Date Presented 04/01/2022
The research questions were as follows: (1) Do OT practitioners address caregiver stress? (2) What are the sources of caregiver stress among parents of children with sensory dysfunction? (3) What intervention methods or tools do OT practitioners use to address caregiver stress? An OT practitioner survey was used to obtain quantitative and qualitative data to answer these questions. These data are important in understanding best practice for client-centered care in pediatrics.
Primary Author and Speaker: Kimberly Schiller Evatt
Contributing Authors: Julie Watson, Rae Ann Smith
PURPOSE: Parenting is a stressful occupation, even more so for caregivers of children with sensory dysfunction. Support for caregivers, burdened by stress due to sensory behaviors, is within the scope of occupational therapy practice for a client-centered approach. While pediatric occupational therapy practitioners (OTPs) often observe caregiver stress, little was found regarding the specifics of how it is addressed in occupational therapy practice. The purpose of this study was to determine quantitative and qualitative information regarding what signs of stress are observed and how OTs address this issue. The issue is essential as a client-centered approach because caregiver burden affects the quantity and quality of occupational engagement that the caregiver can support. Further, sensory processing issues are highly prevalent in children with autism spectrum disorder (ASD). The incidence of ASD is expected to continue to rise.
METHOD: A twelve-question online survey was developed with closed-ended and open-ended questions regarding how OTPs address the issue in practice. A convenience sample of pediatric OT practitioners was obtained by disseminating the survey through the American Occupational Therapy Association’s OTCommun forum, Facebook, and an email invitation to pediatric OTPs. Questions focused on current practice for assessing and addressing observed caregiver stress. The research questions for this study were: 1) Do OTPs address caregiver stress? 2) What are the sources of caregivers’ stress among parents of children with sensory dysfunction? and 3) What intervention methods or tools do OTPs use to address caregiver stress?
RESULTS: Quantitative data was analyzed using SPSS statistical software using paired-samples t-tests, and qualitative information was analyzed using thematic analysis. Most (97%) respondents (n = 121) reported that they had observed caregiver stress. Seventy-eight percent reported that they had addressed caregiver stress during discussions with the caregiver. However, only 7% reported the use of an objective tool to assess caregiver stress. Anxiety, depression, and fatigue of caregivers were common themes reported by OTs. Methods used to address caregiver stress included self-care education, parent support groups, information on respite, and referral to medical or mental health services.
CONCLUSION: Caregiver stress impacts both the pediatric client and the ability of the caregiver to provide support to a developing child. Sensory processing issues have a unique effect due to the behaviors that can cause taxing of time and energy on the caregiver. The topic of sensory processing is well-embedded in the curriculum of entry-level occupational therapy coursework. However, the study found that OTPs with more experience were more likely to address caregiver stress as part of the intervention. The researchers recommend increased topic educational opportunities for OT practitioners, use of a tool to assess caregiver stress, and OT networking to find local caregiver supports and resources to promote a client-centered approach and practice using an evidence base.
Centers for Disease Control and Prevention (2019). Data & statistics on autism spectrum disorder. Retrieved from https://www.cdc.gov/ncbddd/autism/data.html
Crasta, J., Salzinger, E., Lin, M., Gavin, W., & Davies, P. (2020). Sensory process and attention profiles among children with sensory processing disorders and autism spectrum disorders. Frontiers in Integrative Neuroscience, 14(22), 1-10. https://doi.org/10.3389/fnint.2020.00022
Daily, K., Clyde, A., & Oscarson, B. (2019). The relationship between sensory processing differences and parental stress in preschool-age children with behavioral concerns. American Journal of Occupational Therapy, 73(1), 7311505107. https://doi.org/10.5014/ajot.2019.73S1-PO3002
Kirby, A., White, T., & Baranek, G. (2015). Caregiver strain and sensory features in children with autism spectrum disorder and other developmental disabilities. American Journal on Intellectual and Developmental Disabilities, 120(1), 32–45.