This study aimed to investigate the effects of a sensory-based and occupation-based telehealth family-centered coaching program on the occupational performance and satisfaction of children with Autism Spectrum Disorder (ASD) and the parenting efficacy of their main caregivers in South Korea.
This study applied a single-case experimental design. The participants were three caregivers of children with ASD aged 3 to 7 years. In order to recruited the participants, the Korean Childhood Autism Rating Scale-2 (K-CARS-2) and the Korean Short Sensory Profile-2 (K-SSP-2) were applied for the screening assessments. The Korean version of the Participation and Environment Measure for Children and Youth (K-PEM-CY) and the Korean Canadian Occupational Performance Measure (K-COPM) was used to identify the goal-directed activity to be achieved via the telehealth family-centered occupational therapy (OT) coaching program. The K-COPM was also applied to assess the changes in the performance and satisfaction of goal-directed activities in children with ASD and the Goal Attainment Scaling (GAS) was used to assess the degree of changes in goal-directed activities. Changes in parenting efficacy of the main caregivers were evaluated using the Korean Parenting Efficacy Test (K-PET). These outcome measures were performed a total of 4 times to assess the effectiveness and continuity of the program. The caregiver of the child with ASD received non-face-to-face family-centered OT coaching program using ZOOM for 60 minutes once a week for 8 weeks. After the program, a semi-structured interview was conducted to gather the perspectives of the caregivers about the telehealth OT coaching program. Data from the outcome measures were presented using visual analysis and a qualitative thematic content analysis was employed to analyze the interview data.
Three children with ASD selected goal-directed activities as 'eating', 'sleeping', and 'using the toilet' which presented limitations in participation due to sensory processing difficulties. After the OT coaching program, all children had positive changes in their performance and satisfaction of goal-directed activities and these changes were sustained after one month. There was small but positive changes in the competence in parenting efficacy of the caregiver of children with ASD. Based on the perspectives of the caregivers, the following themes were emerged regarding the OT coaching program: 'Changes in parental perception for a child's participation in an activity', 'Collaborative relationship between a therapist and a caregiver', 'Importance of the caregiver's role', 'Improvement in the child's interaction skills,' and 'Advantages and disadvantages of the OT coaching program.'
This study is significant as it offered the OT coaching program through telehealth for children with ASD and their caregivers in South Korea, resulting in positive effects. The results of this study will serve as the foundation for developing guidelines to establish the policy for the telehealth service in the OT field and is expected to be a valuable resource to conduct various studies that can demonstrate the statistical effectiveness of telehealth OT services in the future.