Caregiver Coaching in Occupational Therapy-Led Early Intervention: A Scoping Review

Caregiver coaching is increasingly used in early intervention (EI) to build caregiver capacity and support children's development within everyday routines. Occupational therapy (OT) aligns closely with this approach through its emphasis on meaningful occupations and family-centred, contextually embedded practice, yet implementation and reporting remain variable across OT-led EI services.

This scoping review aimed to map how caregiver coaching is implemented within OT-led EI services, focusing on goal-setting practices, coaching models and delivery formats, therapist roles and strategies, and reported child and caregiver outcomes.

A scoping review was conducted in accordance with the framework proposed by Arksey and O'Malley and was reported following the PRISMA-ScR guidelines. Searches were conducted in PubMed, CINAHL, Scopus, Web of Science and Cochrane CENTRAL for English-language, peer-reviewed studies published between January 2000 and June 2025. Eligible studies involved caregivers of children aged 0-6 years receiving OT-led EI services that incorporated caregiver coaching. Data were charted using a standardized form and synthesized through descriptive numerical summaries and qualitative thematic analysis.

Sixteen studies met the inclusion criteria. Goal setting varied from collaborative, family-centred processes to therapist-driven or programme-defined approaches. Occupational Performance Coaching and relationship-based developmental models were most frequently described, delivered through in-person, telehealth, hybrid or community-based formats. Therapists predominantly adopted facilitative coaching roles using observation, modelling, guided practice and feedback. Child outcomes were reported more frequently than caregiver outcomes, with limited emphasis on occupation- and participation-based measures.

Caregiver coaching within OT-led EI shows promising outcomes but remains highly variable in implementation and reporting. Greater conceptual clarity and increased emphasis on occupation-focused outcomes are needed to strengthen evidence-informed OT practice in EI.