Parent-mediated intervention: adherence and adverse effects

Abstract

Purpose: The purpose of this study was to investigate parent implementation of home-based therapy regimens, and the relationship between implementation and family-level outcomes. Method: A stratified (by child age group) random sample of 538 families raising children with disabilities in Alberta, Canada took part. Participants completed the Family Life Survey, which incorporated child and family measures, and items measuring parent implementation of home-based therapy regimens. Results: Parents are more likely to implement therapeutic regimens when these are “enfolded” into other daily activities and routines. If parents have to “find a slot” in the daily routine to implement therapy, they will sacrifice personal leisure, participation in paid work, and time spent with other family members. Greater parent sacrifices/trade-offs was negatively associated with family well-being. Conclusion: As a general rule, children do well when their families do well, and families do well when they have the resources they need to juggle work and family and care demands. Recruiting parents as interventionists can tax family resources. Rehabilitation professionals must weigh up the pros and cons of parent-mediated intervention, and look to enfolding therapy into the everyday family routine.

Implications for Rehabilitation

• Parents are more likely to implement prescribed therapeutic activities and exercises when these are “enfolded” into the everyday family routine.

• Higher levels of parental adherence and implementation of home-based therapy programs is associated with poorer family well-being.

• Rehabilitation professionals must weigh the pros and cons of parent-mediated intervention, and help families find ways to enfold intervention into their daily routine.

• Developmental disability
• family-centered care
• home programs
• parent
• therapy

Declaration of interest

The authors report no declarations of interest.

This research was supported by grants from the Alberta Centre for Child, Family and Community Research (ACCFCR) and the Social Sciences and Humanities Research Council (SSHRC).