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4314 Enriched Home Environment: A Model & Intervention to Facilitate Participation in Children with ASD


Thursday, July 23, 2009: 3:15 PM-4:30 PM
St. Charles Ballroom 6 (Pheasant Run Resort and Conference Center)
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Enabling childhood participation in home activities requires complex interactions between the child and a stimulating ecology. Home environment plays a vital role in child development. Children with autism may have lower participation in home activities. This study explores a measurement and an intervention model to understand the relationship between a child with autism and a stimulating ecology as defined by an enriched home environment. The study contributes to understanding the importance of an enriched environment for facilitating participation in children. Background:
Enabling childhood participation in home activities requires complex interactions between the child and a stimulating ecology. Home environment plays a vital role in child development. Children with Autism Spectrum Disorder (ASD) may have lower participation in home activities due to motor, sensory and cognitive difficulties. This study explores a measurement and an intervention model to understand the relationship between a child with ASD and a stimulating ecology as defined by an enriched home environment. The study contributes in understanding the importance of an enriched environment for facilitating participation of children with ASD in home activities.
Objectives:
1.       Examine the relationship between participation of children with autism, parenting stress and the enriched home environment and to identify key factors in the environment that influence the child’s participation in home activities.
2.      Develop a measurement and an intervention model of an enriched home environment
2.1.   Develop a Home Environment Checklist (HEC) to assess the level of environmental complexity present in the home environment of children with ASD.
2.2.  Implement an eight-week home modification program to provide learning, sensory and a socially stimulating environment.
2.3.  Identify changes in participation of children with ASD in home activities following an eight-week intervention program.
Methods:
To examine the relationship between participation of children with ASD and environmental factors (parenting stress and enriched home environment), 22 Children with a diagnosis of ASD ages 3 to 6 years were recruited for the study.  Home Observation for Measurement of Environment (HOME) and Preschool Activity Card Sort (PACS) assessments were performed in the child’s home in the presence of the parents. The parents filled out a demographic questionnaire, Parenting Stress Index (PSI), and Social Responsiveness Scale (SRS). 
To implement an eight-week home modification program, 2 children were recruited. Pre intervention data was collected using the Home Environment Checklist, Preschool Activity Card Sort, Parenting Stress Index, and Sensory Profile. Following an eight-week home modification program, post intervention data was collected using the Preschool Activity Card Sort. Pre and Post intervention data, on PACS was analyzed to report changes in the participation patterns of children with ASD. The eight-week program had the following aims for each week.
Week 1: The parents filled the following assessments:
  • Social responsiveness scale: to identify if the child is low or high functioning.
  • Parenting stress Index: to assess the level of stress in the parents.
  • Sensory Profile: to identify the child’s responsiveness to sensory input across sensory systems.
  • Preschool activity card sort was completed to identify the participation patterns of children,
  •  Home Environment Checklist was filled based on the observations of the home environment and
  • Parent interview was conducted to get information on the daily routine of the child.
Week 2: Parents were explained about the importance of home modification for children with ASD and the daily schedule of the child with ASD was discussed. The play and the study area of the child with ASD was identified.
Week 3: Suggestions about organizing the play study and rest area of the child were given to the parents.
Week 4: Information was provided on how to use various educational material and toys that are available at home to provide a learning environment to the child. Also new toy/s was introduced depending on the need of the child.
Week 5: Stress relieving strategies were taught to the parents.
Week 6: Activities that involved parent and child interaction to improve social interaction were introduced.
Week 7: A sensory area for the child was created.
Week 8: The preschool activity card sort with the parents was completed.
Data Analysis:
To examine relationships between participation and environmental factors, a spearman rank coefficient analysis and a multiple regression analysis was used.
A percentage change was documented to analyze the changes in participation in home activities following an eight-week home intervention.
Results:
Significant correlations were found between parenting stress, the characteristics of the home environment and participation patterns of children in home activities. Based on multiple regression analysis, the variance in participation in low demand leisure activities of children with autism was predicted by the availability of the learning materials in the home and the parenting stress after controlling for the severity of child diagnosis.
An increase in the scores on participation in home activities following an eight-week home modification intervention was also reported, though these results were not statistically significant.
Conclusions: The results of the study helped in understanding the environmental factors that influence participation of children in home activities. Also, the Home Environment Checklist (HEC) can be used by clinicians to assess the level of environmental complexity in home environment of children. HEC can provide a new perspective of designing and planning services for children with autism to improve their participation in home activities. Providing an enriched home environment to children with ASD can improve their participation in home activities. Overall, this study provides a guideline to develop a measurement and intervention model to develop enriched home environment for children with ASD.

Learning Objectives:

  • Develop an understanding of the influence of environmental factors on participation of children with ASD in home activities
  • Explore a measurement and an intervention model of an enriched home environment that provides cognitive, sensory and social experiences to the child.
  • Assessment of the home environment of children with ASD and define an enriched home environment to facilitate participation
  • Explore the relationship between participation and enriched home environment following an of an eight week home modification intervention for children with ASD

Content Area: Family and Sibling Support

Presenter:

Divya Sood, OTD, OTR/L
Assistant Professor
University of Missouri, Columbia

Divya Sood is an Assistant Professor in the Department of Occupational Therapy and Occupational Sciences, University of Missouri. She is also the Director of Occupational Therapy Research at the Thompson Center for Autism and Neurodevelopmental Disorders. Her research interests focus on developing participation models for children with autism.