The Parental Experience of a Home-Based Joint Attention Intervention for Preschoolers with Autism

Background:

Many parents report that receiving a diagnosis of autism for their young child is one of the most distressing events in their lives. At this very vulnerable time they feel pressured to immediately begin an intervention regime. They can receive very conflicting advice about the efficacy of various approaches. Many interventions require the parent to hand over responsibility to other agencies, like early intervention preschools, therapists, autism experts or teams of workers. Parents can become marginalized into the role of the “funders” of programs, rather than the instigators. This model can disempower parents who need to be the life long educators, therapists and advocates for their child.

This study looked at the implementation of a home based intervention for families with a preschool aged child with autism. It used a parent training paradigm, and focused on developing joint attention skills, using both behavioural and developmental, play based strategies. Methods of training were both psycho-educational and experiential. Parents were given notes on autism, interventions, and the rationale for targeting joint attention, as a pivotal skill to teach these children.

Objectives:

The first objective of this study was to explore the efficacy of training parents to teach joint attention skills to their children with autism using this model. The next objective was to measure the effects of that teaching on the children’s cognitive, adaptive, behavioural and language development. The final objective was to explore the experience of this intervention for parents, and to measure its effects on parental stress and feelings of competency.

Methods:

Six families with a three to four year old child, recently diagnosed with autism, were recruited from the local autism advisors. They completed 20 intervention sessions with the researcher. Initial sessions were intensive, and clinic based, then they ran weekly, in the home for the last 10 weeks. Each session involved a 10 minute, videoed, semi structured play between the child and the parent; a table based skill teaching session, a floor play session and a discussion of how to embed the skill into routines. Notes were given weekly.

The experimental design was a single subject repeated design. Pre and post measures included a range of cognitive, behavioural, adaptive and language standardized assessments of the child. Parent assessment included the Parenting Stress Index II, and a semi structured interview conducted at the end of the program. Pre and post assessments will be statistically analysed for significant change and the interviews will be transcribed and analysed for recurrent themes. The videos will be coded for changes over time in skill acquisition, in both the parents and the children.

Results:

Data is being processed at the moment and preliminary results will be presented at the conference.

Conclusions:

This study will give a clearer picture of the usefulness of a time limited, skill targeted, parent training program, not only for facilitating a child with autism’s development, but also for fostering parental wellbeing, and feelings of competence.