Defense Date

2024

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Health Related Sciences

First Advisor

Stacey Reynolds

Second Advisor

Audrey Kane

Third Advisor

Sarah Schoen

Fourth Advisor

Jacquie Rainey

Fifth Advisor

Carol Schall

Abstract

Caregivers of children with autism spectrum disorder (ASD) play an integral role in the carry-over of the skills addressed through interventions (Althoff et al., 2019). Occupational therapy (OT) using Ayres Sensory Integration® approach (ASI®) is one of the most utilized, caregiver-requested interventions for children with ASD (Schaaf et al., 2013). While family-centered practice is foundational to the OT profession, caregiver participation is optional, potentially leading to reduced effectiveness and variability of intervention outcomes (Jaffe et al., 2020). To date, the acceptability, feasibility, and effectiveness of caregiver in-session engagement within ASI® has not been evaluated; the purpose of this study was to address these gaps using a caregiver in-session engagement model (CIEM) for children with ASD and their caregivers. The CIEM is a practitioner-facilitated, caregiver in-session engagement intervention comprising affective, behavioral, and cognitive levels of engagement. In this study caregivers and children participated in 10 sessions integrating CIEM and ASI®. The study achieved three primary aims: (1) Evaluating the fidelity of the CIEM within ASI® sessions, (2) Determining the acceptability and feasibility of the CIEM for both OT practitioners and caregivers, and (3) Assessing caregiver engagement outcomes resulting from the CIEM intervention. Findings indicated that the CIEM was feasible and acceptable, with positive impacts on caregiver engagement observed across affective, behavioral, and cognitive domains. These results provide foundational evidence for integrating the CIEM model more widely within pediatric OT practice and suggest a promising mechanism for quantifying the outcomes of caregiver in-session participation during ASI® for children with ASD.

Rights

© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

12-10-2024

Available for download on Thursday, December 10, 2026

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