Date Presented 4/20/2018
The purpose of this study was to investigate parent and occupational therapy practitioner perceptions of family-centered practice in early intervention settings. The results can be used to gain a better understanding of the application of family-centered practice and barriers to its success.
Primary Author and Speaker: Mallory Halverson
Additional Authors and Speakers: Melissa Barrios, Tina Mankey
Contributing Authors: Jacinda Witt, Deborah Coltharp
PURPOSE: Family-centered practice is a model of occupational therapy practice that operates under the assumption that the family knows their child best. This philosophy is especially important in practice with the early intervention population because young children operate as an extension of the family rather than as independent individuals. Research has shown that the degree of family centeredness can differ vastly by practice setting (Fingerhut et al., 2013). Although many studies have separately examined occupational therapy practitioner or parent perspectives on family-centered practice (Bulkeley et al., 2016; Fingerhut et al., 2013; Podvey et al., 2010), these perspectives have not been explored concurrently. The purpose of this study was to investigate parent and occupational therapy practitioner perceptions of family-centered practice in early intervention settings. The results can be used to gain a better understanding of the application of family-centered practice and barriers to its success.
METHOD: Survey methodology was used with a convenience sample of 24 participants from early intervention practice settings in one southern state; 15 were practitioners (13 occupational therapists, two occupational therapy assistants) and nine were parents. All occupational therapy practitioners currently provided services to children aged 0–3, and all parents had a child aged 0–3 who received occupational therapy services. Partner sites were responsible for distributing and collecting surveys.
Participants completed the researcher-generated Family-Centered Practice Survey containing 14 Likert-scale questions (0 = never present, 5 = always present) and an area for additional comments. Questions were the same in the parent and practitioner versions of the questionnaire but were tailored with language appropriate to participants’ role. The Family-Centered Practice Survey was developed on the basis of the three main components of the family-centered practice model: Parents know their child best, interventions should be flexible and tailored to the family’s unique needs, and interventions should support family functioning.
Demographic information requested from practitioners included credentials, details of practice experience, and knowledge of the family-centered practice mode. Demographic information requested from parents included number of children, details of their child’s treatment plan, types of developmental delays affecting the child, and their experience with early intervention.
RESULTS: Overall, ratings of family centeredness were fairly high from both parents and practitioners. No items were rated below 2. Survey items related to strengthening and supporting family function and general family centeredness tended to receive lower ratings. Questions related to parents knowing their child best, treatment flexibility, and meeting the unique needs of the family tended to receive higher ratings.
CONCLUSION: The results of this study show that parents and practitioners typically agreed on the family centeredness of practice in early intervention. It appears that parents were highly valued as experts on their child, but our findings also suggest that family function many not be as highly considered in current practice. Although the value of family-centered practice is widely accepted, it is important to reflect on its actual implementation in the profession. These findings suggest ways to improve the application of family-centered practice and a focused scope for future research.
References
Bulkeley, K., Bundy, A., Roberts, J., & Einfeld, S. (2016). Family-centered management of sensory challenges of children with autism: Single-case experiment design. American Journal of Occupational Therapy, 70, 7005220040. https://doi.org/10.5014/ajot.2016.017822
Fingerhut, P. E., Piro, J., Sutton, A., Campbell, R., Lewis, C., Lawji, D., & Martinez, N. (2013). Family-centered principles implemented in home-based, clinic-based, and school-based pediatric settings. American Journal of Occupational Therapy, 67, 228–235. https://doi.org/10.5014/ajot.2013.006957
Podvey, M. C., Hinojosa, J., & Koenig, K. (2010). The transition from early intervention to preschool special education services: Family-centered practice that promotes positive outcomes. Journal of Occupational Therapy, Schools, and Early Intervention, 2, 73–83. https://doi.org/10.1080/19411240903146111
