Date Presented 3/31/2017
This session introduces parent–infant swim classes as co-occupation-based interventions. Research outcomes indicate both mothers and infants benefit from the enhanced parenting competence, emotional availability, and aquatic handling skills learned through aquatic co-occupation.
Primary Author and Speaker: Chanele Molano
Additional Authors and Speakers: Hope Sadowski, Jeanne Wenos
Contributing Authors: Andrew Peachey
PURPOSE: Low parenting competence and limited emotional availability are associated with decreased quality of the parent–infant relationship. Co-occupation-based interventions, such as parent–infant swim classes, facilitate close bodily contact and teach parents handling skills that can generalize into the home environment. Numerous websites allude to the benefits of these classes; however, there are currently no evidence-based claims supported by the occupational therapy literature. Furthermore, we hypothesized that parent–infant swim classes would provide clinically relevant improvements in maternal parenting competence, emotional availability, and aquatic handling skills.
DESIGN: This study used a concurrent, mixed-method strategy with a one-group pretest–posttest design and a phenomenological design within the lens of the Person–Environment–Occupation (PEO) Model. Mothers (n = 9) were recruited via convenience sampling from a parent–infant swim class, which consisted of eight sessions lasting 30 min each over 2 wk at a local community wellness center. This class was intended for parents with infants ages 6–18 mo regardless of diagnosis.
METHOD: Quantitative measures included the Parenting Sense of Competence (PSOC) scale, the Emotional Availability Self-Report (EA–SR), the Parent–Child Interaction Observation Tool, and the Checklist for Aquatic Skills. The PSOC scale is a 17-item Likert-scale questionnaire that measures parenting self-esteem across two different aspects of parenting competence: satisfaction and efficacy (1 = strongly disagree to 6 = strongly agree). The EA–SR is a 36-item self-report survey that measures a caregiver’s perception of the emotional quality of the relationship with the infant (1 = do not agree at all to 5 = agree totally). Both instruments were embedded in a Qualtrics (Provo, UT) survey and sent via email to the participants before and after the parent–infant swim class.
The Checklist for Aquatic Skills was used to assess parent handling skills (e.g., positioning infant; 1 = ease to 4 = requires assistance) at baseline and upon class completion to determine motor learning acquisition. The Parent–Child Interaction Observation Tool was used to analyze video data of each session by rating mother–infant interactions on a scale from 1 to 3 across 10 items (e.g., Do child and parent look at one another frequently? 1 = infrequent eye contact to 3 = frequent and warm eye contact).
Wilcoxon signed-rank tests were used to assess significant changes in PSOC Total, Satisfaction, and Efficacy scores and EA–SR Mutual Attunement, Child Involvement with Parent, Affect Quality, Intrusiveness, and Hostility scores. Qualitative measures included field notes, video recordings of each session, and a focus group conducted on the last day of the class. Axial coding, using themes derived from the PEO Model (e.g., aquatic environment on mother–infant relationship), was used for focus group analysis.
RESULTS: We recruited nine mothers enrolled in a 2-wk parent–infant swim class. Clinically significant improvements in maternal parenting competence were noted in PSOC Efficacy scores (z = –2.03, p = .04). PSOC Total and EA–SR Intrusiveness scores improved from pretest to posttest; however, the differences were not statistically significant (z = –1.75, p = .08, and z = –1.89, p = .06, respectively). Focus group analysis also revealed the maternal gains of participating in these classes: increased maternal comfort, handling skills, and interest in the aquatic environment.
CONCLUSION: Our hypothesis was supported in that parent–infant swim classes provided clinically relevant improvements in maternal parenting competence, emotional availability, and aquatic handling skills. To increase the power and transferability of our study, we will recruit 40 additional mothers. Occupational therapists, especially those working in early intervention, can attest to the importance of treating the parent and infant as a unit. These research findings provide initial support for occupational therapists to consider using parent–infant swim classes as a form of co-occupation-based intervention to improve maternal parenting competence, emotional availability, and aquatic handling skills.
