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Archer-Kuhn B, Lind C, Beltrano N, Garrisen L, Hettler J, Reilly S. Realizing an Evidence-Based Framework for the Management and Delivery of Family Support Services. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2024; 21:455-473. [PMID: 38288721 DOI: 10.1080/26408066.2024.2310599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
PURPOSE This paper reports on how service providers and academic researchers partnered to support the journey of a primary prevention organization in western Canada as they reviewed their programming against an evidence-based practice (EBP) framework. The process allows the organization to increase their EBP culture by encouraging staff understanding and uptake of their nine family support programs. It also informs service users and other stakeholders of the evidentiary status of different kinds of support services. In this way, the families become more informed and engaged partners who might easily evaluate the respective risks and benefits of the various applications. METHOD As part of the process, an evidence-based framework used a common language to assess the efficacy of the respective nine programs. RESULTS All nine programs are now mapped into the EBP framework. CONCLUSIONS This review allows staff to become more intentional and informed about the EBPs they employ to support vulnerable families and to use this knowledge to better inform the families with whom they work. This paper and the process the agency followed can be a model for other organizations who serve families experiencing short-term housing crisis, provide infant nursery care, and other support services for families with young children.
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Affiliation(s)
- Beth Archer-Kuhn
- Faculty of Social Work, University of Calgary, Calgary, AB, Canada
| | - Candace Lind
- Faculty of Nursing, University of Calgary, Calgary, Canada
| | - Natalie Beltrano
- School of Social Work, University of Windsor, Windsor, ON, Canada
| | - Lisa Garrisen
- of Programs, Children's Cottage Society, Calgary, AB, Canada
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King G, Graham F, Ahkbari Ziegler S. Comparing three coaching approaches in pediatric rehabilitation: contexts, outcomes, and mechanisms. Disabil Rehabil 2024; 46:2708-2719. [PMID: 37386721 DOI: 10.1080/09638288.2023.2229731] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 06/21/2023] [Indexed: 07/01/2023]
Abstract
PURPOSE This Perspectives paper advances understanding of coaching in pediatric rehabilitation. We compare three coaching approaches designed for pediatric rehabilitation: Coping with and Caring for Infants with Special Needs (COPCA), Occupational Performance Coaching (OPC), and Solution-Focused Coaching in Pediatric Rehabilitation (SFC-peds). OBJECTIVES Our objectives are to contrast the theory underpinning the approaches, discuss the evidence for outcomes and hypothesized mechanisms of change, consider the necessary mindsets of effective coaches, and propose directions for research and practice. SUMMARY The coaching approaches have different theoretical bases and are designed for specific contexts, yet are similar in their mechanisms of change and intended outcomes. There is growing evidence of important effects of coaching on coachees' goal achievement, empowerment, and capacity building. Studies indicate that stakeholders value coaching, and provide a preliminary understanding of the mechanisms, including engagement and self-efficacy, by which coaching approaches support clients' self-directed and sustained change. Open, curious, and client-centered practitioner mindsets are fundamental to effective coaching. CONCLUSIONS Coaching is a distinctive group of relational, goal-oriented, and evidence-based approaches that support goal achievement and empowerment. These approaches reflect and advance an ongoing paradigm shift in pediatric rehabilitation-a movement from therapist-as-expert approaches to those that build empowerment and capacity.
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Affiliation(s)
- Gillian King
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Fiona Graham
- Rehabilitation and Research Unit, University of Otago, Wellington, New Zealand
| | - Schirin Ahkbari Ziegler
- School of Health Sciences, Institute of Physiotherapy, Zurich University of Applied Sciences, Winterthur, Switzerland
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Moeller MP, Gale E, Szarkowski A, Smith T, Birdsey BC, Moodie STF, Carr G, Stredler-Brown A, Yoshinaga-Itano C, Holzinger D. Family-Centered Early Intervention Deaf/Hard of Hearing (FCEI-DHH): Foundation Principles. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2024; 29:SI53-SI63. [PMID: 38422441 DOI: 10.1093/deafed/enad037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 03/02/2024]
Abstract
This article is the fifth in a series of eight articles that comprise a special issue on Family-Centered Early Intervention (FCEI) for children who are deaf or hard of hearing (DHH) and their families, or FCEI-DHH. The 10 FCEI-DHH Principles are organized conceptually into three sections (a) Foundation Principles, (b) Support Principles, and (c) Structure Principles. Collectively, they describe the essential Principles that guide FCEI for children who are DHH and their families. This article describes the Foundation Principles (Principles 1 and Principle 2). The Foundation Principles emphasize the essential elements of ensuring that families with children who are DHH can access early intervention (EI) and other appropriate supports, as well as highlight the need for provision of EI that is family-centered. Implementation of these FCEI-DHH Principles is intended to improve the lives and the outcomes of children who are DHH and their families around the globe.
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Affiliation(s)
- Mary Pat Moeller
- Center for Childhood Deafness, Language & Learning, Boys Town National Research Hospital, Omaha, NE, United States
| | - Elaine Gale
- School of Education, Deaf and Hard-of-Hearing Program, Hunter College, City University of New York, New York, NY, United States
| | - Amy Szarkowski
- The Institute, Children's Center for Communication/Beverly School for the Deaf, Beverly, MA, United States
- Institute for Community Inclusion, University of Massachusetts Boston, Boston, MA, United States
| | | | - Bianca C Birdsey
- Global Coalition of Parents of Children who are Deaf or Hard of Hearing (GPODHH), Durban, South Africa
| | - Sheila T F Moodie
- Health Sciences, School of Communication Sciences & Disorders, Western University, London, ON, Canada
| | - Gwen Carr
- Early Hearing Detection and Intervention and Family Centered Practice, London, United Kingdom
| | - Arlene Stredler-Brown
- Colorado Early Hearing Detection and Intervention Program, Colorado Department of Human Services, Denver, CO, United States
| | | | - Daniel Holzinger
- Institute of Neurology of Senses and Language, Hospital of St. John of God, Linz, Austria
- Research Institute for Developmental Medicine, Johannes Kepler University, Linz, Austria
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Fergus A, Wyker C, Heyl N, Lewis T, Hartsook K. Factors influencing caregiver buy-in to early intervention physical therapy. J Pediatr Rehabil Med 2024; 17:221-235. [PMID: 38251072 DOI: 10.3233/prm-230025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2024] Open
Abstract
OBJECTIVE The family-centered care framework of Early Intervention (EI) has shifted the focus toward caregiver engagement, but the underlying processes that build this are unknown. The aims of this study were 1) to describe the process of caregiver engagement in therapy and (2) to identify factors perceived to influence caregiver buy-in, confidence, and engagement in EI. METHODS This preliminary descriptive study utilized quantitative questionnaires and qualitative semi-structured interviews of EI participants (23 caregivers and four physical therapists). Interviews were transcribed and theme coded until saturation was achieved and a concept map was developed. RESULTS All caregivers believed that their children benefited from EI, that they were empowered and confident in caring for their children, and their quality of life improved based on the quantitative data. The qualitative data revealed that building a rapport and therapeutic relationship is the foundation to developing buy-in. Reciprocal communication is critical to the relationship and the buy-in. Caregiver knowledge and awareness of progress foster caregiver buy-in and confidence once the relationship is established. CONCLUSION Improved understanding of the factors influencing the development of buy-in will provide a framework for the clinician to enhance caregiver buy-in. Enhanced buy-in may promote parental engagement and improved outcomes for the child and family.
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Dostie R, Gaboury I, Trottier N, Hurtubise K, Camden C. Acceptability of a Multimodal Telerehabilitation Intervention for Children Ages 3-8 Years with Motor Difficulties: Results of a Qualitative Study. Dev Neurorehabil 2023; 26:287-301. [PMID: 37403439 DOI: 10.1080/17518423.2023.2233020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 06/29/2023] [Accepted: 07/01/2023] [Indexed: 07/06/2023]
Abstract
PURPOSE The purpose of this study is to explore the acceptability of a telerehabilitation intervention provided to parents of children with motor difficulties. MATERIAL AND METHODS Sixteen parents of children were purposefully recruited to participate in semi-structured interviews aimed at assessing the acceptability of the telerehabilitation intervention. Interviews were analyzed thematically. RESULTS All participants described evolving acceptability associated with their interactions with the web platform. The opportunities generated, suitability in relation to families' values and perceived effects positively impacted acceptability. The understanding and consistency of intervention delivery, the child's level of involvement, the associated parental burden of the intervention and the therapeutic alliances created also affected acceptability. CONCLUSION Our study findings support the acceptability of a telerehabilitation intervention for families of children with motor difficulties. Telerehabilitation seems to be more acceptable to families with children without suspected or confirmed diagnoses.
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Pflock KA, Fragala-Pinkham M, Shulman J, Babcock BD. Hospitalized Infants With Medical Complexity Experience Slow Acquisition of Gross Motor Skills. Hosp Pediatr 2023; 13:408-415. [PMID: 37096549 DOI: 10.1542/hpeds.2022-006848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
OBJECTIVES The progression of infant gross motor development during an acute hospitalization is unknown. Understanding gross motor skill acquisition in hospitalized infants with complex medical conditions is necessary to develop and evaluate interventions that may lessen delays. Establishing a baseline of gross motor abilities and skill development for these infants will guide future research. The primary purposes of this observational study were to: (1) describe gross motor skills of infants with complex medical conditions (n = 143) during an acute hospitalization and (2) evaluate the rate of change in gross motor skill development in a heterogenous group of hospitalized infants with prolonged length of stay (n = 45). METHODS Gross motor skills in hospitalized infants aged birth to 18 months receiving physical therapy were evaluated monthly using the Alberta Infant Motor Scale. Regression analysis was completed to assess rate of change in gross motor skills. RESULTS Of the 143 participants, 91 (64%) demonstrated significant motor delay at initial evaluation. Infants with prolonged hospitalization (mean 26.9 ± 17.5 weeks) gained new gross motor skills at a significant rate of 1.4 points per month in Alberta Infant Motor Scale raw scores; however, most (76%) continued with gross motor delays. CONCLUSIONS Infants with complex medical conditions admitted for prolonged hospitalization frequently have delayed gross motor development at baseline and have slower than typical acquisition of gross motor skills during hospitalization, gaining 1.4 new skills per month compared with peers acquiring 5 to 8 new skills monthly. Further research is needed to determine effectiveness of interventions designed to mitigate gross motor delay in hospitalized infants.
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Affiliation(s)
- Kelly A Pflock
- Physical Therapy and Occupational Therapy Department, Boston Children's Hospital, Boston, Massachusetts
- Thom Marlboro Area Early Intervention, Marlborough, Massachusetts; and
| | - Maria Fragala-Pinkham
- Physical Therapy and Occupational Therapy Department, Boston Children's Hospital, Boston, Massachusetts
| | - Julie Shulman
- Physical Therapy and Occupational Therapy Department, Boston Children's Hospital, Boston, Massachusetts
| | - Breanne Dusel Babcock
- Physical Therapy and Occupational Therapy Department, Boston Children's Hospital, Boston, Massachusetts
- Elite Physical Therapy, Attleboro, Massachusetts
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Akhbari Ziegler S, Suárez X. Reliability, Construct Validity and Completeness of the "Winterthur Observation Protocol" Applied to Early Intervention in Pediatric Physiotherapy Using Coaching. Phys Occup Ther Pediatr 2023; 43:596-610. [PMID: 36823516 DOI: 10.1080/01942638.2023.2181724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 02/02/2023] [Accepted: 02/10/2023] [Indexed: 02/25/2023]
Abstract
AIM To assess intra- and inter-rater reliability, construct validity and completeness of the "Winterthur Observation Protocol" (WOP). METHODS Intra-rater and inter-rater reliability were calculated with the interclass correlation coefficient (ICC) with 95% confidence intervals and Cohens's kappa coefficient based on 18 5-min sequences from six video-recorded early intervention sessions rated by two assessors. Construct validity was based on an increase of coaching over time (three video-recorded sessions) in six therapists during a course on coaching techniques. WOP's completeness - the capacity to cover at least 95% of the specific coaching strategies - was assessed based on 18 video-recorded sessions. RESULTS Intra-rater reliability was excellent: ICCs of continuous variables varied from .87 to 1.0; the kappa-value of categorical variables was 0.90. Inter-rater reliability was sufficient to excellent: ICCs of continuous variables were .47-1.0; the kappa-value of categorical variables was .89, indicating excellent intra-rater reliability. Increasing application of coaching behavior during the course provided evidence of construct validity. More than 95% of the specific coaching strategies could be scored with the WOP. CONCLUSION The WOP is a promising instrument to quantify the contents of early intervention approaches in pediatric physical therapy using coaching. Results must be interpreted with caution due to limited generalizability.
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Affiliation(s)
- Schirin Akhbari Ziegler
- School of Health Sciences, Institute of Physiotherapy, Zurich University of Applied Sciences ZHAW, Winterthur, Switzerland
| | - Ximena Suárez
- Facultad de Medicina, Universidad Nacional Autónoma de México Mexico City, Mexico
- Medicine faculty, Universidad de Salamanca, Salamanca, Spain
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Lee PX, Wong TCS, Ng PYB, Yuen HCC, Pontre I, Craig J, Taylor S, Hatfield M. Coaching in an Acute Pediatric Setting: A Qualitative Approach to Understanding the Perspectives of Occupational Therapists. Phys Occup Ther Pediatr 2023; 43:212-227. [PMID: 36253934 DOI: 10.1080/01942638.2022.2131500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
AIMS To identify barriers and enablers to implementing coaching in acute pediatric settings from the perspective of occupational therapists and develop an implementation plan to address the identified barriers at a large metropolitan hospital. METHODS Participatory Action Research was used, and two stages of focus groups were conducted with 17 occupational therapists working in an acute pediatric hospital. Reflexive thematic analysis was employed for data analysis. RESULTS Stage one themes; (1) Lack of clarity around coaching definition, (2) Acute setting barriers to coaching, (3) Family acceptance and appropriateness, and (4) Enablers for coaching. Stage two themes; (1) Addressing skepticism about coaching, (2) Logistics and approvals, and (3) Implementation strategies for coaching. In Stage Two, participants and researchers developed an implementation plan. CONCLUSION Occupational therapists perceived coaching as hard to implement in acute pediatric settings due to acuity of caseloads and traditional medical models. The six-step implementation plan aims to enhance therapist knowledge and motivation as well as reduce environmental barriers, with the aim of embedding coaching into acute pediatric settings.
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Affiliation(s)
- Pei Xuan Lee
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | | | - Pei Yun Beatrice Ng
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | | | - Isabelle Pontre
- Occupational Therapy Department, Perth Children's Hospital, Child and Adolescent Health Service, Perth, Western Australia, Australia
| | - Joanna Craig
- Occupational Therapy Department, Perth Children's Hospital, Child and Adolescent Health Service, Perth, Western Australia, Australia
| | - Susan Taylor
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia.,Occupational Therapy Department, Perth Children's Hospital, Child and Adolescent Health Service, Perth, Western Australia, Australia
| | - Megan Hatfield
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
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Implementation of an Early Communication Intervention for Young Children with Cerebral Palsy Using Single-Subject Research Design. J Clin Med 2022; 12:jcm12010232. [PMID: 36615031 PMCID: PMC9821676 DOI: 10.3390/jcm12010232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 12/31/2022] Open
Abstract
The implementation of an intervention protocol aimed at increasing vocal complexity in three pre-linguistic children with cerebral palsy (two males, starting age 15 months, and one female, starting age 16 months) was evaluated utilising a repeated ABA case series design. The study progressed until the children were 36 months of age. Weekly probes with trained and untrained items were administered across each of three intervention blocks. Successive blocks targeted more advanced protophone production and speech movement patterns, individualised for each participant. Positive treatment effects were seen for all participants in terms of a greater rate of achievement of target protophone categories and speech movement patterns. Tau coefficients for trained items demonstrated overall moderate to large AB phase contrast effect sizes, with limited evidence of generalisation to untrained items. Control items featuring protophones and speech movements not targeted for intervention showed no change across phases for any participant. Our data suggest that emerging speech-production skills in prelinguistic infants with CP can be positively influenced through a multimodal intervention focused on capitalising on early periods of plasticity when language learning is most sensitive.
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Popova ES, O'Brien JC, Taylor RR. Communicating With Intention: Therapist and Parent Perspectives on Family-Centered Care in Early Intervention. Am J Occup Ther 2022; 76:23327. [PMID: 35861628 DOI: 10.5014/ajot.2022.049131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Responsive communication is critical to ensuring family-centered care in early intervention (EI). The Intentional Relationship Model (IRM) offers a framework for examining therapist-parent communication and offers strategies for supporting therapist responsiveness. OBJECTIVE To explore family-centered care and therapists' communication in EI using the IRM. DESIGN Prospective descriptive study. SETTING Illinois EI program. PARTICIPANTS Convenience sample of 101 therapists and 19 parents enrolled in an EI program. Therapist disciplines included developmental (n = 24), occupational (n = 32), physical (n = 17), and speech (n = 28) therapy. OUTCOMES AND MEASURES Demographic questionnaire, Early Interventionist Self-Efficacy Scale, Early Intervention Parenting Self-Efficacy Scale, Measure of Processes of Care (MPOC)-Short Form, MPOC-Service Provider, Clinical Assessment of Modes (CAM), and Clinical Assessment of Suboptimal Interaction-Short Form (CASI-SF). RESULTS Therapists used family-centered practices specific to relationship building more frequently than information sharing (especially sharing of general information). Therapists used the empathizing, encouraging, and instructing modes most frequently in their interactions with families. Participants' scores on the MPOC, CAM, and CASI-SF were significantly correlated. CONCLUSIONS AND RELEVANCE Therapist-parent interactions were aligned with family-centered care. Opportunities for practitioners were identified in (1) sharing specific and general information and (2) expanding the use of collaborating, problem-solving, and advocating modes. What This Article Adds: In this study, we explored how the IRM can inform family-centered practices in EI through examination of therapists' interpersonal competency and therapeutic mode use.
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Affiliation(s)
- Evguenia S Popova
- Evguenia S. Popova, PhD, OTR/L, is Assistant Professor, Department of Occupational Therapy, Rush University, Chicago, IL;
| | - Jane C O'Brien
- Jane C. O'Brien, PhD, OTR/L, FAOTA, is Professor, Department of Occupational Therapy, University of New England, Portland, ME
| | - Renée R Taylor
- Renée R. Taylor, PhD, is Professor, Department of Occupational Therapy, University of Illinois at Chicago
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Hurtubise K, Gaboury I, Berbari J, Battista MC, Schuster T, Phoenix M, Rosenbaum P, Kraus De Camargo O, Lovo S, Pritchard-Wiart L, Zwicker JG, Beaudoin AJ, Morin M, Poder T, Gagnon MP, Roch G, Levac D, Tousignant M, Colquhoun H, Miller K, Churchill J, Robeson P, Ruegg A, Nault M, Camden C. Training Intervention and Program of Support (TIPS) for fostering adoption of family-centred telehealth in pediatric rehabilitation: Protocol for a multi-method, prospective hybrid type 3 implementation-effectiveness study (Preprint). JMIR Res Protoc 2022; 11:e40218. [PMID: 36306158 PMCID: PMC9652740 DOI: 10.2196/40218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 07/28/2022] [Accepted: 08/04/2022] [Indexed: 11/23/2022] Open
Abstract
Background Children with disability face long wait times for rehabilitation services. Before the COVID-19 pandemic, telehealth adoption was low across pediatric rehabilitation. Owing to the COVID-19 pandemic restrictions, pediatric therapists were asked to rapidly shift to telehealth, often with minimal training. To facilitate the behavior changes necessary for telehealth adoption, provision of appropriate evidence-based training and support is required. However, evidence to support the effective implementation of such training is lacking. The successful real-world implementation of a training intervention and program of support (TIPS) targeting pediatric therapists to enhance the adoption of family-centered telerehabilitation (FCT) requires the evaluation of both implementation and effectiveness. Objective This study aimed to evaluate TIPS implementation in different pediatric rehabilitation settings and assess TIPS effectiveness, as it relates to therapists’ adoption, service wait times, families’ perception of service quality, and costs. Methods This 4-year, pan-Canadian study involves managers, pediatric occupational therapists, physiotherapists, speech-language pathologists, and families from 20 sites in 8 provincial jurisdictions. It will use a multimethod, prospective, hybrid type 3 implementation-effectiveness design. An interrupted time series will assess TIPS implementation. TIPS will comprise a 1-month training intervention with self-paced learning modules and a webinar, followed by an 11-month support program, including monthly site meetings and access to a virtual community of practice. Longitudinal mixed modeling will be used to analyze indicators of therapists’ adoption of and fidelity to FCT collected at 10 time points. To identify barriers and facilitators to adoption and fidelity, qualitative data will be collected during implementation and analyzed using a deductive-inductive thematic approach. To evaluate effectiveness, a quasi-experimental pretest-posttest design will use questionnaires to evaluate TIPS effectiveness at service, therapist, and family levels. Generalized linear mixed effects models will be used in data analysis. Manager, therapist, and family interviews will be conducted after implementation and analyzed using reflective thematic analysis. Finally, cost data will be gathered to calculate public system and societal costs. Results Ethics approval has been obtained from 2 jurisdictions (February 2022 and July 2022); approval is pending in the others. In total, 20 sites have been recruited, and data collection is anticipated to start in September 2022 and is projected to be completed by September 2024. Data analysis will occur concurrently with data collection, with results disseminated throughout the study period. Conclusions This study will generate knowledge about the effectiveness of TIPS targeting pediatric therapists to enhance FCT adoption in pediatric rehabilitation settings, identify facilitators for and barriers to adoption, and document the impact of telehealth adoption on therapists, services, and families. The study knowledge gained will refine the training intervention, enhance intervention uptake, and support the integration of telehealth as a consistent pediatric rehabilitation service option for families of children with disabilities. Trial Registration ClinicalTrials.gov NCT05312827; https://clinicaltrials.gov/ct2/show/NCT05312827 International Registered Report Identifier (IRRID) PRR1-10.2196/40218
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Affiliation(s)
- Karen Hurtubise
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster Univeristy, Hamilton, ON, Canada
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, QC, Canada
- CanChild Centre for Childhood Disability Research, School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Isabelle Gaboury
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, QC, Canada
| | - Jade Berbari
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Marie-Claude Battista
- Department of Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Tibor Schuster
- Department of Family Medicine, McGill Univeristy, Montreal, QC, Canada
| | - Michelle Phoenix
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster Univeristy, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Peter Rosenbaum
- CanChild Centre for Childhood Disability Research, School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Olaf Kraus De Camargo
- CanChild Centre for Childhood Disability Research, School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Stacey Lovo
- School of Rehabilitation Sciences, University of Saskatchewan, Saskatoon, SK, Canada
| | | | - Jill G Zwicker
- CanChild Centre for Childhood Disability Research, School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
- Department of Occupational Sciences and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Audrée Jeanne Beaudoin
- Institut Universitaire de Première Ligne en Santé et Services Sociaux, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
- École de Réadaptation, Faculté de Médecine et Sciences de la Santé, Univeristé de Sherbrooke, Sherbrooke, QC, Canada
| | - Mélanie Morin
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
- École de Réadaptation, Faculté de Médecine et Sciences de la Santé, Univeristé de Sherbrooke, Sherbrooke, QC, Canada
| | - Thomas Poder
- School of Public Health, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Est de l'Île de Montréal, Montréal, QC, Canada
| | - Marie-Pierre Gagnon
- Population Health and Optimal Health Practices Research Unit, Centre Hospitalier de Québec-Univeristé Laval Research Centre, Québec, QC, Canada
- Faculty of Nursing, Univeristé Laval, Québec, QC, Canada
| | - Geneviève Roch
- Population Health and Optimal Health Practices Research Unit, Centre Hospitalier de Québec-Univeristé Laval Research Centre, Québec, QC, Canada
- Faculty of Nursing, Univeristé Laval, Québec, QC, Canada
| | - Danielle Levac
- CanChild Centre for Childhood Disability Research, School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
- Faculty of Medicine, Univeristé de Montréal, Montréal, QC, Canada
| | - Michel Tousignant
- École de Réadaptation, Faculté de Médecine et Sciences de la Santé, Univeristé de Sherbrooke, Sherbrooke, QC, Canada
| | - Heather Colquhoun
- Occupational Science and Occupational Therapy Department, University of Toronto, Toronto, ON, Canada
| | - Kimberly Miller
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
- Department of Physical Therapy, Univeristy of British Columbia, Vancouver, BC, Canada
| | | | | | - Andréa Ruegg
- Training Intervention and Program of Support Study Team, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Martine Nault
- Training Intervention and Program of Support Study Team, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Chantal Camden
- CanChild Centre for Childhood Disability Research, School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
- École de Réadaptation, Faculté de Médecine et Sciences de la Santé, Univeristé de Sherbrooke, Sherbrooke, QC, Canada
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Coaching While Waiting for Autism Spectrum Disorder Assessment: A Pilot Feasibility Study for a Randomized Controlled Trial on Occupational Performance Coaching and Service Navigation. J Autism Dev Disord 2022:10.1007/s10803-022-05558-3. [PMID: 35488977 PMCID: PMC9055011 DOI: 10.1007/s10803-022-05558-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2022] [Indexed: 11/18/2022]
Abstract
Aim To determine whether short-phase Occupational Performance Coaching combined with service navigation support is feasible for families waiting for autism assessment. Method A pilot feasibility study was conducted using a blinded randomization procedure that allocated participants to one of three trial arms: (1) face-to-face coaching, (2) videoconference coaching, and (3) usual care. Outcomes included a retention aim of 70–80%, goal attainment and secondary standardised measures of adaptive behaviour, social skills, parenting stress, service access and family quality of life. Results Caregivers and children (n = 16, child mean age of 3 years 7 months) were recruited following referral for an autism assessment. Retention was 75%, with change scores in performance and satisfaction of selected goals higher in the intervention groups than the usual care group. Interpretation Findings support progression to a future randomized controlled trial assessing intervention efficacy.
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Adiguzel H, Sarikabadayi YU, Elbasan B. Investigation of the effectiveness of family collaborative physiotherapy programs applied to high-risk infants. Physiother Theory Pract 2022:1-17. [PMID: 35387569 DOI: 10.1080/09593985.2022.2062504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND The inclusion of families in intervention programs for infants may be more effective in ensuring adherence and positive outcomes. Approaches that include natural and enriched environments that provide communication and family interaction are important in the rehabilitation of high-risk infants. OBJECTIVE To compare the effectiveness of Family Collaborative Approach (FCA) and Neurodevelopmental Therapy (NDT)-based family training. METHODS High-risk infants (n = 63) with a mean age of 32.60 ± 4.53 months received early intervention for 12 weeks. Prechtl's General movements (GMs) assessment, Hammersmith Neonatal Neurological Examination (HNNE), Hammersmith Infant Neurological Examination (HINE), BAYLEY-III Scales of Infant and Toddler Development, and Third Addition (BSID-III) were performed. RESULTS Significant differences between groups were found in HINE scores at the 3rd, 6th, and 12th months (p ≤ .028), and in BSID-III scores at the 6th month (cognitive, language, and motor) (p < .001) and the 12th month (language) (p = .031). There was significant difference between NDT and control group in 3rd month HINE scores and Reflex&Reactions scores (p ≤ .021). FCA group and NDT group was significantly different from control group in 6th month HINE (p = .032) and 12th month HINE scores (p = .007). FCA group significantly different from NDT group (p ≤ .002) and control group (p < .001) in 6th month BSID-III cognitive, language, and motor scores. There was significant difference between FCA and control group in 12 month BSID-III language scores (p = .024). CONCLUSIONS Early physiotherapy interventions were effective in high-risk infants and FCA program was superior to NDT.
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Affiliation(s)
- Hatice Adiguzel
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Kahramanmaras Sutcu Imam University, Dulkadiroglu, Turkey
| | | | - Bulent Elbasan
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gazi University, Cankaya, Turkey
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Binns AV, Cunningham BJ, Andres A, Oram Cardy J. Current practices, supports, and challenges in speech-language pathology service provision for autistic preschoolers. AUTISM & DEVELOPMENTAL LANGUAGE IMPAIRMENTS 2022; 7:23969415221120768. [PMID: 36382071 PMCID: PMC9620702 DOI: 10.1177/23969415221120768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Background Speech-language pathology services are among the most frequently accessed services for young autistic children. Therefore, understanding the nature of these services, what challenges these clinicians face, and what supports they value is critical for developing appropriate policies and practices that can maximize positive outcomes for children and families. This study had two primary aims. The first was to examine the self-reported assessment and intervention practices of community-based Speech Language Pathologists (SLPs) and communicative disorders assistants (CDAs; who provide services under the supervision of a SLP) in supporting preschool children with suspected and diagnosed autism. The second aim was to identify barriers and supports (facilitators) to providing services in the community using the Consolidated Framework for Implementation Research (CFIR) as a framework. Methods A cross-sectional online survey was used to collect qualitative and quantitative data from clinicians in Ontario Canada who were providing speech and language services to preschool children with suspected or diagnosed autism. Quantitative data were used to describe clinicians" practices, and qualitative data captured their perspectives on barriers and supports to providing services. Results A total of 258 clinicians participated in the survey. On average, clinicians reported almost half of the preschoolers on their caseload had either diagnosed or suspected autism. There was consistency across the skill development areas assessed by SLPs, and targeted during therapy sessions, with the top four areas targeted being: foundational social communication, language, play and pragmatics. However, there was wide variation in speech and language assessment and intervention practices reported by this sample of clinicians (i.e., service delivery models, tools or programs used, length and duration of therapy services, level of collaboration with other professionals). Clinicians identified several barriers to providing services: limited funding and time, lack of inter-professional collaboration, difficulty accessing services, community messaging about autism services, family readiness and clinician knowledge. Supports (facilitators) included: access to autism-focused professional development, inter- and intra-professional collaboration, and access to additional supports in the community.
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Affiliation(s)
- Amanda V Binns
- Bloorview Research Institute, Holland Bloorview
Kids Rehabilitation Hospital, Toronto, Ontario, Canada; School of
Communication Sciences and Disorders, Western University, London, Ontario,
Canada; The Institute for Education Research, University Health Network,
Toronto, Ontario, Canada
| | - Barbara Jane Cunningham
- School of Communication Sciences and Disorders,
University of Western Ontario, London, Canada; CanChild, McMaster
University, Hamilton, Ontario, Canada
| | - Allison Andres
- Communication Sciences and Disorders, University of Western
Ontario, London, Canada
| | - Janis Oram Cardy
- Communication Sciences and Disorders, University of Western
Ontario, London, Canada
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Shire SY, Shih W, Barriault T, Kasari C. Exploring coaching and follow-up supports in community-implemented caregiver-mediated JASPER intervention. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:654-665. [PMID: 34961342 DOI: 10.1177/13623613211066132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
LAY ABSTRACT The next step for communication interventions for young children with autism include coaching/teaching for caregivers that have been tested in university clinics and testing these interventions in real world systems with early intervention providers who serve children and families in their communities. However, there are few projects that have tested how well the intervention can be transferred to community providers and what types of progress children and caregivers make in these services. This project took place in partnership with a community early intervention agency in the province of Ontario, Canada. The agency provided government-funded public health services. The agency was funded to take part in a pilot program to try out one of four early intervention models that included coaching for caregivers and was designed to support children's social engagement, play, and communication skills. The team decided to test two ways to start the intervention: (a) begin with observation of the practitioner for 4 weeks and then start coached practice with the child and (b) start coaching immediately. The team also tested two ways to support families for 3 months after intervention: (a) group booster sessions and (b) individual visits. The practitioners delivered the intervention well (M = 83%), and overall, caregivers and children made significant gains by the end of intervention in both observation + coaching and coaching. Attendance for follow-up boosters was variable with fewer families attending groups. More research is needed to test different strategies and roles to individualize interventions for caregivers with a range of goals and learning styles.
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Affiliation(s)
| | - Wendy Shih
- University of California, Los Angeles, USA
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DAMIANO DIANEL, LONGO EGMAR. Early intervention evidence for infants with or at risk for cerebral palsy: an overview of systematic reviews. Dev Med Child Neurol 2021; 63:771-784. [PMID: 33825199 PMCID: PMC9413025 DOI: 10.1111/dmcn.14855] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/04/2021] [Indexed: 12/15/2022]
Abstract
AIM To perform an overview of systematic reviews and more recent randomized controlled trials (RCTs) on early motor interventions in infants aged 0 to 3 years with or at risk of cerebral palsy to inform current clinical and research efforts and provide a benchmark to assess future interventions ideally initiated within the first 6 months. METHOD Standardized searches of the PubMed, Embase, Scopus, and Web of Science databases were conducted for systematic reviews (2009-2020) and RCTs (2015-2020). RESULTS From 840 unique records, 31 full texts were reviewed, yielding three systematic reviews encompassing 46 studies, 16 with comparison groups, and six additional RCTs that met the criteria. Two enrichment- and activity-based approaches had medium effect sizes on motor development, only one with low risk of bias; two others had large task-specific effect sizes but some bias concerns; and three enriched environment studies with some bias concerns had medium effect sizes on cognitive development. Most had small or no effect sizes, bias concerns, and uncertain diagnostic determinations. INTERPRETATION Data synthesis revealed limited data quantity and quality, and suggest, although not yet confirmed, greater benefit from early versus later intervention. Research efforts with greater early diagnostic precision and earlier intervention are accelerating, which may transform future outcomes and practices. What this paper adds For over 50% of trials within the reviews, the intervention was compared to standard care with only two showing efficacy. Similar to results in older children, constraint-induced movement therapy (CIMT) emerged as efficacious with high effect sizes. CIMT was not superior to similarly intense bimanual training or occupational therapy. Goals-Activity-Motor Enrichment intervention initiated before 5 months of age was superior to equally intense standard care. Several other enriched environment strategies promoted cognitive and/or motor development.
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Affiliation(s)
| | - EGMAR LONGO
- Health of Children, Federal University of Rio Grande do Norte/Faculty of Health Sciences of Trairi-UFRN/FACISA, Santa Cruz, Brazil
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Contextual, Client-Centred Coaching Following a Workshop: Assistants Capacity Building in Special Education. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126332. [PMID: 34208053 PMCID: PMC8296150 DOI: 10.3390/ijerph18126332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/01/2021] [Accepted: 06/08/2021] [Indexed: 11/17/2022]
Abstract
Assistants serve an essential role in special education to support children with disabilities, but they should be properly trained and supervised. The coaching approach represents one trend that has been gradually implemented in occupational therapy (OT) and rehabilitation services. Still, few studies clearly define the coaching intervention, measure the fidelity of coaching practices, or evaluate capacity building of the caregivers in the long term. This quasi-experimental study compared one-on-one coaching in natural environments following a workshop with a training workshop. Both public schools do not have regular OT services. The primary outcome was the assistant's performance, measured with the Goal Attainment Scaling (GAS). The secondary outcome was the fidelity of coaching implementation, measured with the Coaching Practices Rating Scale (CPRS). The GAS showed an increased performance of the assistants after the intervention, with significant differences between groups post-intervention (p = 0.015) and large effect size (r = 0.55), but no long-term significant improvements were found at the follow-up (p = 0.072). The CPRS showed an adequate implementation of the five coaching components (joint planning, observation, action, reflection, and feedback), with a total score of 3.5 ± 0.72 (mean ± SD). The results suggest that coaching sessions provided by OTs in schools may improve assistants' skills to facilitate the student's participation.
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Bernie C, Williams K, Graham F, May T. Coaching While Waiting for Autism Spectrum Disorder Assessment: Protocol of a Pilot Feasibility Study for a Randomized Controlled Trial on Occupational Performance Coaching and Service Navigation Support. JMIR Res Protoc 2021; 10:e20011. [PMID: 33410761 PMCID: PMC7819777 DOI: 10.2196/20011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 10/14/2020] [Accepted: 11/03/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND In Australia, the average time between a first concern of autism spectrum disorder (ASD) and diagnosis is over 2 years. After referral for assessment, families often wait 6-12 months before their appointment. This can be a time of uncertainty and stress for families. For some families, other forms of assistance are not accessible and thus timely intervention opportunities are missed. There is little evidence about how to provide the best support for children or caregivers while on assessment waiting lists. OBJECTIVE The aim of this study is to determine whether use of a coaching intervention called Occupational Performance Coaching (OPC) combined with service navigation support is feasible for families waiting for ASD assessment, as a crucial first step in planning a randomized controlled trial. METHODS A pilot and feasibility study will be conducted using recommended constructs and associated measures, which will be reported using CONSORT (Consolidated Standards or Reporting Trials) guidance. Participants will be child and caregiver dyads or triads, recruited within 4 months of their child (aged 1-7 years) being referred to one of two services for an ASD assessment in Victoria, Australia. A blinded randomization procedure will be used to allocate participants to one of three trial arms: (1) coaching and support intervention delivered face to face, (2) coaching and support intervention via videoconference, and (3) usual care. Descriptive statistics will be used to describe the sample characteristics of parents and children, inclusive of service access at baseline and follow up. Recruitment rates will be reported, and retention rates will be evaluated against a predicted rate of 70%-80% in each intervention arm. Goal attainment, using the Canadian Occupational Performance Measure, will indicate preliminary evidence for efficacy within the intervention arms, with an increase of 2 or more points on a 10-point performance and satisfaction scale considered clinically significant. RESULTS The study was approved by The Royal Children's Hospital Research Ethics and Governance Department in September 2018. As of October 2020, 16 families have been recruited to the study. Data analysis is ongoing and results are expected to be published in 2021. CONCLUSIONS Study findings will support planning for a future randomized controlled trial to assess the efficacy of OPC and service navigation support for caregivers of children awaiting ASD assessment. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12620000164998; www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378793&isReview=true. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/20011.
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Affiliation(s)
- Charmaine Bernie
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- Department of Allied Health, The Royal Children's Hospital, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Katrina Williams
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- Department of Paediatrics, Monash University, Clayton, Victoria, Australia
- Developmental Paediatrics, Monash Children's Hospital, Melbourne, Australia
- The Murdoch Children's Research Institute, Melbourne, Australia
| | - Fiona Graham
- Rehabilitation Teaching and Research Unit, Department of Medicine, University of Otago, Wellington, New Zealand
| | - Tamara May
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- Department of Paediatrics, Monash University, Clayton, Victoria, Australia
- The Murdoch Children's Research Institute, Melbourne, Australia
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Akhbari Ziegler S, Hadders‐Algra M. Coaching approaches in early intervention and paediatric rehabilitation. Dev Med Child Neurol 2020; 62:569-574. [PMID: 32065385 PMCID: PMC7187136 DOI: 10.1111/dmcn.14493] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/16/2020] [Indexed: 01/04/2023]
Abstract
Currently, coaching is increasingly applied to foster the involvement of families with an infant or young child with special needs in early intervention and paediatric rehabilitation. Coaching practices are included in many forms of intervention and are regarded as essential to reach beneficial outcomes for the child and family. There are, however, many ambiguities that blur the concept of coaching and hamper its understanding and integration as an evidence-based approach in early intervention and paediatric rehabilitation: lack of differentiation between coaching and training of families, for example. Challenges to incorporate coaching into professional practice relate to adult learning processes and knowledge acquisition, and transformation of attitudes, beliefs, and treatment habits. In this paper, we review the barriers encountered and the possibilities available to promote successful implementation of coaching in early childhood interventions. WHAT THIS PAPER ADDS: Literature defines coaching ambiguously, which hampers its implementation in early intervention. The term 'coaching' should be reserved for relationship-directed, family-centred intervention.
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Affiliation(s)
- Schirin Akhbari Ziegler
- School of Health ProfessionsInstitute of PhysiotherapyZurich University of Applied Sciences ZHAWWinterthurSwitzerland
| | - Mijna Hadders‐Algra
- University of Groningen, University Medical Center GroningenDepartment of Paediatrics, Division of Developmental NeurologyGroningenthe Netherlands
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