The International Journal of Psychosocial Rehabilitation

 

Optimizing Parent Coaches’ Ability to Facilitate Mastery

Experiences of Parents of Children with Autism



Archana Raj

Psychometrist, Central West Autism Intervention Services, ErinokKids, Ontario, Canada

Kiran Kumar, PhD
Professor, Department of Studies in Psychology, University of Mysore, Mysore, India.
     

 

Citation:
Raj A. & Kumar K.. (2009). Optimizing Parent Coaches’ Ability to Facilitate Mastery Experiences of
 Parents of Children with Autism.
 International Journal of Psychosocial Rehabilitation. Vol 14(2).  25-36






Acknowledgments:
This study was conducted as part of Archana Raj’s doctoral thesis at University of Mysore, India. The authors wish to thank the parents, clients, staff, and management of Central West Autism Intervention services, ErinoakKids, Ontario, for the support and cooperation they extended to this study.


Abstract
Mastery experiences exert a significant influence on self-efficacy. A major component of mastery experience is positive appraisal of direct experiences with task-related behaviors. It is possible that parents of children with autism experience fewer opportunities for positive appraisal of parent-child interactions. This study proposes a sensitized model of parent coaching with in-built practices to support coaches to facilitate mastery experiences of this group of parents, in parent-child interactions. The relative capacities of this model and an existing model of parent coaching, as perceived by the coaches, in supporting them to facilitate mastery experiences of parents of children with autism, is the focus of this study. As perceived by the coaches, the sensitized model of coaching enhanced their ability to facilitate parental mastery experiences, compared to the existing model.

Keywords: self-efficacy, mastery experiences, sensitized parent-coaching model


Introduction Autism is a neuro-developmental disorder characterized by severe qualitative impairments in reciprocal social interaction and communication, and restricted, repetitive behaviors, interests, and activities (American Psychiatric Association, 2000). Lovaas et al., in 1973 first emphasized the importance of training parents as intervention providers for their children with autism. They noted that following intensive treatment, children whose parents received training to carry on the intervention continued to make gains compared to children who were returned to institutional settings. Since 1973, significant strides have been made in providing training/coaching to parents of children with autism, with a number of studies reporting parents gaining skills in facilitating functional social-communication and in managing challenging behaviors through parent coaching (e.g., Aldred, Green, & Adams, 2004; Wetherby & Woods, 2006; Rogers et al., 2006; Carr & Durand, 1985; Feldman & Werner, 2002).

In recent years, in developmental research, there has been increased appreciation of cognitive factors associated with parenting, with parental self-efficacy emerging as one of its most powerful predictors (Coleman and Karraker, 1997). Bandura (1977; 1986; and 1989) identifies self-efficacy in terms of one’s belief in one’s ability to successfully perform a particular behavior. In psychology and education, self-efficacy has proven to be a more consistent predictor of behavioral outcomes than have any other motivational constructs (Graham & Weiner, 1996). However, as identified by Coleman and Karraker (1997) and by Jones and Prinz (2005), information is sparse on interventions that target this construct centrally, for parents.

Families of children with autism report a greater number of stressors when compared with families of children with other disabilities (McGrath, 2006); further, it has been identified that the child’s state is the primary factor behind the high levels of stress experienced by this group of parents (Fleischmann, 2005). Sense of competence could be an area of particular vulnerability when child characteristics are chronic and result in special challenges to parenting (Kazak & Marvin, 1984). This information underlines the need for programs for children with autism to address the gap identified by Coleman and Karraker (1997) and Jones and Prinz (2005). The gamut of skill-deficits around social-communication and challenging behaviors that are associated with the diagnosis of autism often leave parents perplexed and feeling inadequate when interacting with their children. Most parents do not have a frame of reference of previous experiences and role models in interacting with children who are predominantly non-responsive in social contexts; therefore, there  is often a tendency to become extremely reliant on the therapists as experts, and feeling that only trained therapists have the competence to address the child’s needs. The identifying feature of autism being a lack of social responsiveness, many parents fail to experience naturally occurring social-reinforcement contingencies experienced by parents of typically developing children and other developmental disabilities. Direct experience with parenting task behavior, in other words, would often have resulted in failure for them, in the form of a lack of, or inadequate social responsiveness from their children. Given the unique nature of parent-child interactions in autism, and the impact such interactions could have on parental cognitions, there is a need to develop parent-coaching models with the explicit purpose of influencing self-efficacy of parents of children with autism (Raj and Salagame, in press), with coaching practices geared to influence parental sense of competence. One way to achieve this end is for coaches to facilitate mastery experiences of the parents, through the process of coaching.

According to Bandura (1994), the most influential source on self-efficacy is through mastery experiences derived from an authentic experiential base. One’s personal history of accomplishment through direct task experience has been identified by Bandura (1989) as exerting the most powerful influence on mastery experiences. Every time a person has the opportunity to master a task, he/she will start to believe in his/her capability to perform the task. Therefore, it becomes paramount that a coaching model with the explicit purpose of affecting parental self-efficacy equips the coaches with techniques to provide experiences of mastery to the parents.

The question naturally arises as to the capacity of traditional parent-coaching models in existence for parents of children with autism to help coaches facilitate mastery experiences of the parents. Based on the primary means through which self-efficacy is believed to develop, i.e., through direct experience with task behavior, traditional parent coaching models with the three core practices of modeling, rehearsal, and feedback have the capacity to facilitate mastery experiences.  However, most of these models were not designed with the purpose of influencing self-efficacy of parents of children with autism.  Specific sensitivities have to be infused into the three core coaching practices of modeling, rehearsal, and feedback (Raj and Salagame, in press), to provide coaches with practices to efficiently facilitate mastery experiences of this group of parents. The goal of this study was to compare the relative efficacies of a traditional parent-coaching model and an enhanced model, to facilitate mastery experiences of parents, as perceived by the coaches.

In-order-to address this goal, an existing ‘parent coaching model’ was compared with an enhanced version of it, called hereafter as “sensitized coaching” developed by the authors, with specific sensitivities infused into the core coaching practices of modeling, rehearsal, and feedback. The current model of parent coaching at the participating agency in this study served as an example of an existing parent-coaching model. It was hypothesized that coaches would perceive the sensitized model of coaching to be more effective in facilitating mastery experiences of parents of children with autism, compared to the existing model. Coaching parents to conduct mand training for their child with autism was the vehicle used to answer the study question.

Method
Operational Definitions
Mand. Mand or request is a unique type of language that directly benefits the child by letting his/her care taker know what he/she wants or does not want at a particular moment. Mand is the first type of language to teach a child with language deficit, as in the case of most children with autism (Sundberg and Partington, 1998).

Mastery experience. The experience of completing an activity successfully, leading to increase in self-efficacy related to the activity (Jackson, 2002)

Dependent and independent variables
The dependent variable in this study was the coaches’ perception of the relative capacity of the sensitized and existing models of parent coaching to facilitate mastery experiences of parents. The dependent variables were the two models of parent coaching.

Design of the study
A group of coaches were first trained on the existing model of parent coaching at the participating agency in this study and then on the sensitized model. They implemented the two models of coaching on two separate groups of parents, consecutively. Coaching was provided to parents in group 1, with the existing model of parent coaching at the participating agency. Following this phase, coaching was provided to parents in group 2 with the sensitized coaching model.

Participants
All parent coaches were Instructor Therapists (ITs) working for the participating agency. The twelve coaches who participated in this study were matched on specific variables as summarized in Table 1.
Fifteen mothers per group, matched on their pre-coaching self-efficacy scores received coaching. Table 2 summarizes characteristics of the parents. Their children were between the ages of four and eight years, had a diagnosis of autism, and were clients of the participating agency. These children exhibited low rates of mands (less than 10 times per hour in parent-child interactive situations). They did not exhibit aggression towards others and/or self-injurious behaviors (Raj and Salagame, in press).
 
Table 1
Characteristics of the 12 Coaches Who Participated in the Study
Variables                                                                      Specifics
Gender                                                                                                 Females
Education                                                                                             Minimum of a college diploma in early childhood education or applied behavioral sciences
Average time/day spent in providing therapy                                          six hours
Average duration of employment with the agency                                   one year
 

Measures
A Coach Feedback Form was developed by the authors to measure coaches’ perception of the capacity of the two models of parent coaching to equip them to influence mastery experiences of parents. In developing this form, the authors had discussions with a number of coaches at the participating agency to identify what they hoped to provide parents with, through coaching. Common themes that emerged included (a) enhance parent confidence; (b) create opportunities for productive parent-child interactions; (c) reduce parents’ reliance on trained therapists; (d) help parents generalize skills across different environments; (e) have standards of performance for parents to work towards; and (e) keep parents motivated throughout the duration of the coaching period. In essence, what the coaches hoped for was to facilitate mastery experiences of the parents. The Feedback Form was developed based on the input from the coaches. The form has 22 statements. Coaches compared the existing and the sensitized models on each of the 22 statements. They used a 6-point scale with response options ranging from strongly agree to strongly disagree. Coaches’ ratings were added up, resulting in separate scores for the sensitized and existing model. Based on the scores of 15 coaches, the Cronbach’s alpha coefficient for this Form as it measures existing parent-coaching model is .96. Cronbach’s alpha coefficient for this Form with-reference-to the sensitized parent-coaching model is .79.

Parents in group 1 and group 2 were matched on two measures of self-efficacy (a) The self-efficacy subscale of The Parenting Sense of Competence Scale (Mash and Johnston, 1983) and (b) The Task-Specific Self-Efficacy scale (Raj and Salagame, in press).  The Parenting Sense of Competence Scale (PSOC) is in the public domain. Cronbach’s alpha coefficient for the self-efficacy sub-scale is .76 (Johnston and Mash, 1989). The same for the Task-Specific Self-Efficacy Scale is .89 (Raj and Salagame, in press). The PSOC scale was used as a measure of domain-general self-efficacy of the participating parents and the Task-Specific Self-Efficacy scale was used as a measure of their sense of competence on facilitating mands for their children.

Procedures
Client Services Management Committee at the participating agency gave permission to conduct this study. Coaches who were employees of the agency were given information on the study, in face-to-face meetings with the first author. All coaches were supervised by their Senior Therapists (STs) and had received training on the existing parent coach model as part of their job. The same coaches received training on the sensitized model from the author, along with their STs, before implementing coaching for parents in group 2. The coaches were provided with the Feedback Form by the author once they concluded implementation of coaching with both the models. The coaches returned the completed Feedback Forms to the author in sealed envelopes, personally.  
Parents who participated in the study were clients of the agency. Parent coaching is routinely offered to all parents of children in the autism program, at the participating agency, as part of the service delivery model. On behalf of the first author, Senior Therapists approached parents who had been identified to receive coaching on facilitating mands for their children, with information on the study. All parent participants gave informed consent. Parents were randomly assigned to group 1 and group 2. They reported on the two self-efficacy measures, before receiving the coaching interventions. These questionnaires were delivered to the parents by the STs working with the families. Completed questionnaires were collected in sealed envelopes by the STs and delivered to the first author.

The following provisions were in place to counter extraneous factors which could have potentially acted as confounds on the dependent variables (a) coaches received training on the sensitized model of coaching only after they finished implementing coaching with group; (b) both models of coaching were identified as parent coaching to limit any implications that one model might be inherently superior to the other; (c) coaches were not familiarized with the concepts of self-efficacy and mastery and; (d) all coaches had equal opportunities to establish rapport with the children and the parents before starting parent coaching.

Interventions
It is identified in literature that change in parental sense of competence depends on a change in ratio of successes to failures in parenting responding and on a change in the subsequent reappraisal of competencies (Bandura, 1981). Based on these directions and with the aim of providing coaches with specific tools to influence mastery experiences of parents, the following provisions were incorporated into the practices of modeling, rehearsal, and feedback in the existing model, resulting in a sensitized model of parent coaching. The provisions are as follows (a) operationally defining sub-skills of the task to pinpoint the behaviours to be modeled to the parent, and to make the task achievable; (b) creating opportunities for the parent to generalize sub-skills through rehearsal; (c) making quantitative data available to the parent, to engage in self-appraisal of competence, in addition to coach’s feedback; and (d) systematically fading out coach’s models to increase opportunities for the parent to perform the task independently (Raj and Salagame, in press).

Table 2
Characteristics of the 30 Parents Who Participated in the Study
Variables                                                                      Specifics
Gender                                                                                     Females
Pre-intervention skill level                                                          Less than five facilitations of child’s  mands observed during half-an-hour of mother-child interactions
Age range                                                                                30-40 years
 

 Table 3 compares the existing model and the sensitized model of coaching and identifies how each feature of the sensitized model helps the coach to facilitate mastery experiences of the parents. Figure 1 and Figure 2 depict the salient features of the existing model and the sensitized model (Raj and Salagame, in press). Every parent who participated in this study received 1:1 coaching, in the presence of the child, for two hours on a specific day of the week. Parents in group 1 received three months of coaching according to the coaching practice at the agency. Duration of coaching for parents in group 2 was dependent on achieving performance criteria as outlined in Table 2.

Table 3
Comparison of the Two Models of Coaching and the Impact of the Sensitized Model on Coach’s Capacity to  Facilitate Mastery Experiences of the Parent 
Existing Model Sensitized Model Impact on facilitating Mastery Experiences
Coaching addresses
sub-skills of a
targeted skill.
Sub-skills are further operationally defined, in a measurable, achievable way. Target skill becomes objective, achievable, and measurable; supports goal setting and achievement.
Parents have
opportunities
to rehearse
sub-skills.
During rehearsal, the coach focuses on contriving a number of generalization opportunities on the sub-skills. Parent experiences success in varied contexts of parent-child interactions.
Coach provides
feedback to the
parent.
In addition to feedback, coach maintains quantitative data on behalf on the parent and shares the progress towards achieving performance criteria. Parent has a tangible and objective information system, for self-appraisal of performance.
Parent receives
three months of
coaching.
Coaching terminates only once parent achieves criterion on independent performance in (a) coaching sessions and (b) novel situations. Parent has many opportunities for self-reflection, self-correction, and generalization of skills.
Arbitrary ratio of
models from the
coach and  
independent
attempts by
the parent.
Coach follows a prescribed ratioa of models and opportunities
for independent attempts by parent, in-order-to fade out support, systematically.
Reduces parent’s    reliance on the coach.
     
  a The coach encourages the parent to try a sub-skill independently after the skill had been modeled to the parent, a maximum of two times. At the independent attempt, if the parent shows signs of not being able to follow through, the coach models the skill again two times and encourages the parent to try the skill independently.

Figure 1


Figure 2



   
Fidelity of implementation of coaching
STs observed and gave feedback to the coaches on both models of coaching, in-vivo or through videos on the coaching, on an average of two times per month. In addition, the supervising STs rated a random sample of coaches on procedural integrity for implementing the sensitized model of coaching on two separate occasions, during the course of the intervention. A rating scale of eight items, developed by the authors was used for this purpose. The results indicated that each of the coaches had 80% or above adherence to the prescribed procedures, across each of the two occasions (Raj & Salagame, in press).

Data analysis
The study involved repeated measurements on a single sample. Analysis of significance of difference between the coaches’ ratings of the two models of coaching was conducted using the Wilcoxon Matched-Pairs Signed Ranks Test. In addition, a content analysis of the coaches’ responses on the Feedback Form was also undertaken. The aim was to isolate features of the two models with reference to their relative capacities to influence mastery experiences.

Results
 Wilcoxon Matched-Pairs Signed Ranks Test was used to test significance of difference of coaches’ ratings of the two models of parent coaching. Results are provided in Table 4. According to the statistical analysis, there was a significant difference between the ratings (z=2.903, N-Ties=12, p=.002). Information on the raw scores provided in Figure 3 indicates that 11 of the 12 coaches rated the sensitized model higher than the existing model of parent coaching. Statistical analysis support acceptance of the directional hypothesis that coaches would perceive the sensitized model of parent coaching to be more effective in providing them with enhanced capacity to impact mastery experiences of parents, compared to the existing model.

Figure 3


Table 4
Results of Paired Samples Test
 
N                                   Z                                   N-Ties                           P
12                                  2.903                             12                                  .002


Discussion
According to the results, coaches perceived that the sensitized coaching model better equipped them to influence parental mastery experiences. Content analysis revealed further facets of the sensitized model that differentiated it from the existing model, as perceived by the coaches.
In the sensitized model, sub-skills are operationally defined in an objective, achievable, and measurable way. Thus, a composite task that could look overwhelming was broken down into objective and achievable component goals, enhancing the coaches’ ability to facilitate experiences of success for the parents. According to Evers et al. (2006), a key coaching competency is for the coach to help the coachee set goals that are valued, specific, realistic, and attainable. These aspects are in-built in the sensitized coaching model, enhancing both the coach’s and the coachee’s capacity to set and achieve goals, both essential for mastery experiences.

According to the coaches, supplementing their feedback with data, with emphasis on helping the parent monitor progress, is a salient feature of the sensitized coaching model. In-order-to make consistent progress, the coach should be able to help the coachee monitor and evaluate his/her performance (Graham et al., 1994). The data, when used as a performance monitoring system, allow coaches to meet this criterion. Additionally, the data help coaches motivate parents and act as a motivational system for themselves.

The coach’s ultimate goal is for the coachee to demonstrate sustained performance by achieving the competence and confidence to engage in self-reflection, self-correction, and generalization of skills and strategies to new situations, beyond the realm of the coaching environment (Flaherty, 1999; Kinlaw, 1999). Through the generalization opportunities on the sub-skills in the sensitized model, the coach facilitates the parent contacting mastery experiences in different contexts of parent-child interactions, across locations and time. In addition, systematic fading of coach’s support, achieved by following a prescribed ratio of models vs. independent attempts by parent, helps buffer over-dependence on the coach and increases independent implementation of the sub-skills by the parent.

Coaches went back to conducting coaching with the existing model of coaching once the study was completed. As a follow-up, this author sought their input on how their experiences with the sensitized model continue to influence their current practice as coaches. According to their input, they are more diligent in task-analyzing the skills being coached to arrive at sub-skills, and operationally defining the sub-skills in measurable and achievable terms. They are also more aware of the need to make use of an objective system of tracking and sharing parental strengths and challenges throughout the course of the coaching. Systematic fading of prompts with the goal of minimizing parents’ dependence on them continues to influence the current practice of the coaches.
 
Conclusion
The outcomes of this study reinforce the benefits of sensitizing the core practices of coaching to enhance the capacity of the coaches to influence mastery experiences of parents of children with autism. Since mastery experiences have the most powerful influence on self-efficacy and since self-efficacy can influence the quality of care that parents provide to their children as well as the degree of enjoyment they derive from the parenting experience (Coleman and Karraker, 1997), the practice of sensitizing traditional coaching models could have far-reaching benefits for families of children with autism.  However, it is necessary to apply the model to a large sample size of coaches across different programs for children with autism to better understand its strengths and weaknesses. In addition, this model needs to be compared with other models of parent coaching in existence for parents of children with autism.

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