'I wouldn't want one or the other': Understanding parents' preferences for direct support or parent coaching for young autistic children.
Phoebe Jordan, Carla Wallace-Watkin, Jessica Tupou and 2 others
PMID 39394944WHAT IT FOUND
Parents valued both direct therapy and parent coaching but preferred direct support when forced to choose.
They found coaching overwhelming or stressful, while direct therapy relieved them of the pressure to deliver treatment themselves and appeared to benefit the child more.
Key findings
01When forced to choose, 77% of parents preferred direct support over parent coaching.
02Parents preferred direct support because it relieved the pressure of delivering the therapy themselves and they believed their child made more progress in that setting.
03Parent coaching was often experienced as overwhelming due to the cognitive load of managing the child while learning new techniques.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample was small (22 survey, 11 interviews) and selected from those who completed the full programme, potentially biasing results towards parents who had a positive experience. Only 2 fathers were represented in the interviews, limiting insights into paternal perspectives. Participants were predominantly highly educated and from a specific cultural context (New Zealand), which may not generalise to other populations. The study reports preferences, not clinical outcomes, so it does not prove which approach is more effective for the child.
Declared interests
One author is the Clinic Lead of an autism clinic providing support to young autistic children. Several authors provide clinical support to this population. The study was funded by Health Research Council of New Zealand and NHMRC grants.
The easy way to misread this
Do not interpret the preference for direct support as evidence that it is clinically superior. The study measured parental satisfaction and perceived child benefit, not objective outcomes, and parents may have preferred direct therapy because it relieved them of the burden of treatment delivery.