Winnie Dunn, Jane Cox, Lauren Foster, Lisa Mische-Lawson, Jennifer Tanquary; Impact of a Contextual Intervention on Child Participation and Parent Competence Among Children With Autism Spectrum Disorders: A Pretest–Posttest Repeated-Measures Design. Am J Occup Ther 2012;66(5):520-528. doi: 10.5014/ajot.2012.004119.
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© 2018 American Occupational Therapy Association
OBJECTIVE. We tested an occupational therapy contextual intervention for improving participation in children with autism spectrum disorders and for developing parental competence.
METHOD. Using a repeated-measures pretest–posttest design, we evaluated the effectiveness of a contextually relevant reflective guidance occupational therapy intervention involving three components: authentic activity settings, family’s daily routines, and the child’s sensory processing patterns (Sensory Profile). We used these components to coach 20 parents in strategies to support their child’s participation. Intervention sessions involved reflective discussion with parents to support them in identifying strategies to meet their goals and make joint plans for the coming week. We measured child participation (Canadian Occupational Performance Measure, Goal Attainment Scaling) and parent competence (Parenting Sense of Competence, Parenting Stress Index).
RESULTS. Results indicated that parents felt more competent and children significantly increased participation in everyday life, suggesting that this approach is an effective occupational therapy intervention.
Do children increase their participation in family activities and routines?
Do parents increase their competence and decrease stress in their parenting role (i.e., parental competence)?
TEST 1–TEST 2 (baseline): Do outcomes change over a 4-wk period without additional intervention?
TEST 2–TEST 3: Is the intervention effective?
TEST 3–TEST 4: Are effects sustained without contact?
TEST 1–TEST 4: Are there overall changes from first to last meeting?
This study contributes evidence that families are strong resources for managing their own lives. By providing a structure for problem solving (intervention characteristics) and reflective guidance (coaching), we supported parents in finding unique ways to achieve prioritized goals.
Interventions focused solely on supporting families to achieve their prioritized goals lead to significant improvement in children’s participation in ways that parents found useful.
Using coaching with parents to find strategies to achieve their goals leads to the parents feeling more competent in their parenting role.
Linking sensory patterns to daily life activities and settings provides a structure for problem solving.
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