Caregiver Coaching in Early Intervention: A Scoping Review

PURPOSE: The purpose of this scoping review was to explore the conceptual and practice components of caregiver coaching models used within EI and the use of these models by OTPs.

DESIGN/METHOD: A scoping review, following Arksey and O’Malley’s (2005) framework was conducted. Key terms of: ‘parent coaching’ OR ‘parent training’ OR ‘parent education,’ AND ‘early intervention,’ AND ‘occupational therapy’ OR ‘occupational therapist’ OR ‘OT’, were searched in eleven online databases. Only peer reviewed publications between the years 2000 and 2020 conducted in the US were included. A total of 136 articles were retrieved after duplicates were removed. Article titles and abstracts were reviewed for relevance based on additional inclusionary/exclusionary criteria yielding 60 articles. After review of full articles, nine of the 60 studies were deemed eligible. Reference lists of all eligible articles were then searched employing the same inclusionary/exclusionary criteria yielding an additional seven articles, resulting in 16 total articles.

RESULTS: After review, several commonalities of purpose or outcomes emerged including: the use of coaching practices within OT; interventions specifically exploring child outcomes; provider perceptions; and provider-related outcomes. Additionally, three main themes arose from review of the articles: 1) definition of the practices that constitute coaching; 2) issues in implementation of coaching; and 3) contextualization (coaching in the world around us). Studies indicated coaching varies widely in practice and terminology. While providers are familiar with the importance of collaborating with the family during intervention, they are often unsure or skeptical about the use of coaching. Play was overwhelmingly utilized by practitioners as an activity for intervention with decreased emphasis in other routines and occupations such as ADLs, family and community activities, and, depending on age, pre-academic activities. Factors impacting practitioners’ ability to implement coaching interventions included culture-specific views of child-rearing, family etiquettes, family and space configurations, and conceptual language barriers.

DISCUSSION: Findings support practitioners feel a lack of preparation and experience with coaching and need adequate training and ongoing professional development. When coaching is used effectively, there appear to be core conceptual components that are essential to the process that can be used flexibly. Regardless of model or taxonomy, all coaching interventions employed the components of teaching, evaluation, and feedback. There appeared to be a continuous, dynamic interaction of these three main components in effective practices. This flexibility is an important aspect of EI service delivery among diverse families and communities; however, it can also create a lack of clarity as to which strategies should be implemented. The current review found a limited number of studies assessing child/family outcomes when utilizing coaching, a limitation in determining efficacy of the approach. Coaching offers a promising avenue for OT practitioners in EI to collaborate with caregivers to ensure that they have the tools necessary to help their child acquire and maintain an active role in family life.

IMPACT: OTPs are distinctly positioned to provide coaching intervention in EI. It is critical for practitioners to look at a child in the context of their family to embed intervention into a range of routines creating more effective, family-centered interventions.

References

Arksey, H., & O‘Malley, L. (2005) Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 8(1), 19-32. doi.org/10.1080/1364557032000119616

Friedman, M., Woods, J., & Salisbury, C. (2012). Caregiver coaching strategies for early intervention providers: Moving toward operational definitions. Infants and Young Children, 25(1), 62-82. https://doi.org/10.1097/IYC.0b013e31823d8f12

Salisbury, C., Cambray-Engstrom, E., & Woods, J. (2012). Providers’ reported and actual use of coaching strategies in natural environments. Topics in Early Childhood Special Education, 32(2), 88-98. https://doi.org/10.1177/0271121410392802

Stewart, S. L., & Applequist, K. (2019). Diverse families in early intervention: professionals’ views of coaching. Journal of Research in Childhood Education, 33(2), 242–256. https://doi.org/10.1080/02568543.2019.1577777