Considering Carryover: A Parent-Child Approach to Goal Directed Training to Maximize Centre to Home Generalization

Goal directed training is a client-centered and occupationally focused approach which prioritizes independence through active problem solving and repetition of successful strategies. This is in contrast to a more traditional... [ view full abstract ]

Goal directed training is a client-centered and occupationally focused approach which prioritizes independence through active problem solving and repetition of successful strategies. This is in contrast to a more traditional approach of working on specific body functions, hoping to impact on a general success of the activity (Mastos, Miller, Elisasson & Imms 2007). There is emerging literature that working within a parent-child interaction model has a positive impact on a child’s developmental imperatives (Slade 2009). That is, that by coaching the parent, they can create ample opportunities for the activity, manage resistance and increase motivation, and thereby accelerate the time it takes to meet the same goals using naturally occurring contexts.
This paper describes a case study of Jack,* a child with cerebral palsy and his mother. We discuss the successful implementation of an intervention that worked within the parent-child interaction model using goal directed training. By building the parent’s capacity and response repertoire around the specific requirements of the goals, Jack’s resistance to task requirements and intrinsic motivation were also optimally addressed. We found that by developing the skills of Jack’s mother, she was able to integrate therapeutic tasks into their daily routines and ensure Jack had daily practice. The end result being increased functionality in less time across many settings. This study aims to highlights the importance of parent facilitation on achieving successful outcomes across contexts. Further, we provide strategies for clinicians to use with parents to support their child in times of reduced confidence, motivation and refusal.