Date Presented 04/04/2025
Telehealth occupation-based coaching (eOBC) for child and caregiver may increase participation among autistic children. We will report on the feasibility of eOBC for autistic children and caregivers. Attendees will apply findings to clinical practice.
Primary Author and Speaker: Melanie Tkach
Contributing Authors: Winifred Dunn, Timothy Wolf
PURPOSE: Autistic children participate less than nonautistic peers. Existing interventions for autistic children improve skills not participation. Occupation-based coaching (OBC), typically for caregivers of young autistic children, may increase participation in school-age, autistic children when used with child and caregiver (CG). We aimed to evaluate feasibility of telehealth OBC (eOBC) for autistic children and a primary CG: (1) Can we use eOBC with autistic children and caregivers? (2) Is eOBC acceptable to CGs of autistic children? (3) What is the preliminary effect of eOBC on child and family outcomes?
DESIGN: We conducted a quasi-experimental one-group pretest-posttest study. We included autistic children ages 6-14 and a primary adult CG with participation goals, internet access, and fluent English.
METHODS: Participants completed eight eOBC calls. We noted child involvement in eOBC and administered the Canadian Occupational Performance Measure, Child and Adolescent Scale of Participation, Parenting Sense of Competence Scale, Telehealth Acceptability Questionnaire (post only) and Beach Family Quality of Life (QOL) Scale pre- and post-intervention. We calculated descriptive statistics for all feasibility outcomes and Hedge’s g effect sizes with 95% confidence intervals for assessment data.
RESULTS: Most children (93.2%) participated in eOBC. CGs reported high intervention acceptability. eOBC had notable effects on child performance (Hedge’s g = 1.65), satisfaction (Hedge’s g = 1.89), sleep disturbance (Hedge’s g = 0.60), and participation (Hedge’s g=0.23) and family QOL (Hedge’s g = 0.26). Conclusions: eOBC is feasible for autistic children and a primary CG. A larger trial is warranted.
IMPACT STATEMENT: This is the first study on the feasibility of eOBC for children and CGs. Results lay a foundation for a future powered trial and suggest a shift from caregiver to child and caregiver coaching in clinical practice may enhance outcomes in school-age, autistic children.
References
Bowen, D. J., Kreuter, M., Spring, B., Cofta-Woerpel, L., Linnan, L., Weiner, D., Bakken, S., Kaplan, C. P., Squiers, L., & Fabrizio, C. (2009). How we design feasibility studies. American Journal of Preventive Medicine, 36(5), 452–457. https://doi.org/10.1016/j.amepre.2009.02.002
Chen, Y. -J., Duku, E., Zaidman-Zait, A., Szatmari, P., Smith, I. M., Ungar, W. J., Zwaigenbaum, L., Vaillancourt, T., Kerns, C., & Bennett, T. (2023). Variable patterns of daily activity participation across settings in autistic youth: A latent profile transition analysis. Autism, 27(8), 2241–2255. https://doi.org/10.1177/13623613231154729
Lamash, L., Bedell, G., & Josman, N. (2020). Participation patterns of adolescents with autism spectrum disorder compared to their peers: Parents’ perspectives. British Journal of Occupational Therapy, 83(2), 78–87. https://doi.org/10.1177/0308022619853518
Little, L. M., Pope, E., Wallisch, A., & Dunn, W. (2018). Occupation-based coaching by means of telehealth for families of young children with autism spectrum disorder. The American Journal of Occupational Therapy, 72(2), Article 7202205020. https://doi.org/10.5014/ajot.2018.024786
