Enriched Home Environment Program for Preschool Children With Autism Spectrum Disorders

SIGNIFICANCE: Even though children with autism spectrum disorders (ASDs) who are more than 3 yr of age receive special services through school, their families express the need for continued support to promote their child’s engagement in daily activities. In the present study, we discuss the development of the Enriched Home Environment Program (EHEP), which emphasizes providing families of children with ASD the support to promote their child’s participation within the home environment by (1) educating families about the impact of factors that influence their child’s participation, and (2) collaborating with families to help them generate their own strategies to adapt the environment to meet the needs of the child.

INNOVATION: EHEP is an alternative approach to work with families that enables them to identify solutions in collaboration with an occupational therapist within their natural environment to enhance their child’s occupational performance. Evidence suggests that parents of children with ASD should be empowered with knowledge to develop their own strategies to support their child’s participation and should be equipped with information about age-appropriate expectations and how to structure the environment for success. Research questions for this study included the following: What is the impact of EHEP on participation in activities within the home environment of a child with ASD? What are the perceptions of the parents about the impact of EHEP on their child’s participation in activities within the home environment? It was important to understand the perspectives and viewpoints of the parents about EHEP.

METHOD: In this study, we used a descriptive case study methodology design, and the setting took place in the home environment of children with ASD. Two families who had a child (aged 3 to 6 yr) with a diagnosis of ASD participated. To evaluate parents’ perceptions related to the extent of participation of their child in the identified activities, as well parents’ satisfaction with their child’s participation in the identified activities, we utilized the Preschool Activity Card Sort before and after participation in EHEP. Interviews were conducted with the parents to gather information about their perceptions related to EHEP.

EHEP was conducted by the researcher in the home environment of the family. The first session was used to educate parents about the influence of various child-related and home-related factors on the child’s participation within the home. The second session emphasized developing parents’ capacity “to adapt” the home environment, routines, and tasks. The third session focused on developing parents’ capacity “to use” the modified environment, routine, and task to promote the child’s participation. Changes associated with the parents’ perceptions of the extent of their child’s participation in the identified activities as well as their satisfaction with participation in the identified goal were reported. We analyzed the generated qualitative data using the qualitative analytical process.

RESULTS: EHEP had a positive impact on the participation in home activities of two children with ASD. In both case studies, the parents’ perceptions about their child’s extent of participation as well as their satisfaction with participation in the identified goal increased, as measured on a picture archiving and communication system (PACS).

CONCLUSION: EHEP is guided by a family capacity–building practice that aims to strengthen the parents’ knowledge and skills to enable and empower them to generate strategies to enhance their child’s ability to participate in activities within the home environment.