Caregiver, Disabled Persons
Conditions
Keywords
Special Need Assistants/paraprofessionals, Coaching, Occupational therapy, Self-care skills
Brief summary
Special Need Assistants/paraprofessionals serve an essential role in special education to support children with multiple disabilities, but they often lack adequate training and supervision. The study aims to examine the effects of the coaching program for assistants compared to a workshop outside working hours and evaluate the outcomes in students and assistants. The second aim is to measure fidelity implementation of coaching practices and if the intervention was participation-based.
Detailed description
This study addresses the training needs of assistants to minimize participation barriers of the students. The schools will be assigned to one of two groups: both groups will receive a 10 hours training workshop; only the intervention group will receive coaching one-to-one. The duration and number of coaching sessions will depend on the caregivers' time available, daily routines, and goals. Coaching sessions will be recorded for the assessment of treatment fidelity.
Interventions
BEHAVIORALcontextual one-on-one coaching
Training workshop and coaching one-on-one
BEHAVIORALTrainig workshop
Ten-hour training workshop.
Sponsors
Universidad de Zaragoza
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
Two external assessors will measure the fidelity of the implementation of the intervention.
Intervention model description
This study is a quasi-experimental pretest-posttest design. Repeated measures on participants in both arms (as in an RCT) enable assessment of both within-person changes over time and between-arm differences.
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
assistants: * Special Need Assistant of students between 4-21 years of age. * Speak, read and comprehend Spanish. * Be available for workshop and one-on-one coaching. * Able to verbalize changes in their own performance or their students' participation. * Written consent.
Exclusion criteria
assistants: * Have no students involved in the program. Inclusion Criteria students: * Present difficulties in Activities of Daily Living (ADLs). * Have an assistant involved in the study. * Informed consent signature (parents or legal tutors).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Goal Attainment Scaling (GAS). Assistants. | Baseline - 3 month after intervention | Clients identify goals and rate their performance on a 5-point Likert scale ranging from -2 (much less than expected) to +2 (much better than expected). In the baseline, clients can score -1 or -2, and the score 0 is the expected level of success. The 4-point Likert scale is used for quantifying importance (ranging from 0= nothing important to 3= really important) and difficulty (ranging from 0= easy to 3= very difficult). Afterwards, the goal's weight is calculated (importance\*difficulty). A mathematical formula allows computation to T-score with a mean of 50 and a standard deviation of 10. |
| Change in The Canadian Occupational Performance Measure (COPM). Students | baseline- 3 month after intervention | Caregivers identify activities that are problematic for the child. The caregiver rates the child's performance and satisfaction for each participation goal on a 10-point scale, (1=unable to perform, unsatisfied; 10= performs exceptionally well, extremely satisfied). Differences in scores pre-and post-intervention for both performance and satisfaction are determined independently. A 2-points change in these values is considered clinically meaningful. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Natural Environments Rating Scale (NERS) | 12 month after intervention | The NERS describes eight categories: 1) setting; 2) activity; 3) type of activity; 4) engagement of child; 5) activity leader; 6) materials; 7) role of the caregiver; 8) the role of the professional. If there is no child-centred activity, grading is discontinued for the remaining categories. Only the last four categories are rated for an overall score that differentiated traditional or participation-based services. |
| Change in transfer and generalization of learning | 19-20 mounths after intervention | All paraprofessionals were invited to reply to a semi-structured interview through a phone. This interview collected information about their current employment, the degree in which they had been able to put into practice the skills learned and the challenges for their professional development. |
| Change in learning. Social validity | 6 month | Paraprofessionals were invited to reply to a writing questionnaire. This survey collected information about their training preferences and satisfaction with received training. |
| The Coaching Practices Rating Scale. | 12 month after intervention | The Coaching Practices Rating Scale was utilized as a secondary outcome to measure the fidelity of coaching. Its 14 items are based on adults' learning characteristics and coaching practices to determine how the coach use these practices, on a 5-point Likert scale. The scale accepts the rating through video-tapes and has a high degree of construct validity and internal consistency. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Classification of goals and adaptations | 6 month | The types of goals and adaptations were classified according to daily living activities, such as using the toileting, eating, feeding, hygiene and grooming, dressing, functional mobility, and others (miscellanea). Accommodations or adaptations to enhance children's participation were registered during and after the intervention as a) not necessary, b) natural for the child or easy to acquire, c) a rehabilitation device, or d) an architectonic/extensive modification. The adaptations were analyzed as an independent element in the goals that improved performance two or more points in the COPM. |
Outcome results
None listed