Parent as Therapist

Children with cerebral palsy participate in a variety of activity-based interventions as a part of their treatment. For example, a physical therapy program of overground walking and treadmill training may be recommended to improve walking ability. Research shows that repetition increases the likelihood of positive outcomes. As health care providers have limited availability, parents are often expected to fill the gap at home through parent-delivered interventions. Parent-delivered interventions are activities that have been taught or shown to the parent to allow them to deliver them regularly at home or within the community. This allows children to repeat the activities throughout the day, in order to meet clinical goals.

However, implementing these therapies at home is not always straightforward for parents!

In a recent study, researchers reviewed multiple studies on the perspectives of parents and therapists on parent-delivered interventions for CP.  The goal was to identify the barriers and facilitators to parents implementing these therapies and interventions at home, and to make recommendations going forward.

What were the findings?

Barriers to parents successfully implementing these therapies at home included insufficient parental knowledge, parents’ lack of confidence, and insufficient time with the therapist for coaching parents. Facilitators included staff continuity to build long-term relationships between the therapist and family, empowering parents, efficient resource utilisation to accommodate families, and flexible programs tailored to each child’s daily life.

Recommendations going forward included realistic goal setting through collaboration, tailored parental education to increase confidence, and providing training to therapists to improve their coaching skills. The study says that highly skilled therapists who understand the needs of parents and their child are the key to promoting successful parent-delivered interventions.

The study says that although parent-delivered interventions are effective and should be encouraged, therapists should be careful to not over-burden parents who are often already under a lot of pressure.  Caring for a child with CP can be demanding for parents. Therapists need to clearly understand parents’ expectations, motivations and capacity when determining the extent of the parent’s involvement, in order to minimize harms to family dynamics. Parents interested in parent-delivered interventions generally or increasing their confidence should talk to their child’s health care provider.