Using Telepractice to Coach Caregivers of Children with Visual Impairments to Increase the Independent Living Skills of Their Children

Children with visual impairments have unique learning needs because visual impairment impacts a child's ability to learn incidentally though observation (Lowenfeld, 1952, 1973). Literature suggests children with visual impairments do not perform independent living skills at the same level as their peers with typical vision (e.g., Lewis & Iselin, 2002). Teachers of students with visual impairments (TVIs) struggle to find time to teach independent living skills during the school day (e.g., Lohmeier, Blankenship, & Hatlen, 2009), but caregivers may have the time and motivation to prioritize these skills at home. Caregiver coaching has been shown to increase the skills of caregivers of children with disabilities (e.g., Marturana & Woods, 2012); however, coaching models have not yet been widely applied to caregivers of children with visual impairments. Some researchers have applied teleconferencing technologies to provide access to coaching and successfully build the capacity of caregivers of children with disabilities (e.g., Baharav & Reiser, 2010). As such, telepractice coaching was explored as a tool to bridge physical distance between coaches with expertise in educating children with visual impairments and caregivers who have the opportunity to implement instruction in independent living skills for their children with visual impairments. A single case, multiple baseline across contexts design was used to implement a telepractice caregiver coaching intervention in the homes of three caregiver-child dyads for two to three times a week over about 10 weeks. The included children were tactual learners with no other significant disabilities aged 5 to 11 years old. The study sought to answer the questions: (a) does telepractice coaching with the Family Guided Routines Based Intervention (FGRBI) coaching model (e.g., Woods, 2017) increase caregiver correct use of coached instructional strategies during independent living skills routines with their children who have visual impairments? and (b) does caregiver use of coached instructional strategies increase the child's independent completion of independent living skills tasks? Because the coaching intervention was only implemented across all three contexts in one dyad, data from that dyad only can be considered as evidence of the effectiveness of the intervention. In that dyad, the caregiver increased her skills above baseline levels in all three contexts and demonstrated mastery in two contexts. However, great variability in the data make it difficult to conclude with certainty that there is a functional relation between telepractice caregiver coaching and caregiver instructional strategy use in teaching her child with a visual impairment. In addition, instructional skills learned in one skill context were generalized by some caregivers to other independent living skills contexts without coaching. Challenges with the length and duration of sessions caused concern regarding the social validity of the intervention. However, data collected after the study from participants and an external rater as well as maintenance data suggested high social validity of the intervention. Findings suggest the use of telepractice to deliver interactive caregiver coaching should be further investigated to determine its effectiveness to increase both caregiver instructional skills and the independent living skills of children with visual impairments. If telepractice is found to be effective, TVIs may benefit from using telepractice coaching to build relationships and strengthen capacity within the families of their students. Further research is necessary to examine the use of the telepractice coaching intervention to meet the needs of families and children with diverse characteristics, explore the role of siblings as peer models, and expand the role of the child in coaching. Further, the composition of the telepractice coaching intervention should be investigated to determine which intervention components may be most effective for which families, and how frequently they should be delivered for maximum efficiency. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]