnaires about their families and their child[ren] with disabilities. The percentage of needs parents endorsed as important and the percentage of important needs endorsed as unmet were calculated. Differences across demographic variables were assessed. Overall, parents reported an average of 75% of needs as important with significantly more needs endorsed as important regarding being an informed, engaged member of the child's care team (M = 83%) than needs related to support and guidance (M = 65%, p < 0.001). Furthermore, parents reported an average of 58% of important needs as unmet, with no significant differences in subscale averages. Significant associations were found for race/ethnicity, education, income, partner availability, number of children with disabilities in the household, transportation access, neighborhood opportunities, parent efficacy and social, emotional, and behavioral concerns. Parents reported a high percentage of needs as important, but a large percentage of these important needs were considered unmet. Significant disparities based on racial/ethnic identities and access to resources were found. In order to successfully engage parents in special education therapy activities, providers must work to understand and address parents' engagement needs, paying special attention to each family's unique circumstances to optimize engagement. – Name: AbstractInfo Label: Abstractor Group: Ab Data: As Provided – Name: DateEntry Label: Entry Date Group: Date Data: 2025 – Name: AN Label: Accession Number Group: ID Data: EJ1464147 |
| PLink | https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1464147 |
| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1007/s10803-024-06282-w Languages: – Text: English PhysicalDescription: Pagination: PageCount: 20 StartPage: 1254 Subjects: – SubjectFull: Parents Type: general – SubjectFull: Needs Type: general – SubjectFull: Parent Participation Type: general – SubjectFull: Children Type: general – SubjectFull: Students with Disabilities Type: general – SubjectFull: Family School Relationship Type: general – SubjectFull: Allied Health Personnel Type: general – SubjectFull: Rehabilitation Type: general Titles: – TitleFull: Perceived Parent Needs for Improving Parent Participation in School-Based Therapies for Children with Disabilities Using the Parent-Therapist Partnership Survey Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Ashley N. Murphy – PersonEntity: Name: NameFull: Kathleen Moskowitz – PersonEntity: Name: NameFull: Francesca Fernandez – PersonEntity: Name: NameFull: Heather J. Risser IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 04 Type: published Y: 2025 Identifiers: – Type: issn-print Value: 0162-3257 – Type: issn-electronic Value: 1573-3432 Numbering: – Type: volume Value: 55 – Type: issue Value: 4 Titles: – TitleFull: Journal of Autism and Developmental Disorders Type: main |
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