Enriched Home Environment: a Model & Intervention to Facilitate Participation in Children with ASD

Background:
Enabling childhood participation in home activities requires complex interactions between the child and a stimulating ecology. Home environment plays a vital role in child development. Children with Autism Spectrum Disorder (ASD) may have lower participation in home activities. This study explores a measurement and an intervention model to understand the relationship between a child with ASD and a stimulating ecology as defined by an enriched home environment.

Objectives:
Examine the relationship between participation of children with autism, parenting stress and the enriched home environment and to identify key factors in the environment that influence the child’s participation in home activities.
Develop a measurement and an intervention model of an enriched home environment.
Develop a Home Environment Checklist (HEC) to assess the level of environmental complexity present in the home environment of children with ASD.
Implement an eight-week home modification program to provide learning, sensory and a socially stimulating environment.
Identify changes in participation of children with ASD in home activities following an eight-week intervention program.

Methods:
To examine the relationship between participation of children with ASD and environmental factors (parenting stress and enriched home environment), 22 Children with a diagnosis of ASD ages 3 to 6 years were recruited for the study.  Home Observation for Measurement of Environment (HOME) and Preschool Activity Card Sort (PACS) assessments were performed. The parents filled the Parenting Stress Index (PSI), and Social Responsiveness Scale (SRS).  A spearman rank coefficient and a multiple regression analysis was used to analyze the relationships.
To implement an eight-week home modification program, 2 children were recruited. Pre intervention data was collected using the Home Environment Checklist (HEC), Preschool Activity Card Sort, Parenting Stress Index, and Sensory Profile. Following an eight-week home modification program, post intervention data was collected using the Preschool Activity Card Sort. A percentage change was documented to analyze the changes in participation in home activities following an eight-week home intervention.

Results:
Significant correlations were found between parenting stress, the characteristics of the home environment and participation patterns of children in home activities. Based on multiple regression analysis, the variance in participation in low demand leisure activities of children with autism was predicted by the availability of the learning materials in the home and the parenting stress after controlling for the severity of child diagnosis.
Also an increase in the scores on  the preschool activity card sort following an eight-week home modification intervention were reported for both the children, though these results were not statistically significant.

Conclusions:
The results of the study helped in understanding the environmental factors that influence participation of children in home activities. Also, the Home Environment Checklist can be used to measure the level of environmental complexity in home environment of children. Providing an enriched home environment to children with ASD can improve their participation in home activities. Overall, this study provides a guideline to develop a measurement and intervention model to develop enriched home environment for children with ASD.