MD candidate Albert Einstein College of Medicine Northwell Health Lake Success, New York, United States
Background: Developmental therapies (DTs) are essential for children with developmental disabilities. Homework exercises (HE) may help children retain skills learning during DT through repetition and active parental involvement.
Objective: To examine the relationship between HE and parent satisfaction with DTs, parent-perceived improvement in child skills, location of DTs, and payment method.
Design/Methods: Families waiting for their regularly scheduled developmental pediatrics appointment were recruited to complete a written questionnaire eliciting information regarding DTs utilized by the child, including PT, OT, Speech Therapy, Special Instruction, Feeding Therapy, and Applied Behavioral Analysis. For children receiving 2 or more DTs, one was selected at random for inclusion in data analysis. ANOVA, Chi-square, and Mann-Whitney U tests were used to examine associations between HE and 4 measures: parent satisfaction, parent-perceived improvement, location of DTs (home/center vs. school vs. combination), and payment method (insurance/self-pay vs. school/state vs. combination).
Results: 118 questionnaires were received for patients ages 1-17 years (mean 7.72 y; 76.4% male; 51.7% white). HE were therapist-recommended for 37 children (31.4%). All 37 parents who received therapist-recommended HE for their children completed these exercises. Parents of children with HE reported greater satisfaction with therapy services (U=1065.5, p=0.03). HE were also positively associated with parent-perceived child skills improvement (X2=5.18, p=0.02). Location of services was also significantly associated with HE assignment (p<0.001); children only receiving therapy at home or a center were more likely to receive HE than those only receiving therapy at school. Also, HE were more often recommended for children whose therapy was paid for by a combination of methods than for children whose DT was paid for by school or state (t=-3.17, p=0.02). Conclusion(s): Given that HE are associated with significantly increased parent satisfaction and parent perceived improvement in child skills, it is concerning that only 31.4% of families report receiving HE. The lower rate of HE for DTs provided in a school setting was also concerning. Based on parent perceptions of satisfaction and clinical response, greater emphasis should be placed on HE for children receiving DTs.
Authors/Institutions: Christine Campisi, Northwell Health, Lake Success, New York, United States; Jamie P. Sklar, Northwell Health, New Hyde Park, New York, United States; Ruth L. Milanaik, Northwell Health, New Hyde Park, New York, United States