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2004 Jordan Institute
for Families

Vol. 9, No. 2
January 2004

Specialized Program Model:
Families on the Grow

As far as we know, Families on the Grow is the only child welfare program in North Carolina specifically designed to serve families where a parent has cognitive limitations. To learn about this innovative program we spoke with Laura Quinn, MA, the program’s consultant psychologist and lead instructor.

How did Families on the Grow get started?
It began in 1997 as an idea shared by two employees of Wake County Human Services: Gaye Styron, CPS Treatment and Program Manager, and Gretchen Evans, child welfare supervisor. They and other members of the community recognized that many more families with cognitively limited parents were being served by DSS in an involuntary way than through other community agencies. They wanted to find a way to identify and support these parents before they got involved with the child welfare system.

Families on the Grow took full form in 1998 as a multi-agency collaboration. Partners included our CPS treatment unit, the ARC of Wake County, Wake Technical Community College, and Community Partnerships, which provided in-home training to parents on a voluntary basis.

What happened?
This collaborative enterprise struggled to stay together from the beginning. It had difficulty with conflicting responsibilities and mandates, communication problems, and a lack of sustainable funding for services to families not involved with child welfare. The collaborative aspect of the program came apart in spring 2000, though we kept meeting through spring 2002. Today, to get the support they need, cognitively limited parents in Wake County must either be involved with child welfare or be receiving services through one of the county’s DD case managers. Child welfare is by far the swifter route to services—waiting lists for DD services in North Carolina can be long, and parents aren’t given priority over other people, despite the consequences this can have for their children.

What is Families on the Grow today?
Today Families on the Grow is based completely at Wake County Human Services. We have a special CPS unit consisting of six specially-trained CPS treatment case workers, one supervisor, and a part-time psychologist/trainer. The unit is paid for with a combination of county, state, and federal funding, just like our other CPS units.

Using information about the parents we were seeing, we developed an easy-to-use assessment tool. Parents are assessed using this scale whenever there is an open CPS/foster care case. Parents identified as “at risk” are referred to me or another psychologist for evaluation. I use the Reynolds Intellectual Assessment Scale, the Weschler, and other tools to determine their level of cognitive function. If parents are found to be limited they are admitted to the program, where they are:

  • Enrolled in an intensive, specialized parenting class. Unlike typical parenting classes, which meet for two hours or so once a week for ten weeks, Families on the Grow parenting classes are offered in a 15-week series in which classes occur three times a week. To meet the needs of parents, these classes are characterized by more repetition; simpler, more concrete language; a slower pace; many hands-on activities; and a focus on the small parts that make up different parenting tasks. Reading materials are geared to people who read at a second or third grade level.

  • Referred to other community agencies and supportive community services. Referrals are not enough with this population, Quinn says. “Social workers must take the time to train these parents to make and keep straightforward appointments, such as doctors’ appointments.” However, if there is any complexity to the appointment (e.g., one for SSI), parents fare much better when they have an advocate or professional attend with them.

  • In-home services delivered by specially-trained caseworkers. The program often hires people with expertise in developmental disabilities or early intervention.

Do you have any advice for child welfare workers?
Identifying cognitively-limited parents is a critical first step. After that, provide appropriate referrals and education. Get parents to keep a daily routine—it is great for them and their kids, but it is hard to do! Be prepared to provide extra support.

For more information about Families on the Grow, contact Laura Quinn (919/212-7195;

Parents and Children Served by
Families on the Grow

Most are women
. 90% of the cognitively-limited parents involved with Families on the Grow are women. When men are involved, they are usually a partner/husband. Families on the Grow has never served a family where the father was the primary caregiver for the children.

Minorities are disproportionately represented. White parents involved in Families on the Grow are often from rural areas.

Status of children. In 50% of families involved with Families on the Grow the children are still at home. “The rate of removal is much higher for this population,” Quinn says. “Reunification is rare, but it happens.”

Parents suffer from isolation. Because they often do not work, have no transportation, and often have no spouse and a limited social support network, mothers in Families on the Grow get depressed, overwhelmed, and lonely. When this happens, getting the children into a good daycare program is extremely useful; it gives the children the stimulation they need and reduces their mothers’ stress.

Many have dual or multi-diagnoses. Many mothers in Families on the Grow also suffer from depression, anxiety, mental illness, personality disorders, and substance abuse.

Domestic Violence. These moms experience disproportionately high rates of domestic violence. Quinn suspects this is due in part to the fact many of these mothers depend heavily on their partners for income.

References for this and other articles in this issue