**7. Amending the adopted model and combining with other CMs**

The three identified models raised a fundamental issue. How would the researcher choose between them and which one should he choose? Were these CMs rival or complimentary to one another? In fact the answers came as part of an evolving process during the course of the research. The most credible solution was to try and combine the three available conceptual models. In addition he also had to supplement the model to elaborate the concept of empow‐ erment.

Initially Bronfenbrenner's theory on human ecology seemed sufficient as it brought together the insights from the other two approaches and provided a general picture of society with respect to its different layers in order to explain interactions between the components of the microsystem level and wider society. However our literature searches allied with the authors' experiences identified some limitations. Although this model stresses the relationships between various components within different social layers, it does not help us to fully explore and understand the relationship among the family members.

Thus the McMaster family functioning model was used as an extension of the ecological model. The main reason for adopting the family functioning model was to consider the family as the unit of analysis in the research. Although Bronfenbrenner's theory is based on systems theory, inherently it is an *individualistic* approach whereas McMaster theory has a *holistic* perspective and focuses on the family and the impact of disability on all members of the family – notably mothers and fathers. The main focus is on present problems not past origins which can be considered a particular concern for clinicians and practitioners. The emphasis is for family members to address present concerns, resistances, or blockages so as to find solutions for their problems. When using the McMaster approach, the practitioner functions as a catalyst, clarifier and facilitator. The goal is to help family members to identify and solve problems themselves.

However the Family Functioning model alone was insufficient in understanding how this problem solving process might be done. The addition of Dunst's family support model further extended the model by including the types of support – formal and informal – that are beneficial to families. But important as this was in identifying the range and level of supports across systems, in itself it did not focus on the process of empowerment a point we will come back to later.

A word of caution relating to merging CMs. In extending a basic CM to cover some merits of another one there should be some semblance in their background and overlaps between them. The CMs in this study recognised the core role that family relationships had within other systems such as the extended family, school and religious systems. These levels of similarity provided a basis for extending the ecology model to encompass aspects of the McMaster, Enabling and Empowering Families CMs.

Within each of these domains specific aspects that researcher had found to be especially relevant for parents' empowerment in Iran were highlighted. Moreover it is the combination of these different perspectives that is the main and novel feature of the proposed model in this paper.

Also it could be argued that we should separate the questions of our research at the outset and answer them in the context of separate and suitable conceptual models. Sometimes this may be a good recommendation. However, in some instances, especially in times of dealing with complex phenomena such as parental empowerment, a more comprehensive understanding of the subject will not occur by separating the questions that are actually deeply related and answering them in unrelated CMs. Our suggestion is that in such cases expanding the chosen CM to encompass other related questions is a better strategy.

### **8. Focus on empowerment**

research. The most credible solution was to try and combine the three available conceptual models. In addition he also had to supplement the model to elaborate the concept of empow‐

Initially Bronfenbrenner's theory on human ecology seemed sufficient as it brought together the insights from the other two approaches and provided a general picture of society with respect to its different layers in order to explain interactions between the components of the microsystem level and wider society. However our literature searches allied with the authors' experiences identified some limitations. Although this model stresses the relationships between various components within different social layers, it does not help us to fully explore

Thus the McMaster family functioning model was used as an extension of the ecological model. The main reason for adopting the family functioning model was to consider the family as the unit of analysis in the research. Although Bronfenbrenner's theory is based on systems theory, inherently it is an *individualistic* approach whereas McMaster theory has a *holistic* perspective and focuses on the family and the impact of disability on all members of the family – notably mothers and fathers. The main focus is on present problems not past origins which can be considered a particular concern for clinicians and practitioners. The emphasis is for family members to address present concerns, resistances, or blockages so as to find solutions for their problems. When using the McMaster approach, the practitioner functions as a catalyst, clarifier and facilitator. The goal is to help family members to identify and solve problems themselves.

However the Family Functioning model alone was insufficient in understanding how this problem solving process might be done. The addition of Dunst's family support model further extended the model by including the types of support – formal and informal – that are beneficial to families. But important as this was in identifying the range and level of supports across systems, in itself it did not focus on the process of empowerment a point we will come

A word of caution relating to merging CMs. In extending a basic CM to cover some merits of another one there should be some semblance in their background and overlaps between them. The CMs in this study recognised the core role that family relationships had within other systems such as the extended family, school and religious systems. These levels of similarity provided a basis for extending the ecology model to encompass aspects of the McMaster,

Within each of these domains specific aspects that researcher had found to be especially relevant for parents' empowerment in Iran were highlighted. Moreover it is the combination of these different perspectives that is the main and novel feature of the proposed model in this

Also it could be argued that we should separate the questions of our research at the outset and answer them in the context of separate and suitable conceptual models. Sometimes this may be a good recommendation. However, in some instances, especially in times of dealing with complex phenomena such as parental empowerment, a more comprehensive understanding of the subject will not occur by separating the questions that are actually deeply related and

and understand the relationship among the family members.

erment.

238 Autism Spectrum Disorder - Recent Advances

back to later.

paper.

Enabling and Empowering Families CMs.

As Shultz et al., 1995, suggests empowerment can exist at three main levels: individual, organizational and community level. This became apparent in the different stages of the research programme.

Each of the three mentioned CMs has its own advantages for dealing with one of Scultz's levels. A variation of a "family systems model" is the McMaster model of family functioning (MMFF), described by [10] in the mid-50s. This outlines the basic concept of family functioning [17] and is based on the theory that the primary function of the family unit is to provide a setting for the development and maintenance of family members on the biological, social, and psycho‐ logical levels [10]. Over a period of thirty years this model has evolved and the reformulations of it have tried to overcome some of the problems that emerged in the initial application of the model [17]. It facilitates empowerment at an individual level. Empowerment at this level entails psychological processes such as parental wellbeing, coping strategies and self-esteem.

Likewise an understanding of the socio-political environment, which includes knowledge of the laws and an appreciation by parents of their rights and responsibilities with respect to their situation helps with organizational empowerment. This level of empowerment enhances goaldirected actions by members of a group or organization. A model plays an important role at this level of empowerment. This was provided through the model of Enabling and Empow‐ ering Families. In this CM available sources of help are also important. [5] argue that a better relationship between parents, service providers and professionals increases the level of empowerment. Iranian parents in these studies were asking for more and improved profes‐ sional services for their children and themselves. Therefore, at this stage of research, examining the service delivery-related factors that influence family empowerment was particularly helpful.

Finally at the broad level of community, empowerment reflects actions taken by a group of people to improve life in their society. The ecological model clearly explains this concept and defines approaches for helping families to strengthen their abilities to provide their children with experiences and opportunities similar to other children with regular development. Parents were asking for development-enhancing qualities above the individual or organiza‐ tional level and were hoping to change the dominant attitude of the society and the stigma that resulted from having a child with ASD. This happened when a group of parents who were participants of the studies went on to form a non-governmental organisation for Autism to lobby for better services and to provide mutual support to families.This was the first Iranian nongovernmental association in this kind.

#### **9. Further additions to the model**

There were still aspects in family empowerment that even the extended CMs could not deal completely with, notably how educating families produced changes in them. This needs additional conceptual insights which were provided by [13] and [12]. Although their theories had been initially developed for nursing education, the attractive aspect was the emphasis that education is more than knowledge acquisition and should lead to action. [13] suggested that learning through understanding one's own situation and abilities, is built around the processes of *enlightenment*, *empowerment* and *emancipation*. In the educational sessions parents under‐ stand "who they are", i.e., the "Enlightenment". The second process helps parents to "change" who they are, i.e., "Empowerment". Following this, the third main dimension is presented, i.e., "Emancipation", the process which helped parents to "become" what they wanted to be. This highlights the importance of education in bringing about changes in parents and their activities so that they have their own voice in changing the attitudes of their society. On the other hand relying solely on this model of empowerment would imply that the process of emancipation occurred for all parents to the same extent which was not true. For example the Parental NGO faced different system problems which caused serious crises for both the NGO and the members. Thus the broader model that had evolved was needed to account for the individual variations that remained and which were evident after as well as before the training such as the nature of the disability, family dynamics and community reactions. Again, it must be noticed that in extending a CM the auxiliary theories should have commonality with the main CM, or at least be consistent with it. Thus enlightenment, empowerment, and emanci‐ pation concepts can be construed as an elaboration of the family functioning model. In this model the primary function of the family unit is to provide a setting for the development and maintenance of the family members on the biological, social, and psychological levels. To be able to provide the necessary bases for family development, the family's needs and desires must be known. Parental awareness about their needs could be obtained through information provision, exchange of experience with other parents and letting them have their own voices to talk about their ideas and to explain things from their own perspective. Family enlighten‐ ment, empowerment and emancipation will be obtained by improving family functioning and their communication with one another along with fostering the emotional health of its members through information provision, exchange of experience and having their own voices through their own advocacy. Equally these three concepts could help us in understanding the improvement of family functioning levels through providing more opportunities for being influential in their society.

Figure 1 presents the resulting model to emerge from the research and development pro‐ gramme. Here we draw out the ways in which this model could assist practitioners and also identify further research questions that emanate from it.

Finding theories and models of family programmes is not a big challenge. The challenge is to adopt them in a way that is suitable to use in the context of the reality of the life of families and children with developmental disabilities in different societies. Similar approaches could be adopted to guide the development of clinical practice and services especially in less affluent countries. A useful starting point is the model that has evolved in Iran albeit within the context A Conceptual Model for Empowering Families in Less Affluent Countries Who Have a Child With Autism http://dx.doi.org/10.5772/59111 241

**9. Further additions to the model**

240 Autism Spectrum Disorder - Recent Advances

influential in their society.

identify further research questions that emanate from it.

There were still aspects in family empowerment that even the extended CMs could not deal completely with, notably how educating families produced changes in them. This needs additional conceptual insights which were provided by [13] and [12]. Although their theories had been initially developed for nursing education, the attractive aspect was the emphasis that education is more than knowledge acquisition and should lead to action. [13] suggested that learning through understanding one's own situation and abilities, is built around the processes of *enlightenment*, *empowerment* and *emancipation*. In the educational sessions parents under‐ stand "who they are", i.e., the "Enlightenment". The second process helps parents to "change" who they are, i.e., "Empowerment". Following this, the third main dimension is presented, i.e., "Emancipation", the process which helped parents to "become" what they wanted to be. This highlights the importance of education in bringing about changes in parents and their activities so that they have their own voice in changing the attitudes of their society. On the other hand relying solely on this model of empowerment would imply that the process of emancipation occurred for all parents to the same extent which was not true. For example the Parental NGO faced different system problems which caused serious crises for both the NGO and the members. Thus the broader model that had evolved was needed to account for the individual variations that remained and which were evident after as well as before the training such as the nature of the disability, family dynamics and community reactions. Again, it must be noticed that in extending a CM the auxiliary theories should have commonality with the main CM, or at least be consistent with it. Thus enlightenment, empowerment, and emanci‐ pation concepts can be construed as an elaboration of the family functioning model. In this model the primary function of the family unit is to provide a setting for the development and maintenance of the family members on the biological, social, and psychological levels. To be able to provide the necessary bases for family development, the family's needs and desires must be known. Parental awareness about their needs could be obtained through information provision, exchange of experience with other parents and letting them have their own voices to talk about their ideas and to explain things from their own perspective. Family enlighten‐ ment, empowerment and emancipation will be obtained by improving family functioning and their communication with one another along with fostering the emotional health of its members through information provision, exchange of experience and having their own voices through their own advocacy. Equally these three concepts could help us in understanding the improvement of family functioning levels through providing more opportunities for being

Figure 1 presents the resulting model to emerge from the research and development pro‐ gramme. Here we draw out the ways in which this model could assist practitioners and also

Finding theories and models of family programmes is not a big challenge. The challenge is to adopt them in a way that is suitable to use in the context of the reality of the life of families and children with developmental disabilities in different societies. Similar approaches could be adopted to guide the development of clinical practice and services especially in less affluent countries. A useful starting point is the model that has evolved in Iran albeit within the context

**Figure 1.** The final model which was used to answer the research questions that emanate from the thesis on "Parental Empowering".

of research. In recent years this process has begun and various strategies have been tested along the development of resources to support these new styles of working.

The following are some of the key components of service provision based on the integrated conceptual model.


**•** Greater public awareness of ASD is promoted through parental advocacy, use of media and briefing for community leaders.

In sum, the model envisages a community-based, family centred service based on partnership working among all the stakeholders.

Equally this model generates further research questions. Chief among them are the following:

