Visual Supports at Home for Children with ASD: Using Parent and Staff Experiences to Develop and Pilot a Brief Intervention

Background:

Visual Supports are one of the evidence based psychosocial interventions recommended in clinical guidelines for ASD and commonly used in school settings to support individuals with ASD to understand expectations, to reduce anxiety and to participate purposefully in daily life. Their use is reported across intervention paradigms. However, there is very little evidence about how parents and carers of children or adults with ASD are or should be, supported to access and use these at home or in the community. There is also a lack of comprehensive, evidence based guidance or ready-made resources for professionals.

Objectives:

We aim to:

1. explore experiences of parents, carers and staff in relation to access to relevant visual supports
2. explore how practical knowledge of home visual supports is shared with families in ways that enables use
3. develop and evaluate a Home Visual Support Project model for practice

Methods:

Following a systematic literature review, questionnaires and focus groups were conducted with parents/ carers of children with ASD (aged 2-12 years) and a multi-professional group of staff working in specialist roles with children with additional support needs and their families (n=22).

The results of the questionnaires (n=101) informed the content of the focus group discussion. This centred around challenges and solutions related to timely access to the right visual supports and reasonable support to start and maintain their use. Focus group data were transcribed and thematic analysis undertaken. Outcomes were used to develop resources and a model for practice, which could be easily delivered within current UK public service provision.

Results:

1. Key themes generated between families and professionals were remarkably similar and were:

• Participation focussed
  • Considering child’s opportunities and motivation
  • Providing supports relevant to the child within their environment
• Knowledge and understanding
  • Information
  • Training for families and staff
• Resources
  • Accessibility of a range of visual supports
  • Means of creating individualised resources
  • Need for a forum to discuss how to adapt to needs as they change over time
• Support to families
• Individualised support and planning
• Timely support
• Structured processes to gather information
• Developmentally appropriate visual supports, linked to current priorities for the child and family
• Consistency between home, school and community settings

2. Parent and Staff resources (for 3 stages of development) and a model for practice were developed and these will be available for demonstration at the conference.

3. Pilot evaluation results for 30 parents using qualitative and quantitative parent measures will be reported.

Conclusions:

The mixed methodology provided an effective means of identifying challenges and solutions to the mismatch between provision of visual supports in home, school and community settings. Key themes generated were used to develop resources for practice, which were participation focussed; share knowledge and information; provide access to practical resources and support to families. The methodology and results from this research may be used to inform low-cost service provision in other countries.