Autistic children participate less and have fewer opportunities to develop participation skills than nonautistic peers. The extent to which occupation-based coaching (OBC), a metacognitive strategy training intervention, affects participation in school-age autistic children is unknown. We conducted a single-group pretest-posttest design to evaluate the feasibility and preliminary effect of telehealth OBC for autistic children (n = 13) and primary caregivers (n = 12). Participants completed eight telehealth OBC sessions to address activity-based goals; they completed child, caregiver, and family outcomes pre- and post-intervention. Recruitment, retention, caregiver measure completion, and intervention adherence rates exceeded feasibility benchmarks. OBC had large effects on child performance (Hedge's g = 1.65) and satisfaction (Hedge's g = 1.89), a moderate effect on child sleep disturbance (Hedge's g = 0.60), and small effects on child participation (Hedge's g = 0.23) and family quality of life (Hedge's g = 0.26). Further research in a large-scale study is warranted with changes to better support child measure completion and enhance the study protocol.
Keywords: autism; caregivers; children; occupational therapy; participation.
Can we use virtual occupation-based coaching with autistic children and primary caregivers?Autistic children participate less than nonautistic peers at home, school, and in the community. As a result, autistic children have fewer chances to learn to start an activity, problem solve challenges, and build relationships needed for participation and life transitions. We completed a research study to learn whether virtual occupation-based coaching (OBC) can be used with school-age autistic children and a caregiver and if it affects participation in this population. Participants completed eight OBC sessions on Zoom to address activity-based goals. Participants also completed questionnaires in an online survey before and after virtual OBC sessions. We were able to recruit and retain an adequate number of participants in the study, and most participants completed all virtual OBC sessions. Caregivers and children had high and low rates of questionnaire completion, respectively. Most autistic children participated in virtual OBC sessions, and parents said virtual OBC with their child was acceptable. After virtual OBC, children performed activity-based goals better (large change), had less sleep disturbance (medium change), and participated more (small change). Caregivers of autistic children reported greater satisfaction with their child’s ability to perform activity-based goals (large change) and the quality time their families spent together (small change). Virtual OBC with autistic children and primary caregivers may be feasible for occupational therapy practice. More research is warranted to better understand how virtual OBC affects child, caregiver, and family outcomes.