Occupational Performance Coaching With Parents of Young Children With Developmental Disability

A Parent-Coaching Intervention to Promote Community Participation of Young Children With Developmental Disability

Participation in community activities allows children to meet friends, learns new skills, fosters independence, and paves the foundation for lifelong health. High rates of community participation restriction have been reported in children with developmental disabilities who are aged six years or below, a critical developmental period. Occupational Performance Coaching (OPC), grounded in self-determination theory, is aimed to facilitate children's participation in life situations through coaching parents. Studies have shown that OPC is effective to promote children's activity participation. However, there have been limited randomized controlled trials demonstrating the efficacy of OPC, especially with the specific focus on children's community participation. The investigators propose to evaluate the feasibility and acceptability of conducting a pilot randomized controlled trial of OPC for parents of preschool children with developmental disabilities in Hong Kong, and to test its initial efficacy on promoting children's community participation.

The parent-coaching intervention consists of up to 8 weekly/fortnightly sessions, and each session will last up to one hour.

The parent consultations are given for up to 8 weekly/fortnightly sessions, and each session may last up to one hour.

The OPC intervention comprises three components: (1) connect - building parents' trust in the coach by using verbal and nonverbal strategies; (2) structure - building parents' competence by adopting a problem-solving framework of setting goals, exploring options, planning action, carrying out plans, checking performance, and generalizing; and (3) share - building parents' autonomy by reciprocally exchanging information between the coach and parents with an emphasis on eliciting parents existing knowledge. During the exploration of the options for a particular goal, collaborative performance analysis is used. The coach follows the four steps to (a) identify parents' perception of what currently happens, (b) identify what they would like to happen, (c) explore barriers and bridges to the desired performance, and (d) identify their needs for taking actions to achieve goals. Parents are guided to find strategies to facilitate their child's performance to support goal achievement.

The parent consultation consists of the use of the toolbox to provide parents with available environmental resources and strategies to enhance community participation of their child with developmental disability, followed by the understanding of current situation and the identification of problems encountered by parents. Direct informing approach will be used to instruct parents about the availability of environmental resources close to their living areas and what they can plan to do by using possible supportive strategies. In addition, information about child disability and/or developmental milestone may be provided if needed.

Performance and satisfaction scores (1-10) of the Canadian Occupational Performance Measure. Higher scores mean a better outcome.

5-6 weeks before intervention; 1-2 weeks before intervention; 1-2 weeks after intervention; 8-9 weeks after the intervention

Frequency scores (0-7) and involvement scores (1-5) of the community section of the Young Children's Participation and Environment Measure. Higher scores mean a better outcome.

5-6 weeks before intervention; 1-2 weeks before intervention; 1-2 weeks after intervention; 8-9 weeks after the intervention

Efficacy scores (7-42) and satisfaction scores (9-56) of the Parenting Sense of Competence Scale. Higher scores mean a better outcome.

5-6 weeks before intervention; 1-2 weeks before intervention; 1-2 weeks after intervention; 8-9 weeks after the intervention

The scores (0-21 for each subscale) of the Depression, Anxiety and Stress Scale-21. Higher scores mean a worse outcome.

5-6 weeks before intervention; 1-2 weeks before intervention; 1-2 weeks after intervention; 8-9 weeks after the intervention

5-6 weeks before intervention; 1-2 weeks before intervention; 1-2 weeks after intervention; 8-9 weeks after the intervention

Scaled scores (0-100) of the daily activity and social/cognitive domains of the Pediatric Evaluation of Disability Inventory computer-adaptive tests. Higher scores mean a better outcome.

5-6 weeks before intervention; 1-2 weeks before intervention; 1-2 weeks after intervention; 8-9 weeks after the intervention

Perceived environmental support scores (0-100) of the community section of the Young Children's Participation and Environment Measure. Higher scores mean a better outcome.

5-6 weeks before intervention; 1-2 weeks before intervention; 1-2 weeks after intervention; 8-9 weeks after the intervention

Inclusion Criteria: the child has a clinical diagnosis of developmental disability (including but not limited to intellectual disability, developmental delay, or autism spectrum disorder) given by pediatricians/psychiatrist the parents are the child's main caregiver who have a long-term parenting role with at least 50% of caregiving responsibilities the parents are able to converse in Chinese the parents desire to improve their child's participation in community activities Exclusion Criteria: the child has developmental disability combined with physical impairment (e.g., amputation, cerebral palsy, spina bifida) the child has developmental disability combined with sensory impairment (e.g., blindness, deafness)

Chien CW, Lai YYC, Lin CY, Graham F. Occupational Performance Coaching With Parents to Promote Community Participation of Young Children With Developmental Disabilities: Protocol for a Feasibility and Pilot Randomized Control Trial. Front Pediatr. 2021 Nov 5;9:720885. doi: 10.3389/fped.2021.720885. eCollection 2021.