Equivalent and Accessible Parental Education Programs for Autism A Case study on the developmental process, obstacle and factors that promote success in working with improvement

The purpose of this study was to gain a fuller understanding of the sort of assistance, support, or education parents feel they need from school counselors in parenting adolescents. The research question examined was: What sort of assistance, support, or education do independent school parents feel they need from school counselors in raising adolescent children? The participants for this study were parents of middle school children attending an independent school located in an urban southern city. All parents of children attending the independent school were asked to respond to an online “needs assessment” survey asking parents to select parent education topics that are of interest to them. Parents participating in this phase of the study had an opportunity to volunteer for the next phase of the study, an online card sort activity. Parents who volunteered for the online card sort activity were sent a link to the online card sort activity where they took a list of parent education topics and arranged them into groups as they saw fit. Analysis of the results revealed nine themes, or categories of topics that are of interest to parents of middle school children: Parenting Skills, Adolescent Self-Management, Self-Awareness and Esteem, Academic Opportunities and Career Choices, Peer Relationships and Skills, Emotional Wellness, Physical Health and Wellness, Parent-Teacher/Staff Communication, and Technology Safety and Use. An informal concept map was created to visually represent the categories of parent education topics that emerged from the study. The results of this study can assist professional school counselors in designing parent education and consultation curriculum and interventions, and help ensure that school counselors better meet parents’ needs.

Introduction: Implementing low-intensity interventions, such as group-based parent education and training (PET), is a cost and time effective way of providing early intervention for families and their children with autism spectrum disorder (ASD) in low- and middle-income countries (LMICs). Relatively little empirical research demonstrates the effectiveness of parent education and training in this context. Methods: The study aimed to develop and pilot a group-based parent education and training (PET) programme (COMPAS) and determine its appropriateness and acceptability. Secondly, it aimed to investigate the clinical effectiveness of the programme to improve the communication interaction skills and self-efficacy beliefs of parents of young children with autism. The study followed an exploratory sequential mixed methods research design and used the Replicating Effective Programs (REP) framework. Sixty-one participants took part in the study which consisted of 3 phases. In phase one we developed the programme and teaching materials and activities. In the pre-implementation phase, we collected qualitative and quantitative data via questionnaires from two stakeholder groups (25 parents and 5 autism experts). In the implementation phase, we used a single group pre-test post-test design with 31 parents of children with autism to determine changes in parent-child interaction and parenting self-efficacy. The primary outcome of the implementation phase, parent-child interaction, was measured using the Parenting Interactions with Children: Checklist of Observations Linked to Outcomes (PICCOLO), and the secondary outcome, parenting self-efficacy, was measured using the Parenting Sense of Competence Scale (PSOC) and the Parenting Self-Efficacy Measuring Instrument (P-SEMI). Results: In the pre-implementation phase, a panel of experts agreed the training content was comprehensive and relevant, and that the manual was user-friendly. After the pilot study parents felt confident that they could use at least one of the strategies taught during everyday routines or play with their child. Results from the implementation phase indicated significant improvement in parenting interactions (p < .05, d = 1.26) and self-efficacy (p < .05, d = 0.35) after the training. Conclusion: We developed and piloted a training programme in a LMIC setting which resulted in increased interaction skills and self-efficacy for parents of young children with autism. This study indicates that brief, group parent education and training in a LMIC is feasible and can be effective in improving parenting skills and feelings of competence.

SAMMANFATTNING Introduktion: Barnhälsovården i Sverige når nästan alla barn och föräldrar. Föräldrastöd är en av de viktigaste insatserna samhället kan bistå med för att minska negativa utfall hos barn och unga. Implementering av föräldrastöd i grupp är komplext och modellen kan behöva utvärderas utifrån komponenterna faciliterare, innovation, kontext och mottagare.  Syfte: Syftet var att beskriva främjande och hindrande faktorer för deltagande i föräldrastöd i grupp i svensk BHV utifrån kontext, föräldrastödets innehåll, samt erfarenheter från föräldrar och BHV-sjuksköterskor. Metod: Litteraturstudie med deduktiv ansats. Implementeringsmodell i-PARISH användes i en riktad innehållsanalys. Artikelsökningar gjordes i CINAHL och PubMed. Sammanlagt inkluderades 18 vetenskapliga artiklar.  Resultat: Resultatet presenteras under fyra kategorier och 13 subkategorier utifrån i-PARIHS. Ledaren var avgörande för att gruppen skulle utveckla en sammanhållning och delta aktiv. För att lyckas med detta behövde ledaren vara bekväm i sitt ledarskap, påläst och uppdaterad. Föräldrarna uppskattade när de hade en ledare som uppmuntrade dem att prata i gruppen och som såg till att diskussion flöt på. Föräldrar uttryckte flera skäl och förklaringar till varför de inte ville eller kunde delta i en föräldrastödgrupp. Slutsats: Både främjande och hindrande faktorer med föräldrastöd i grupp i svensk BHV framkom. BHV behöver få fler föräldrar att känna sig inkluderade i föräldrastödsutbildningen samt vara lyhörd för deltagarna olika behov. Det är också viktigt att BHV-sjuksköterskors behov av utbildning och fortbildning tillgodoses för att kunna leda grupperna på ett professionellt sätt. / ABSTRACT Background: The child health services (CHS) in Sweden reach almost all children and parents. Parental support is one of the most important initiatives society can assist in reducing negative outcomes in children and young people. Implementation of parental support in groups is complex and the model may need to be evaluated on the basis of the component facilitator, innovation, context and recipient. Aim: The aim was to describe promoting and hindering factors for participation in parental support in group format in the Swedish CHS based on context, the content of parental support, and experiences from parents and CHS nurses. Method: Literature study with deductive approach. The implementation model i-PARISH was used in a targeted content analysis. Articles were searched for in CINAHL and PubMed. A total of 18 scientific articles were included. Results: The results are presented under four categories based on i-PARIHS. The leader was crucial for the group to develop cohesion and participate actively. To succeed in this, the leader needed to be comfortable with the leadership, read and updated. The parents appreciated when they had a leader who encouraged them to speak in the group and who made sure that discussion flowed. Parents expressed several reasons and explanations to why they did not want or could not participate in a parent support group. Conclusion: Both promoting and hindering factors regarding Swedish parental support in group format emerged. CHS needs to make more parents feel included in the parental support education and be sensitive to the participants' different needs. It is also important that CHSnurses' needs for education and training are met in order to be able to lead the groups in a professional manner.Keywords: Parent education, Child health service, experiences, implementati

While there are numerous websites discussing attachment parenting in infancy, there are currently no interactive research-based websites devoted to attachment parenting throughout early childhood. To fill this need the author developed the Foundations of Parenting website (http://www.foundationsofparenting.org). Evaluation, a tool so far under-utilized by parenting education websites, is necessary for both quality control and improving websites. Thus, in addition to development of the website, the author also formatively evaluated the Foundations of Parenting program by using website-utilization tools and visitor feedback through an online survey to analyze utilization and visitor satisfaction. The website was well-used (674 unique visitors and 189 return visitors with a visitor page depth of 6.7 pages over a 23 day period) for a newly-created website, as can be seen by an examination of traffic rankings of small websites at www.alexa.com. The quantitative survey items assessed the usefulness of the website, the attractiveness of the website, ease of use of the website, whether the website met the participants needs, how interesting the content was, whether the website led them to reconsider former attitudes and made them aware of new things, and whether the participant had decided to do things differently due to the website. A MANOVA procedure was used to identify distinctions in these items in association with selected demographic variables, while the open-ended questions invited the survey participants to elaborate on their quantitative answers. The majority of survey participants, 75 percent, agreed or strongly agreed with the above quantitative survey items, and 87.6 percent felt that the website was useful or very useful. Thus, a large majority of users indicated that the website was useful, attractive, easy to use, interesting, helped them reconsider former attitudes, helped them become aware of new things, and influenced them to decide to do something differently. MANOVA analyses revealed website ratings varied only by ethnicity. Reports compiled by SuperStats tracked the amount of website usage as well as visitor pathways through the website, visitor page depth, the amount of time spent on the website, which pages were most popular, as well as the page depth of the most popular pages. These reports revealed that users tended to search for information they were looking for and leave instead of reading through website content from beginning to end. Participants provided helpful suggestions and feedback to improve the website. Implications of this feedback for website improvement and ideas for further research are discussed.

Eating and feeding are skills learned in early childhood that are important to human survival. These activities are complex and require physical, sensory, cognitive, and behavioral skills. Understanding the nature of picky eating and addressing it in this essential developmental period is critical to establishing healthy eating habits that persist into adulthood. Educating and equipping parents and caregivers with the tools they need to support their child will create healthy, sustainable eating habits. Picky eating is a concern for parents of children at all developmental stages that is frequently associated with parent stress and mealtime disruptions. Researchers often refer to picky eating as a passing childhood phase; however, clinical studies and longitudinal results indicate that picky eating could persist into adulthood and cause obesity, cardiovascular disease, metabolic disorders, and respiratory problems. Three main factors cause picky eating: the child, the caregiver, and the mealtime climate. Together in Every Bite is a virtual hands-on parent education program that aims to educate parents and caregivers to establish healthy habits around mealtime and decrease picky eating behavior in children in their early developmental stages (6-24 months) and decrease mealtime stress and anxiety. Caregivers will engage in problem-solving and plan-building activities coinciding with the learned material, developing their self-efficacy and confidence while reducing stress and anxiety. The program director will also distribute valuable information provided through this platform to health professionals who work with parents of infants. This paper outlines the relevant literature and theory, and the evaluation, funding, and dissemination plans for Together in Every Bite.

Due the fear of Sudden Infant Death Syndrome (SIDS), parents have been putting infants on their backs. The American Academy of Pediatrics (AAP) started to recommend balancing sleeping in supine with prone play - also called Tummy Time-to encourage optimal, healthy infant development (Zachry & Kitzman, 2011). Due to various reasons, parents avoid putting the infants in the prone position even when awake. Evidence-based literature has shown that infants sleeping in supine without spending time in prone can lead to motor delay in their first year of life (Barlett & Fanning Kneale, 2003; Dudek-Shriber & Zelazny, 2007). Evidence also shows that weight bearing in prone is associated with motor development (Salls et al. 2002). This doctoral project attempts to identify the links between prone activities, postural control and fine motor development through research on evidence-based literature. It also provides a theoretical foundation, investigates the evidence and best practice in designing an educational package on prone play for typically developing and high risks infants. It also advocates best practice in occupational therapy by addressing a lack of evidenced based literature and attempts to add to the knowledge base in regards to tummy time and its effect on fine motor development. The target audiences are parents and caregivers of infants; the health care professionals that work with them; the funding agencies and policy makers. The qualitative and quantitative benefits of the parent education program will align with health promotion and wellness initiatives of the Ontario government. The project will describes a detailed evaluation plan and dissemination of results with estimated budgets. This will include presentation to the community and the ministries in the government. The project will contribute to these areas of occupational therapy: (1) addressing evidence-based practice in tummy time with typically developing and high risks infants; (2) providing best practice for implementing a Prone to Play program to foster upper extremity motor development; and (3) promoting health and wellness initiatives in occupational therapy.

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