Social programs are essential tools for governments that aim to mitigate the effects of socioeconomic disadvantage, vulnerability, morbidity, and mortality (Bernal-Salazar & Rico, 2010; Shahidi et al., 2019). Researching and evaluating these programs enhances their effectiveness, further benefiting public management (Haefner, 2011; Rossi et al., 2018).

Vulnerability is often characterized by limited economic income, unstable employment, lower education levels, challenges in accessing basic services, inadequate housing, and difficulty in navigating adverse situations. These conditions frequently result in environments marked by violence and family conflict that often have the greatest impact on women and children (Busso, 2001; Ortiz-Ruiz & Díaz-Grajales, 2018). This is a pervasive issue in Latin America (Giacometti & Pautassi, 2014). In Ecuador, for instance, there are alarming statistics regarding child violence; for instance, 47% of afro-descendant parents use physical discipline on their children. Although this trend appears to be declining among the mestizo/white and indigenous populations, it remains a concern (Yumbay, 2019).

To promote children’s well-being and prevent abuse, early intervention and support for vulnerable families that emphasize positive parenting are crucial (Fernandez, 2007). Such programs must be evidence-based, and their designs and evaluations must be firmly grounded in previous research. A significant challenge in non-English-speaking countries arises when psychological tools developed in different cultural contexts are employed without proper adaptation or without understanding of their psychometric properties (Matus et al., 2008). This situation complicates the assessment of programs that target childhood and family functioning (Valencia & Gómez, 2010).

Several instruments assess family functioning. Some instruments primarily highlight problems or dysfunctional family attributes, while others focus on family strengths, balancing the consideration of challenges with resources and resilience (Early & GlenMaye, 2000). Johnson et al. (2008) conducted an exhaustive review of 85 family assessment instruments related to children’s well-being. They identified seven scales that were particularly promising: the North Carolina Family Assessment Scale (NCFAS), the North Carolina Family Assessment Scale for Reunification (NCFAS-R), Strengths and Stressors Tracking Device (SSTD), Family Assessment Form (FAF), Family Assessment Checklist (FAC), Ackerman-Schoendorf Scales for Parent Evaluation of Custody (ASPECT), and Darlington Family Assessment System (DFAS). Among these, the NCFAS emerged as the most validated scale for assessing children’s well-being and demonstrated excellent suitability for evaluations in such contexts.

The NCFAS emerges as a pivotal scale for assessing family functioning that emphasizes the identification of family strengths and extensive utilization within vulnerable populations. It facilitates in-depth analyses of improvements in family intervention processes, sustained monitoring of user progress, and comprehensive assessment of program efficacy (Johnson et al., 2008). In 1991, following the approval of the Intensive Family Preservation Services (IFPS) program by North Carolina legislation, the NCFAS was developed as part of a state contract. The original authors were assigned to develop an evaluative tool aimed at identifying alterations in family functioning induced by the program. The scale was intended to be ecologically oriented and to align with the primary objective of the IFPS program of preventing unnecessary removal of children from their homes and inducing transformation while maintaining family unity (Kirk & Reed-Ashcraft, 2004). Over the years, several versions of the NCFAS have been introduced: the NCFAS-R for reunification, the NCFAS-G for general services, and the NCFAS G + R, which blends elements from the NCFAS-G and the NCFAS-R. Each version of the scale is distinctly formulated with respect to its intended objective (Kirk, 2012).

These versions of the NCFAS serve as potent tools for a holistic assessment of family well-being. Initially conceived with child welfare issues in mind, the applicability of these scales have been broadened to families that do not necessarily interface with child protection agencies (Kirk, 2012). Several studies, including those by Reed (1998), Reed-Ashcraft et al. (2001), Kirk et al. (2005), Kirk and Martens (2006), Kirk et al. (2007), Valencia and Gómez (2010) and Kirk and Martens (2015), have affirmed the psychometric integrity of the NCFAS across its various iterations. Supported by evidence of its internal consistency and validity, the original NCFAS and its subsequent versions have been a staple in myriad studies, as delineated in Table 1. Examples of these studies include works by Fernandez (2007), Farrell et al. (2010), Gómez et al. (2010), Hurley et al. (2011), Conner and Fraser (2011), and Olsen et al. (2015).

Table 1 Psychometric Properties of the NCFAS in all its Versions and Various Studies Using the Scale
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Lee and Lindsey (2010) investigated the measurement properties of the NCFAS within the realm of youth mental health services. They found that the NCFAS did not operate identically between child mental health contexts and child welfare frameworks. This pivotal revelation underscores the necessity of tailoring the NCFAS when deploying it for specific cohorts, such as vulnerable preschool-aged children, to ensure its potency and pertinence.

An agreement between the National Family Preservation Network (NFPN) and the Child Protector of Chile facilitated the translation of the NCFAS into Spanish. The Spanish rendition was developed using expert evaluations from both the NFPN and the Faculty of Education and Family Sciences of the Finis Terrae University of Chile. The translated version encompasses five components: scale and definitions; frequently asked questions; goal establishment; case studies; and a PowerPoint presentation for training purposes. The Spanish iteration of the NCFAS exhibited sound psychometric properties when applied to the Chilean populace. The Chilean exploration centered on children and adolescents who averaged 9.4 years of age (SD = 4.2) and were enrolled in programs that catered to families with high-risk indicators for child maltreatment (Valencia & Gómez, 2010).

The NCFAS has been extensively used in contexts characterized by elevated risks with the aim of preventing family disintegration. In Ecuador, the most culturally proximate environment where the scale received validation was Chile. Researchers investigated the psychometric properties of the scale congruent with the original objectives of its creation with a focus on high-risk children. We propose that in Ecuador, the NCFAS might be suitable for preschoolers who are vulnerable due to their social circumstances, even if they are not explicitly recognized as high-risk or incorporated into the protection system. The Ecuadorian cohort differs from the Chilean cohort both demographically and in its unique characteristics. Hence, we address two pivotal questions: (1) What is the factorial structure of the NCFAS for Ecuadorian families with vulnerable preschoolers? and (2) How internally consistent is the NCFAS for this sample?

Methods

Participants

Recruitment and Eligibility

We recruited participants for this study through 14 Child Development Center (CDC) coordinators who held degrees in various fields of psychology, including clinical, educational, and child psychology. At the onset of the study, these professionals were already acquainted with the children and had been familiar with their family environments for a minimum of seven months.

The inclusion criteria required the children to belong to vulnerable populations with families that were unable to provide adequate care due to circumstances such as poverty, extreme poverty, unemployment, suboptimal income levels, insufficient parental capabilities, reduced cultural acuity, and/or a lack of educational attainment. We determined eligibility by analyzing the vulnerability forms completed by each family.

Sample Characteristics

A total of 470 children met the inclusion criteria. Table 2 presents the descriptive characteristics of the participants. Due to the constraints of the COVID-19 pandemic, we were able to obtain socioeconomic information for only 413 of the 470 children. From the collected data, 29% of the children reported experiencing insufficient food availability in recent weeks, and 82% of the parents were employed, although 50% were employed in temporary capacities. Of the children’s mothers, 62% were employed, with only 22% in permanent positions. A substantial 99% of children resided with their biological mothers; however, 33% did not live with both biological parents. It was reported that 15% resided in households where domestic violence was prevalent.

Table 2 Descriptive Age of the Participants
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Procedure

We obtained authorization to use the scale by contacting the NFPN, which supplied us with the original Spanish-translated scale package. Subsequently, the Ministry of Economic and Social Inclusion granted approval for the implementation of the NCFAS at the 14 CDCs in Machala, Ecuador. To ensure adherence to the NCFAS, we conducted training using the package supplied by the NFPN involving professionals across all 14 CDCs. Although these professionals developed their assessment skills independently, our team collaborated on completing each NCFAS form to enhance the rigor of the process. We recruited an external evaluator skilled in conducting psychological interviews to enable collaboration with the principal researcher in overseeing, monitoring, and controlling the completion of the NCFAS forms.

We created a Google Forms document to optimize data collection by facilitating online registration and transitioning from paper and pencil to a digital instrument. After obtaining informed consent from the children’s representative and the coordinator, we began the information collection process with scheduled visits to each CDC.

Each analysis took approximately 30 min per child. During this time, professionals answered the questions of the scale, relying on their knowledge acquired through daily interactions and care processes and referring to individual file information. This file contained (a) a record of individuals receiving care at the center, (b) a vulnerability sheet, (c) a general data sheet, (d) a child care sheet, (e) a child nutritional status monitoring sheet, and (f) a comprehensive child development indicators sheet. From July 2019 to February 2020, we meticulously executed data collection. The data were coded to maintain confidentiality and preserve the anonymity of the digital records of cases.

Measurement

We used the original version of the NCFAS, which was translated into Spanish by the NFPN. It features 5 global and 31 specific items as presented in Table 3 (Kirk & Reed-Ashcraft, 2007). This scale is designed to assess difficulties and strengths, with scoring occurring at the commencement and conclusion of the program. Initial ratings assist in develo** intervention plans and setting objectives, while final ratings assess changes after program application (Kirk & Reed-Ashcraft, 1998). The evaluation employs a scaling system ranging from -3 to +2, with each value corresponding to a distinct level of family functioning. A score of -3 indicates a “severe problem”, showing deteriorating family dynamics. A score of +2 represents a “clear strength” or an optimum level of familial functioning. A score of 0 serves as the baseline, representing an “adequate” level of functioning and suggesting no immediate need for intervention from protective services, although it does not signify the absence of familial challenges. A guideline is provided to aid professionals in the scoring process. For intermediate values such as +1, “minor strength,” and -1 and -2, representing “minor problem” and “moderate problem,” there are no fixed criteria; therefore, professionals use their judgment and expertize to assign these scores (Kirk & Reed-Ashcraft, 2007).

Table 3 Global and Specific Items of the NCFAS Instrument. Original Version
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Kirk and Reed-Ashcraft (2004) found that certain items are not applicable in specific family structures. For instance, when children are not of school age or lack siblings, evaluation is not feasible, and the item is marked NA (not applicable).

Data Analysis

We analyzed descriptive statistics and internal consistency using the Python program (Python, 2022). We ascertained validity through data processing with Jamovi version 2.2 computer software (Jamovi, 2021). The data management necessitated the conversion of rating values from +2 (clear strength) to -3 (serious problem) into positive values ranging from 1 (clear strength) to 6 (serious problem).

We conducted an initial descriptive analysis to ascertain the distribution of the items. In this analysis, we focused on global items, which are equivalent to specific items, and used methodologies similar to those in preceding studies of the same scale. The principal descriptive statistics encompassed the mean, mode, standard deviation, skewness, and kurtosis. We processed the data associated with the child well-being factor using a method that handles listwise deletion, incorporating the items “school performance” and “relationship with sibling(s)” This approach was essential because 233 out of the 470 children were only children, and some were not of age for academic performance measurement.

To validate the Ecuadorian iteration of the NCFAS, we employed both confirmatory factor analysis (CFA) and exploratory factor analysis (EFA). For these analyses, global weighting items were omitted because their outcomes are contingent on the ratings of other items. We first executed CFA on the complete sample (n = 470) to confirm the coherence in the item distribution based on the original NCFAS. Following this, cross-validation was instituted by partitioning the study group into two distinct, nonoverlap** subsamples (n1 = 235, n2 = 235). The first subsample underwent a sequence of EFAs with oblique rotation, a method that is suitable for correlated and uncorrelated factors and yields accessible interpretation (Osborne, 2015). Finally, we applied CFA on the alternate subsample (n2 = 235) to confirm coherence in item distribution in alignment with the EFA outcomes and compared it with the reference values of the EFA adjustment indices: comparative fit index (CFI), Tucker–Lewis index (TLI), standardized root mean square residual (SRMR), and root mean square error of approximation (RMSEA). Indices indicative of optimal fit included CFI values of 0.95 or higher, RMSEA values of 0.05 or lower (Lai, 2021), TLI values greater than 0.90 (** stone to gain insight into the reliability and validity of the NCFAS in the unique context of Ecuador. The findings illuminate the need for further nuanced explorations and validations in varied settings to truly grasp the multifaceted implications and applications of the NCFAS.

Practical Implications

The proven psychometric reliability and validity of the NCFAS make it an integral part of various research and intervention programs (Akin & Gomi, 2017; Akin et al., 2018; Conner & Fraser, 2011; Taibo et al., 2018; Farrell et al., 2010; Fernandez, 2007, 2013a, 2013b; Fernandez & Atwool, 2013; Fernandez & Lee, 2011, 2013; Gómez, 2010; Gómez et al., 2012; Hurley et al., 2011; Katsikitis et al., 2013; Malvaso & Delfabbro, 2020; Meadowcroft et al., 2018; Pérez & Santelices, 2016; Yan & De Luca, 2021). By evaluating its psychometric properties and outlining a factorial structure suitable for preschoolers within vulnerable families in Ecuador, we enable the use of the NCFAS in child-centered programs in Ecuador. This allows for the quantification of the outcomes and transformations that families experience during interventions.

Likewise, we can use the scale as a pivotal tool in creating innovative programs aimed at preempting child maltreatment within familial contexts. Historically, there has been a lack of measures dedicated to exploring family dynamics among Ecuadorian preschoolers and evaluating the effectiveness of intervention schemes. The NCFAS fills this gap as a validated, reliable, concise, and user-friendly tool that is essential for both researchers and practitioners in evaluating familial functions.

Limitations

We recognize the limitations of the current study. Our ability to generalize the findings is potentially constrained by the specific sample, especially in the context of the extensive research on NCFAS. Additionally, the unique characteristics of our sample, which was derived from the CDC of a single city in Ecuador, indicate that our results may not apply to vulnerable preschoolers in other cities or reflect the broader Ecuadorian populace. Despite these limitations, our study provides evidence of internal consistency and reliability within a three-factor model and offers empirical support for the use of the NCFAS in evaluating vulnerable preschoolers. This aids in identifying immediate family functioning issues that require intervention and promotes improvements in family functionality. Seeing this scale as the first instrument to assess family functioning with validated psychometric properties in Ecuador accelerates the evaluation of programmatic outcomes in terms of economic efficacy and societal benefit. Furthermore, it can form a basis for future studies exploring the psychometric properties of the NCFAS in other representative samples, covering various areas and demographic sectors in Ecuador, and including high-risk or nonvulnerable populations.