The Feasibility of Occupation-Based Coaching for Autistic Children and Primary Caregivers

Autistic children participate less and have fewer opportunities to develop participation skills than nonautistic peers. The extent to which occupation-based coaching (OBC), a metacognitive strategy training intervention, affects participation in school-age autistic children is unknown. We conducted a single-group pretest-posttest design to evaluate the feasibility and preliminary effect of telehealth OBC for autistic children (n = 13) and primary caregivers (n = 12). Participants completed eight telehealth OBC sessions to address activity-based goals; they completed child, caregiver, and family outcomes pre- and post-intervention. Recruitment, retention, caregiver measure completion, and intervention adherence rates exceeded feasibility benchmarks. OBC had large effects on child performance (Hedge's g = 1.65) and satisfaction (Hedge's g = 1.89), a moderate effect on child sleep disturbance (Hedge's g = 0.60), and small effects on child participation (Hedge's g = 0.23) and family quality of life (Hedge's g = 0.26). Further research in a large-scale study is warranted with changes to better support child measure completion and enhance the study protocol.