Thesis (Sc.D.)--Boston University / Occupational therapists recognize that families are central to the wellbeing of children and that incorporating parent perspectives into intervention is an essential component of the therapy process. Although family-centered outcomes are specifically espoused in the pediatric occupational therapy literature, parent perspectives have not been the focus of efficacy studies. This collection of papers reports three sets of findings designed to understand parents' perspectives related to occupational therapy using sensory integration approaches. In both studies, interviews with parents were conducted, audiotaped, transcribed, and analyzed using grounded theory methods. The first study reported here describes parents' point of view regarding their hopes for outcomes prior to their children's participation in occupational therapy using a sensory integration approach. These parents identified two overarching directions for therapy. One focus for change was their children. Three themes pertinent to the occupation of children; social participation, self regulation, and perceived competence, were identified. Parents also include themselves as both agents and recipients of change. The second and third papers describe parents' point of view after their children have been discharged from therapy. The parents' perceptions of the benefits of therapy for their children are categorized into three interrelated constructs: abilities, activities, and reconstruction of self-worth. For themselves, parents value understanding their children's behavior in new ways. This shift in understanding is hypothesized to facilitate a change in expectations for themselves and their children. Further, parents value having their parenting experience validated and being able to support and advocate for their children. The parents' actual experience of sitting in the waiting room while their children received occupational therapy also emerged as a powerful theme. Through their interactions with one another, sharing stories, experiences, parenting challenges, and resources, the particular group of parents interviewed for the second study gave and received naturally occurring support for parenting children with sensory integration dysfunction. Implications for expanding the definition of family-centered intervention and for future research are proposed.

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