Role of the Caregiver in Sustaining Gains due to Developmental Intervention

Abstract

Positive parent-child interactions are critical for effectively navigating the course of a child’s development. In children with developmental and behavioural disorders intervention plan needs to cater to both the child as well as the entire family, to ensure positive changes for both. Due to limited data, time and resource constraints, clinicians in India often are not able to optimally engage and optimize caregiver involvement in the treatment plan. A 2 years and 9-months-old boy presented to a multidisciplinary child development centre due to delayed speech and hyperactivity. In addition, he was found to be fidgety, restless, could not wait for his turn, stubborn, showed head banging when demands were not met and temper tantrums. A battery of developmental assessment led to a diagnosis of attention deficit hyperactivity disorder (ADHD), predominantly hyperactive-impulsive type (DSV-IV-TR). The child received an individualized goal based multi-disciplinary intervention involving
parental counselling, occupational therapy and speech and language therapy over a period of 2 years. In addition, parents were actively engaged and coached to implement best practices i.e., reduced screen time, increase play time, home cooked food, sleep hygiene and parent diary. This collaborative approach with parents helped to accelerate and sustain the effectiveness of the multidisciplinary intervention. In a child with ADHD, predominantly hyperactive-impulsive type, caregiver-centred approach plays a vital role in augmenting and sustaining the desired outcomes achieved by a multidisciplinary intervention.