Collaborating With Parents in Early Intervention: OTs’ Perspectives on Engaging Parents in Early Intervention (EI)

Part C of the Individuals with Disabilities Educational Act requires interventionists and parents to work collaboratively as services are designed to meet the needs of the family to assist in their child’s development (IDEA, 2004). Family-Centered Practice is based on parents’ strengths and helps parents make decisions that they consider essential for their families (Davis & Gavidia-Payne, 2009). Infants and toddlers requiring EI services is anticipated to rise annually at a rate of 3.1%, resulting in an increased need for service providers trained in working collaboratively with parents (U.S. Department of Education, 2018). There is limited evidence on occupational therapy practitioners’ (OTPs) understanding of FCP, however, literature reports that the most challenging issues in delivering Early Interventions services are collaboration and the ability to manage family dynamics (Bowyer, Moore, Tiongco, Tkach, & Thom; 2017).

A qualitative phenomenological study was conducted to explore perceptions of OTs working in EI regarding their collaboration with families and their ability to help parents engage in purposeful and meaningful activities with their child. By examining the level of understanding, engagement, and value practitioners have regarding collaboration with parents, members of the OT profession may determine future needs for education, training, and program development in this area.

The study population included licensed occupational therapists with a minimum of 3-years working experience in the area of EI who resided in the United States and were able to understand and respond to questions verbally posed in English. Participants were recruited via social media platforms such as Facebook and CommOT. Data was collected through the use of individual semi-structured interviews. Each participant answered the same questions, but the questions allowed for the participant to elaborate in a personally relevant manner. All interviews were transcribed and analyzed to develop codes which were then thematically analyzed

Themes emerged identifying four major areas that impact OTPs ability to work collaboratively with parents using a FCP model: there is confusion on meaning of FCP and its implementation, FCP models cause professional insecurities, FCP requires OTPs to assume a variety of roles outside of OT, and there are systemic issues that affect the ability to implement a FCP model. Therapists described confusion on terminology used to describe this model. Participants reported insecurity in professional identity, job insecurity, liability concerns and in professional expertise. They described having to assume multiple roles outside of OT to assist in family dynamics. Systemic issues affecting FCP included lack of time allotment for collaboration, lack of training and documentation that is unfriendly to parents and not descriptive of child’s performance.

Participants also expressed confusion in using models of interventions based upon building on family strengths. Therapists stated having difficulty describing and documenting how FCP models are used in their session. They did not consider FCP to be a skilled service. Participants reported limited evidence-based practice guidelines on FCP models and emphasized the need for training in FCP interventions in order to use the strategies more successfully in their practice. EI requires a partnership between parents and therapists, where the OTP’s goals are educating parents, providing opportunities where parents can become confident in their skills, and empowering them to be the parent for their child. Therapists who understand and are secure of their skills in using FCP models can achieve the goals set forth by EI and advocate for systemic changes needed to improve EI services.

References

Bowyer, P., Moore, C., Tiongco, C., Tkach, M., & Thom; C. (2017). Journal of Occupational Therapy, Schools, & Early Intervention, 10(1), 18-26. DOI: 10.1080/19411243.2016.12557966

Davis, K. & Gavidia-Payne, S. (2009). The impact of child, family, and professional support characteristics on the quality of life in families of young children with disabilities. Journal of Intellectual and Developmental Disability, 34 (2), 153-162. doi:10.1080/13668250902874608

Individuals with Disabilities Education Act, 20 U.S.C. § 1400 (2004)

U.S. Department of Education. (2019). Early Intervention Program for Infants and Toddlers with Disabilities: Funding Status. Retrieved from: https://www2.ed.gov/programs/osepeip/funding.html