History
Refers to the level of adaptability that existed in the applicant’s childhood family as measured on the Circumplex Model Adaptability Dimension. Family adaptability is measured by considering how childhood family communication patterns, acceptance of differences, decision-making, conflict resolution methods, and family roles/rules/expectations impacted the family’s response to change. For definitional purposes, “family” refers to the family system in which the applicant was primarily raised whether they were blood or non-blood related, e.g., adoptive family, foster family, relative caregivers, etc. For applicants raised in multiple families, please construct one overall rating.
What is Childhood Family Adaptability
Refers to the individual’s disposition as well as the consistency and range of mood.
What is mood
Refers to presence/absence of litter, garbage, clutter and odors in and around the home.
What is cleanliness/Orderliness/Maintenance
Refers to each individual’s knowledge and understanding of a child’s physical, emotional, cognitive and social development. If the individual being evaluated has no parental experience, please rate his/her understanding and potential to function in this area.
What is child development
Refers to how much the couple can count on each other for support on an emotional level. C-2 is applicable only to applicants who are married or in a domestic partner relationship.
What is emotional support
Refers to an adult history of sexual, emotional or physical victimization, traumatic separation and loss, traumatic accidents, illnesses, incidents and life experiences. Does not apply to psychiatric issues which are dealt with in A-9, Psychiatric History or trauma experienced from divorce history which is dealt with in A-11, Marriage/Domestic Partner Relationship History.
What is Adult History of Victimization/Trauma
Refers to the individual’s ability to exchange information with others verbally and non verbally.
What is communication
Refers to the adequacy and reliability of the applicant’s income as well as his/her ability to manage money.
What is finances
Refers to each individual’s choices, understanding, consistency and use of discipline including physical discipline. If the individual being evaluated has no parental experience, please rate his/her understanding and potential to function in this area.
What is disciplinary methods
Refers to the applicants ability to listen to one another and express their own opinion (verbally and nonverbally). C-4 is applicable only to applicants who are married or in a domestic partner relationship.
What is communication between spouse/ domestic partner
Refers to the quality of past marital and/or domestic partner relationships. Also refers to the process of severing these past relationships and the nature of the current relationship with ex-spouse/domestic partner. A-11 is not applicable if there are no previous marriages/domestic partner relationships and/or a marriage/ domestic partnership ended with the death of a spouse/partner.
What is Marriage/ Domestic Partner relationship
Refers to an individual’s current feelings about him or herself.
What is self esteem
Refers to the emotional and tangible support available from non-family members and community resources.
What is support system
Refers to an individual’s investment in the child’s social and academic development. If there are no children in the home please rate how the applicant has functioned in the past or plans to function in this area in the future.
What is learning experiences
Refers to the permanence of the marriage or domestic partnership. C-6 is applicable only to applicants who are married or in a domestic partner relationship.
What is stability of marriage/ domestic partnership
Refers to deprivation and/or traumatic accidents, incidents or circumstances experienced as a child and/or adolescent (age 18 or younger). Does not apply to trauma incurred as a result of physical, sexual or psychological victimization.
What is Childhood history of Deprivation/Trauma
Refers to an individual’s ability to respect, understand and relate to people with a different perspective on life due to differences such as race, physical ability or appearance, political or cultural perspective, generation, sexual orientation, socioeconomic class, religion, educational background, medical or psychiatric condition.
What is acceptance of differences
Refers to the manner in which family members treat and care for pets in the home and any potential safety issues the pets may present to children. F-7 is not applicable if there are no pets in the home.
What is household pets.
Refers to an individual’s level of comfort with and confidence in his/her role as a parent. If the applicant being evaluated has no parental experience, please rate his/her understanding and potential to function in this area.
Refers to the level of dominance and submissiveness within the relationship. C-5 is applicable only to applicants who are married or in a domestic partner relationship
What is balance of power
Refers to history of psychiatric conditions for the individual(s) being evaluated as well as their parents and siblings.
What is Psychiatric History
Refers to the individual’s ability to establish, derive support from and maintain meaningful interpersonal relationships. B-4 does not refer to the individual’s relationship with their spouse/domestic partner and family.
What is interpersonal relationships
Refers to the adequacy and condition of play area, equipment and clothing for child(ren) taking into account developmental and age-appropriateness of items. If the applicant had not had any children in the home, please evaluate his/her understanding of the importance of and ability to meet these child needs
Refers to an individual’s ability to provide adequate supervision and/or substitute childcare when required. If there are no children in the home, please rate the applicant’s plan for childcare upon placement.
What is child supervision
Refers to overall feeling each individual has about the other. C-3 is applicable only to applicants who are married or in a domestic partner relationship.
What is attitude towards spouse/ domestic partner