A scoping review of parental roles in rehabilitation interventions for children with developmental delay, disability, or long-term health condition

Foundational concepts of collaborative practice with parents in occupational therapy for children

INTRODUCTION

In occupational therapy for children, collaborative practice with parents is crucial for meaningful family-centred interventions, yet it remains undefined and inconsistently addressed. This study aimed to establish foundational concepts for collaborative practice with parents in occupational therapy for children in progressing the field with a universal description.

METHODS

This paper encompasses the second dataset of a larger scoping review and a preliminary validation of findings by an advisory panel. Data were gathered from indexed sources on collaborative practice with parents in occupational therapy for children (ages 0-10) using MedLine, PsychInfo, ERIC, Embase, OTSeeker, Scopus, and ProQuest Central. Data were extracted, charted, and descriptively analysed by paired independent reviewers. The Joanna Briggs Institute Manual and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis-extension for Scoping Reviews were used. A draft definition of collaborative practices, developed based on preliminary review findings and an operational definition, was validated by an advisory panel of 13 experienced Australian occupational therapists, whose input was integrated into a final, comprehensive description of collaborative practice.

RESULTS

The scoping review encompassed 299 sources, revealing three major components of collaborative practice: 'collaborative practice aims', 'parent-therapist partnership', and 'strategies for collaboration'. The advisory panel endorsed the draft definition, confirmed its professional relevance, and suggested some modifications.

CONCLUSION

The major outcome of this study is an evidence-based and discipline-specific preliminary description of collaborative practice with parents in occupational therapy for children. This description provides a common language and foundational concepts for the future development of a collaborative practice framework to guide practice and research. Future studies can explore specific components, exploring their mechanisms and significance. Further expanded validation is required, incorporating the perspectives of a wider community of occupational therapists and families to enhance the description's applicability.

The wide world of technological telerehabilitation for pediatric neurologic and neurodevelopmental disorders - a systematic review

Introduction

The use of Information and Communication Technology (ICT) for assessing and treating cognitive and motor disorders is promoting home-based telerehabilitation. This approach involves ongoing monitoring within a motivating context to help patients generalize their skills. It can also reduce healthcare costs and geographic barriers by minimizing hospitalization. This systematic review focuses on investigating key aspects of telerehabilitation protocols for children with neurodevelopmental or neurological disorders, including technology used, outcomes, caregiver involvement, and dosage, to guide clinical practice and future research.

Method

This systematic review adhered to PRISMA guidelines and was registered in PROSPERO. The PICO framework was followed to define the search strategy for technology-based telerehabilitation interventions targeting the pediatric population (aged 0-18) with neurological or neurodevelopmental disorders. The search encompassed Medline/PubMed, EMBASE, and Web of Science databases. Independent reviewers were responsible for selecting relevant papers and extracting data, while data harmonization and analysis were conducted centrally.

Results

A heterogeneous and evolving situation emerged from our data. Our findings reported that most of the technologies adopted for telerehabilitation are commercial devices; however, research prototypes and clinical software were also employed with a high potential for personalization and treatment efficacy. The efficacy of these protocols on health or health-related domains was also explored by categorizing the outcome measures according to the International Classification of Functioning, Disability, and Health (ICF). Most studies targeted motor and neuropsychological functions, while only a minority of papers explored language or multi-domain protocols. Finally, although caregivers were rarely the direct target of intervention, their role was diffusely highlighted as a critical element of the home-based rehabilitation setting.

Discussion

This systematic review offers insights into the integration of technological devices into telerehabilitation programs for pediatric neurologic and neurodevelopmental disorders. It highlights factors contributing to the effectiveness of these interventions and suggests the need for further development, particularly in creating dynamic and multi-domain rehabilitation protocols. Additionally, it emphasizes the importance of promoting home-based and family-centered care, which could involve caregivers more actively in the treatment, potentially leading to improved clinical outcomes for children with neurological or neurodevelopmental conditions.

Systematic review registration

PROSPERO (CRD42020210663).

Tasks performed by parents to enable telepractice for children with communication disorders: an interview study with clinicians and parents

PURPOSE

Current service models in childhood rehabilitation promote the active participation of parents/caregivers in their children's therapies. The existing literature provides a limited understanding of the tasks and responsibilities parents undertake in their children's therapies, especially over telepractice. This study describes the tasks undertaken by parents in their children's speech therapy delivered virtually during the COVID-19 pandemic.

METHODS

A qualitative descriptive study was conducted with parents and speech-language pathologists, using open-ended interviews. Interviews were analyzed using a combination qualitative content analysis and thematic analysis.

RESULTS

Parents performed many tasks to enable telepractice. These tasks happened before (e.g., setting up both physical and virtual space for therapy), during (e.g., managing child's behavior), and after the virtual therapy session (e.g., carrying out home practice). While parents were willing to perform these tasks in order to help their children, some expressed the toll that it can take on them.

CONCLUSIONS

Compared to what is known from in-person visits, some of these tasks were novel and unique to telepractice. We recommend that clinicians and parents collaboratively decide on tasks and responsibilities to avoid burdening parents, and that they weigh the costs associated with performing these tasks against the benefits of teletherapy.IMPLICATIONS FOR REHABILITATIONParents perform many tasks to support their children's therapies, both during and outside of therapy sessionsTherapies delivered virtually require parents to assume additional tasks to support their childrenFor services to be Family-Centered, tasks and responsibilities need to be decided collaboratively between parents and clinicians.

Social Work and Motivation for Rehabilitation in Children with Disorders of the Musculoskeletal System

The relevance of the presented article is due to the lack of information on the impact of social work in the development of rehabilitation motivation in children with disorders of the musculoskeletal system. This research aimed to evaluate the role of social work in shaping rehabilitation motivation in children with musculoskeletal disorders. Using a questionnaire, the study involved 43 children and their carers who received social support and 20 who did not. Analysis revealed a significant correlation between the absence of social support and rehabilitation outcomes. The results underlined the value of rehabilitation, with a predominantly positive response to its methods and outcomes. The data also suggested that the absence of social work could increase the likelihood of unfavorable outcomes. By highlighting the need for comprehensive treatment and rehabilitation strategies, this research provides a basis for improving rehabilitation approaches. Addressing the challenges highlighted could pave the way for optimized public health strategies.

"Your brain can't wait": perspectives of children and adolescents with acquired brain injury and their parents on physical rehabilitation during the subacute phase

PURPOSE

Physical interventions during subacute rehabilitation have potential to improve functional recovery. This study explored the perspectives of children and adolescents with acquired brain injury (ABI) and their parents with respect to physical rehabilitation during the subacute phase.

METHODS

Thirteen children and adolescents with ABI and their parents were included and interviewed using semi-structured interviews. Interview transcripts were analysed using inductive thematic analysis approach.

RESULTS

Six themes were identified: 1) beliefs of physical rehabilitation, 2) content of physical rehabilitation, 3) tailored care, 4) impact of context, 5) communication and 6) transition. The importance of intensive physical practice was widely supported. The positive can-do mentality was emphasised to create an atmosphere of hope, meaning that every effort would be made to achieve maximum recovery. Intensive involvement of parents is considered essential during subacute rehabilitation including an open and mutual dialogue about the focus of rehabilitation, therapy goals and future participation in their own environment.

CONCLUSIONS

Our findings highlight the need for an intensive rehabilitation approach, tailored to the individual's needs. The perspectives of children and adolescents and their parents in our study contribute to a better understanding of factors that are important for optimal recovery through physical rehabilitation during the subacute phase.

Habilitation of sleep problems among mothers and their children with autism spectrum disorder: Insights from multi-level exploratory dyadic analyses

Few habilitation strategies for children with autism spectrum disorder (ASD) consider their sleep-related problems. Together with the fact that caregivers of children with ASD also face issues with sleep, there may be yet-to-be uncovered relationships between caregiver-child sleep patterns and sleep quality, offering a key opportunity for clinicians to consider the needs of both child and caregiver in terms of sleep. 29 dyads of mothers and their children with ASD were recruited for this cohort study and both subjective (self-report questionnaires and sleep diaries) and objective (cortisol samples and actigraphy) measures of sleep were collected to investigate significant predictors of sleep quality. Comparative, correlational, and hierarchical analyses were conducted. Findings indicated that both mother and child experience sleep deprivation in terms of shorter sleep duration and poor sleep quality in terms of longer sleep onset latencies and a higher frequency of wake bouts. Exploratory hierarchical analyses also found that child-related sleep difficulties such as sleep disordered breathing and night waking significantly predict mothers’ sleep quality, which may point to the bi-directional influence of mother-child sleep. Based on these findings, it is recommended that clinicians adopt a family systems perspective and consider the sleep environment of the household, particularly that of the caregiver and child, when designing interventions for sleep-related problems in ASD. Finally, there is a need for additional support to promote good quality sleep among caregivers of children with ASD to bolster out-of-clinic care.

Cultural Adaptation of Parent-Implemented Early Communication Interventions: A Scoping Review

PURPOSE

Parent-implemented early communication interventions are commonly delivered to culturally and linguistically diverse families. Although there is evidence from fields such as public health or psychology, there is little guidance regarding what elements to culturally adapt for parent-implemented speech-language pathology interventions. This scoping review addresses this gap by identifying parent-implemented early communication interventions that have been culturally adapted and describing which intervention components were adapted. Definitions of culture, use of adaptation frameworks, and adaptation guidelines, policies, and recommendations are also reported.

METHOD

The databases Cumulative Index to Nursing and Allied Health Literature, MEDLINE, PsycINFO, and Embase via OVID were searched. Supplementary search methods, including hand-searching of references and a gray literature search, were also conducted. Covidence software was used to deduplicate, collate, and review articles. Population, intervention, study, and cultural adaptation data were extracted and synthesized using the Ecological Validity Framework.

RESULTS

Twenty-one articles were included from the database and supplementary searches. No studies defined culture, and only three used cultural adaptation models or frameworks to guide adaptation. Studies varied greatly in what they adapted; language adaptations, such as translation, were conducted most frequently, and intervention goals were rarely adapted. Only three studies obtained parent feedback to inform cultural adaptation for future recommendations.

CONCLUSIONS

More clarity in the reporting of cultural adaptation for communication interventions is required. Cultural adaptation frameworks are useful tools to guide adaptation but can be difficult to operationalize. Additional research in this area is necessary to help clinicians provide culturally responsive, parent-implemented communication interventions.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.20416107.

Positive Effects of the Caregiver Skill Training Program on Children With Developmental Disabilities: Experiences From Serbia

BACKGROUND

Intervention programs for children with developmental disabilities increasingly target caregiver training to implement effective strategies for child development. Research conducted in different countries shows that the Caregiver Skills Training Program (CST) developed by the World Health Organization and Autism Speaks could also be a recommended intervention.

METHODS

The pre-pilot phase included seven, and the pilot phase included 29 families of children with developmental disabilities trained to implement the intervention program. The caregivers were asked to complete the Autism Treatment Evaluation Checklist at the beginning and at the end of the program.

RESULTS

In the pre-pilot phase, the Wilcoxon signed-rank test determined a statistically significant improvement in Speech, Language and Communication (z = -2.99, p < 0.05) and Health/Physical/Behavior (z = -2.375, p < 0.05) after caregiver participation in the training program. In the pilot phase, the paired t-test also determined a statistically significant improvement in Speech, Language and Communication between the first (M = 24.52, SD = 5.57) and the second testing (M = 25.66, SD = 6.11), t₍₂₈₎ = -2.29, p < 0.05, as well as a significant improvement between the first (M = 36.62; SD = 7.15) and the second testing (M = 35.38; SD = 5.91), t₍₂₈₎ = 2.11, p < 0.05 in Health/Physical/Behavior. Eta squared values (0.16 and 0.14) indicate that the intervention effect was significant. No differences were determined in Sociability and Sensory/Cognitive Awareness between the first and the second testing.

CONCLUSION

The initial results of the Caregiver Skills Training Program are encouraging. For this program to be recommended as an evidence-based intervention, further research should be conducted on larger samples, controlling possible intervening variables.