Running head: PARENT-CHILD RELATIONSHIP

Evidenced Based Paper

Josee Lundquist
Touro University, Nevada

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Research Question
The research question I chose to research was, How do occupational therapy services in
early intervention affect the parent-child relationship of families receiving services?
How does this study relate to your research questions?
This study explored how occupational therapy early intervention services impact the
parent-child relationship of these families, which is the main focus of my research question.
Although this study has the same focus as my research question, this study is addressing the
topic from an occupational therapist standpoint, and I intended for my research question to be
from a parents standpoint.
What is the purpose of the study?
The purpose of this study was to explore personal stories of occupational therapists to
understand experiences where they believed they had made real differences in relation to parentchild relationships in children and families they provided services.
Were research questions asked? If so, what are the research questions?
The authors of this qualitative research study did not state any research questions
throughout the journal article.
What is the Study design/type of qualitative research?
Phenomenological study design was used for this study to collect data from the
participants, and report about the study. The author explains the participants were asked to reflect
on work experiences that pertained to the purpose of the study in order to borrow their ideas and
develop a deeper understanding, the idea behind phenomenological research.
How were the participants recruited and selected?
The researcher recruited the participants by sending written invitations to 64 members of
an occupational therapy organization who had declared early intervention as their specialty
treatment area, along with five additional therapists that were not members of the organization.
The first ten participants to reply and meet criteria set by the researchers were selected for the
study. The criteria included currently serving children from birth to three years of age, had at
least five years of experience working with this age group, had completed at least one class about
pediatric issues in the past year, worked with children and their families in the home setting, and

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had an occasion in which they believed that their intervention as an occupational therapist made
a real difference in the parent-child relationship of a family.
How many participants were in the study?
Ten participants were chosen for the study, but one participant didnt complete the study
due to scheduling conflicts. The authors state they used a small number of participants because
this study was not intended to be used to generalize to a larger population.
How are the participants described?
The characteristics of the participants were displayed in a table and included degree,
experience in years as an occupational therapist and in early intervention, case load for children
birth to three years old and total case load, whether the therapist was part time or full time, ages
served, area served, and work setting.
Overall, six of the therapists had Bachelor of Science degrees and three had Master of
Science degrees. Participants experience as an occupational therapist ranged from six years to 30
years and six years to 23 years of experience in early intervention. Four of the participants
worked only part time while the remaining five participants practiced full time, and the majority
of the participants worked in the public school setting.
What is the relationship of the researcher to the participants?
The journal does not state a relationship between the researcher and the participants. The
researcher who collected the data is an occupational therapist in a public school system which
leads me to believe the participants may have had some degree of relationship with the
researcher due to the fact that the majority of them also practiced within the public school system
although locations of the school districts is not disclosed.
What are the sources of data?
The data for this study was collected from nine participants using face-to-face and over
the phone interviews. Prior to the interviews, the participants were provided with a letter asking
them to think about specific occasions when they had felt they had made an impact on the
parent-child relationship and be able to provide detailed stories to support this.

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The first round of the interviews was completed face to face with the participant at either
the participants home, worksite, or in a public library. The interviews took between 27 and 60
minutes each and were audiotaped. These interviews consisted of open-ended questions, and the
participants were given the opportunity to speak without being interrupted.
The second set of interviews with each participant was conducted over the phone, and
lasted between 10 to 20 minutes. This interview was also audiotaped and the time was utilized to
clarify statements made in the initial interview, and discuss themes that had emerged to assure all
viewpoints had been considered.
How are the findings reported?
The findings found were discussed in relation to the eight themes that developed through
analysis of the data. Themes that emerged included valuing relationships and connections,
valuing the parents perspective, working through the family versus fixing the child,
interpreting information from a different perspective, and parents need to be told and shown
positive things about their child. For each theme identified during the study, the authors
elaborated about common and different perceptions the participants verbalized.
What are the findings?
The researchers found all of the participants in the study believed the parent-child
relationship is interdependent with the childs development, and that the relationship and
development could be used to facilitate each other. The participants believe the basis for a
successful intervention is acting as a change agent verse an expert for the parents, so the parents
can then be change agents for their children. Being a change agent includes using the parentchild relationship as a tool to facilitate the development of the child, and including the parent in
the intervention planning because they ultimately know their child the best.
The participants also agreed providing a perspective different from a medical perspective,
such as how a childs diagnosis will affect them functionally can help the parent understand their
child better. Helping the parents read cues can also be beneficial for parents due to the difficulty

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of understanding certain behaviors a child with a disability may present compared to a child who
is typically developing.
Overall, the participants expressed the importance of showing a family you care for their
child as a human and not as a job by pointing out positive things the child does and using a
family centered approach. When the family is actively involved in therapy sessions, the childparent relationship will naturally strengthen.
How do the finding relate to previous research?
The findings of this study correlate well to the previous research and literature. The
researchers cites several studies who indicated parent involvement is crucial in early
intervention, as well as literature associating optimal developmental outcomes and quality
relationships with parents which were also identified beliefs of the participants in this study.
Does the author discuss implications for future research?
The authors found that the participants had a difficult time verbally expressing some of
the information related to questions in the interview. To address this in future research, the
researchers stated a more in-depth picture of how therapies actually conceptualize and then
implement strategies to facilitate parent-child relationship, and possibly using direct observation
of treatments and follow-up interviews. The researchers found the participants mentioning
various strategies used to facilitate the child-parent relationship, with no information about what
strategy works best. The researchers discuss further research to determine what is the most
effective strategy, or if certain strategies work better with specific family concerns.
What are potential sources of bias on the part of the researcher? Did the researcher
describe methods for avoiding bias?
The researchers did not address the possibility for bias or methods to avoid biases. A
potential bias I would consider is the close relationship of the researchers with the field of
occupational therapy. All four researchers are occupational therapists, which I believe may cause
the researchers to already have a positive attitude towards occupational therapy and the parentchild relationship in early intervention.

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Is there a rationale for the participant selection? Are the participants credible
(believable)?
The researchers do not provide rationale for the participant selection, although the focus
of the study was very specific limiting who the participants would potentially be. The
participants present credible, holding either a Bachelors of Science in Occupational Therapy or
Masters of Science in Occupational Therapy, backed by multiple years of experience in early
intervention.
Did the researcher use methods to establish trustworthiness of the data? Do these methods
seem adequate?
The researcher had an Institutional Review Board (IRB), Human Subjects Committee
review and approve the study to incorporate human subjects in the study. The participants were
all provided consent forms and the procedures prior to the study taking place. The researcher also
followed up with a second interview to clarify statements made, and allow the participant to
make any corrections to the interpretations developed by the researcher.
The steps and methods used in this study seem adequate to create a trustworthy study.
The IRB assured that the study was ethical, and with providing the procedures to the participants,
they were aware of what to expect during the study. Informed consent is always important to
conduct a trustworthy study, because when working with human subject, their rights need to be
protected.
Are the themes presented consistent with the data presented? Do the conclusions make
sense to you or do you think the researcher was reading into the findings (or trying to find
what he/she wanted to find)?
The themes presented in this study are consistent with the data reported. The researchers
found that all of the participants shared a common belief about the parent-child relationship
being critical to the childs development and the ability of occupational therapists offer
intervention t using relationship based therapy would facilitate this relationship. The themes

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discussed in this article support this finding, including working with the family versus fixing the
child, interpret the child to the parent, and parents need to be told and shown positive things
about their child. I do not believe the researchers read into the themes to develop these findings,
because they were very consistent throughout all of the interviews.
Was the researcher flexible in the data collection process? Did he/she allow the data to
guide the process?
The researcher was flexible throughout the interviews, using open ended questions and
allowing the participant to talk without interruption during the entire first interview. The
researchers did not try to guide the participants in any certain direction. The researchers then
used the information provided in the first interview to guide what questions would be discussed
in the follow-up interviews.
How would you use this article as a therapist?
As I become a new therapist interested in pediatrics, I believe this article will help me
build a trusting relationship with the families I provide services. The article discusses the
importance of working through the family instead of fixing the child, and how it is a mindset that
comes with experience. A majority of the participants stated, they did not approach interventions
in this manner, but rather as the expert. As I become a therapist, I believe this article will help
remind me to use a top down approach and include the family in all aspects of therapy with their
child.
Another aspect of this article I will use as I become a therapist is the importance stressed
by many of the participants to express positive things about the child to the family. Parents and
children with a disability become accustomed to hearing negative comments, instead of hearing
praise for their child. To show the families I am not there to just get the job done, and rattle off
more deficits the child needs to work on I will try to make it a point to end therapy interventions
with a statement about their child to give them a feeling of accomplishment and pride.

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How does this article support/not support participation in occupation and the field of
occupational therapy?
A significant occupation of children is play, which occupational therapists utilize to
facilitate development. This article clearly portrays the importance of an occupational therapist
role in development and aiding the parent-child relationship as the child engages in play during
therapy. I believe this article is supporting the importance of occupational therapy within early
intervention.

References
Mayer, M. L., White, B. P., Ward, J.D., Barnaby, E. M. (2002). Therapists perceptions about
making a difference in parent-child relationships in early intervention
occupational
411-421.

therapy service. The American Journal of Occupational Therapy, 56 (4),