Date Presented 4/21/2018
In this qualitative study, early intervention occupational therapists shared how they were using principles of family-centered practice when educating families of children with autism spectrum disorder about their child’s sensory needs and involving families in the development of their child’s sensory diet.
Primary Author and Speaker: Danielle Friberg
Contributing Authors: Lorie Richards, Heidi Woolley, Robyn Thompson
BACKGROUND AND PURPOSE: The push in health care toward family-centered practice (Dunst et al., 2006) and the emphasis on early identification of autism spectrum disorder (ASD) may result in an increase in home-based occupational therapy for children with ASD, especially via early intervention (EI) services. One common intervention used to address sensory processing issues in children with ASD is the sensory diet (Wilbarger & Wilbarger, 2002). Yet, there is minimal information regarding how EI occupational therapists educate families about sensory processing issues and include them in the development of sensory diets (Dunstan & Griffiths, 2008; Segal & Beyer, 2006).
This study explored whether and how EI occupational therapists are using family-centered principles when teaching families of children with ASD or suspected ASD about their child’s sensory needs and the use of a sensory diet as a treatment approach. In addition, the study examined whether EI occupational therapists used family-centered practice principles to involve families in the development of their child’s sensory diet, how EI occupational therapists determined the effectiveness of a child’s sensory diet, and occupational therapists’ perceptions of family supports and barriers to implementation of the sensory diet.
METHOD: We used a qualitative descriptive research approach to address the research questions. Participants were recruited by emails to EI agency directors and occupational therapists in the Intermountain West and by postings in EI and pediatric occupational therapy Facebook groups. Inclusion criteria were as follows: licensed occupational therapist currently working in an EI setting, minimum of 2 yr experience working with children with ASD in an EI setting, self-reported use of sensory diets as an intervention approach for children with ASD, and English as their primary language.
Data collection consisted of semistructured interviews with participants to elicit information about how they used family-centered principles when educating families and developing sensory diets and about their perspective on supports and barriers families experienced when implementing a sensory diet. All interviews were audio recorded and transcribed verbatim. Qualitative content analysis using an inductive approach was used to analyze transcript data.
RESULTS: Six occupational therapists participated in the study. They reported incorporating principles of family centeredness when selecting teaching strategies by tailoring their teaching to each family and using a variety of methods including situated learning, mutual problem solving, and handouts. They also described involving families in the development of the sensory diet by having them prioritize problem behaviors and using materials available in the home. Participants reflected family centeredness by enhancing feasibility of the sensory diet through an understanding of family supports and barriers and family routines. They also reported not using standardized or formalized methods when determining effectiveness of the sensory diet.
CONCLUSION: Findings reflect the family-centered philosophy of EI through these occupational therapists’ incorporation of family-centered principles when using a sensory diet to address sensory processing in children with ASD. These results offer occupational therapy practitioners guidance regarding ways to use family-centered principles when implementing a sensory diet in EI. In addition, results suggest the potential usefulness of the development of family-centered materials that practitioners can use to identify families’ priorities, routines, supports, and barriers when addressing sensory processing in the EI setting. Last, results provide support for instruction on the use of family-centered principles in graduate and continuing education courses.
References
Dunst, C. J., Bruder, M. B., Trivette, C. M., & Hamby, D. W. (2006). Everyday activity settings, natural learning environments, and early intervention practices. Journal of Policy and Practice in Intellectual Disabilities, 3, 3–10. https://doi.org/10.1111/j.1741-1130.2006.00046.x
Dunstan, E., & Griffiths, S. (2008). Sensory strategies: Practical support to empower families. New Zealand Journal of Occupational Therapy, 55(1), 5–13.
Segal, R., & Beyer, C. (2006). Integration and application of a home treatment program: A study of parents and occupational therapists. American Journal of Occupational Therapy, 60, 500–510. https://doi.org/10.5014/ajot.60.5.500
Wilbarger, J., & Wilbarger, P. (2002). Application of the sensory diet. In A. Bundy (Ed.), Sensory integration, theory, and practice (pp. 339–378). Philadelphia: F. A. Davis.
