Home-Based Occupational Therapy Early Intervention Programs in Children with Down Syndrome: A Randomized Clinical...

To investigate the effectiveness of combining home-based programs with early intervention (EI) as an occupational therapy strategy for children with Down Syndrome.

A six-month longitudinal pilot study was conducted with 30 children with DS aged 0-3 years, recruited from an early intervention institute in Belo Horizonte, Brazil. Participants were allocated to a control group (EI only) or an experimental group (EI plus home-based programs grounded in Family-Centered Practice (FCP)). Outcomes were assessed at baseline and post-intervention using the Canadian Occupational Performance Measure (COPM), the Pediatric Evaluation of Disability Inventory (PEDI), and the Affordances in the Home Environment for Motor Development (AHEMD).

Both groups demonstrated statistically significant improvements from pre- to post-intervention (p < 0.001). However, the experimental group showed moderate effect sizes (Hedges' g) in occupational performance (0.61), satisfaction (0.50), and self-care (0.56), while the remaining outcomes presented small effects. No significant between-group differences were observed in environmental affordances.

The integration of home-based programs grounded in FCP into early intervention was associated with greater improvements in occupational performance, caregiver satisfaction, and self-care skills in young children with Down Syndrome. These findings support home-based programs as a feasible and effective complementary occupational therapy approach within early intervention services.