The proposed study will include expanding the domain of health literacy to include its role in the optimal development of children with special health care needs. We will focus on two types of health literacy in the special needs context: (a) the specific knowledge and skills needed to interact with and navigate the multiple service systems in which these children and their families are served (e.g., special education, pediatrics, health insurance, social welfare); (b) and the skills needed to provide a thorough health/developmental history to clinicians. Specifically, the aims of this pilot study are: (1)To understand, using qualitative methods, the nature and scope of health literacy from the perspective of English- and Spanish-speaking parents of children with special health care needs, and to identify commonalities and differences in the nature and extent of health literacy-related needs and resources (i.e. social support) within this diverse population of families; (2)To develop a survey specific to parents of children with special needs that will allow analysis of the relationship between health literacy, social support, and key service-related outcomes in the health and educational service sectors, and to conduct preliminary analyses (using a pilot sample of English- and Spanish-speaking parents) of the following three hypotheses: I. Health literacy is (independently) positively associated with key service-related outcomes, e.g. access, care coordination II. Social support is (independently) positively associated with key service-related outcomes, e.g. access, care coordination. III. Level of social support moderates the relationship between health literacy and service-related outcomes
