Implementing Togther Time with children with special needs

 The revised Together Time program was piloted with families from new target populations who face challenges including domestic violence, poverty and parenting children with disabilities.

Families from a variety of backgrounds were recruited to participate in the pilot group that used the revised Together Time Curriculum.  All of the families in this new pilot group were living in poverty and two of the families were homeless. Two mothers, also, had intellectual disabilities (one had suffered a brain injury and the other had mild mental retardation). All families included in this group had a child diagnosed with a developmental disability who was receiving occupational therapy services prior to beginning the group sessions.  Some of the diagnoses of the children in the group included spina bifida, dwarfism, feeding disorders and cerebral palsy.  While the majority of the caregivers who participated were mothers, two fathers and one grandmother also attended the group sessions.

While the pilot group and individual sessions were implemented by licensed occupational therapists, the Together Time curriculum has been developed to allow facilitators from any background to implement the program. The parents and children who participated in this new pilot group participated in 10 group sessions on topics related to bedtime, grooming, meal time, dressing and play time. Caregivers completed Pre and Post Test Questionnaires (completed at session 1 and session 10), and filled out a Family Goals Record Form (completed at session 1 and session 10)

 

Family Goals Record Form Results

On the Family Goals record form, Parents were asked to identify activities of daily living they would like to work on to improve their skills in caring for their child over the 10 sessions. Performance and interaction skills chosen by group participants included:

“I want my child to want to play with me”

“I want my child to have a bedtime routine”

“I want my child to be able to put on his own shirt”

“I want to know more about what my child should be doing at his age.”

At the end of the Together Time program, many parents reported they saw a positive change in their children’s’ ability to more independently perform skills they identified as important as well as a greater feeling of satisfaction in their child’s performance of these skills. These changes indicate families were growing and developing skills in areas they identified as meaningful and useful to their individual needs.

 Pre and Post Test Questionnaires

Families that participated in the new pilot group were asked to provide feedback on the program at the conclusion of 10 group sessions. On the Pre and Post Test questionnaires, parents showed a variety of positive outcomes. One caregiver shared, “the thing I liked best about the Together Time group [was] meeting people and [child’s name] can play with other kids.” Parents reported that Together Time allowed them to learn skills about parenting and discover new things about their children. One mother shared, “I learned he likes different foods,” and commented that her child also learned new skills in the groups such as “he plays more and helps do more with dressing.” A second mother reported “I learned songs and great parenting skills.” A third mother stated that she found the group a valuable resource because she “learned to let [her child] be independent.’

Parents who participated in pre and post group interviews reported having more frequent interactions with other parents. One mother, who stated she “never” spoke with other parents prior to participating in Together Time, reported that following the group she felt she more comfortable talking with other mothers. This change is considerable since we know that parents of children with disabilities often experience isolation and the impact of isolation on mothers and children can be devastating to healthy growth and development as well as their quality of life.

Lessons Learned

The information gathered from this project and the assessment and evaluation tools employed showed that:

  • Together Time group sessions help families feel less isolated and build positive interactions, leading to healthier growth and development.
  • The group sessions promote a supportive and social environment for parents to share feelings and new ideas. Participating in the group helps foster socialization skills among both the parents and their children.
  • Parents genuinely enjoyed participating “as a group” and felt connected to one another.
  • The “meal time” lesson activities were very popular in the group setting and many parents talked about foods their children like and offered suggestions and new ideas to their peers.
  • The “dress-up” play lessons were the most popular home activity.
  • Parents enjoyed having designated times and activities to play and interact with their children.
  • Blankets donated by Project Linus were very useful in many of the home and group activities.  Parents were excited and grateful to be able to keep the blankets, as well as other program materials.
  • Transportation is a major barrier for these families.  Families, who participated in group sessions, were provided taxi cab transportation since they would not otherwise have been able to access the program.
  • Transportation is a major barrier for these families in all aspects of their lives – in general they do not leave home often due to a lack of both public and private transportation.
  • During the times before and after group sessions (while waiting for their cabs) parents socialized and offered advice and support to each other.

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