CAREGIVING TEAMS AND TODDLERS STUDY: TWO SINGLE-CASE CHANGING CRITERION DESIGNS TO EXAMINE THE EFFECTS OF A TWO PARENT-MEDIATED INTERVENTION FOR FAMILIES WITH TODDLERS AT RISK OR WITH AUTISM SPECTRUM DISORDER
This study examined the use of a family occupation-centered coaching intervention to support two parents’ implementation of evidence-based social interaction strategies in their home with their toddler with autism spectrum disorder (ASD). The study was an exploration of applied intervention research in occupational science using the transaction meta-theoretical perspective. Two-single case changing criterion designs (CCDs) within one family with a toddler with ASD were used to study the social interaction processes of a family and to determine the effect of the intervention on parent-child interactions. The research design embedded narrative reasoning and decision-making time points into the procedures to support social validity through caregiver choice of preferred activity, strategies, and criterion. The intervention yielded a 55.26% improvement in the quality of social interactions for the family, 69.27% for the mother, 64.07% for the father, and 30.69% for the child. The magnitude of effect of the study, standard mean difference, was 5.18 for the mother, 4.94 for the father, and 7.17 for the parents as group. The findings demonstrated that a two-caregiver approach to intervention offered benefits for five reasons: intervention enacted with social support helped reduce stress and facilitated skill acquisition, multiple skilled social models supported positive affect sharing, routine family practice increased dosage and generalization, and toddler exposure to more predictable quality interactions, less variability, through the parent’s participation together. Given that ASD is viewed as a disorder of prediction, toddler participation in predictable quality interactions can support practice of sustained habituation and engagement as well as lead to expansion of social skills. Theoretical and clinical reflections are provided for evidence of theory in practice and in support of the translation of occupation-centered and contextualized intervention research in the field of occupational science. The study findings inform the feasibility and social validity of a two-caregiver approach and may have implications for early intervention research, service delivery, and policy.
