Home-based early intensive behavioural intervention for young children with Autism : development of a measure of perceived therapeutic self-efficacy

Abstract

The variability in outcomes observed in home-based EIBI is likely in part to be the result of the quality of therapist performance during intervention sessions.  Therapist behaviour in this context is, however, poorly understood.  Perceived therapeutic self-efficacy may be one factor responsible for governing therapist behaviour.  Exploration of this factor is, at present, hampered by the lack of a valid and reliable measure of perceived therapeutic self-efficacy; the aim of the present thesis was to devise such a measure.  To achieve this, it was necessary to identify barriers that therapists considered to impede their ability to deliver home-based EIBI.  In the first study, 19 therapists delivering home-based EIBI to young children with autism in the South of England were interviewed.  Barriers to intervention delivery included child factors such as challenging behaviour and lack of progress, supervision factors such as being observed during sessions, therapist factors such as emotional reactions to children’s behaviour, and factors related to the intervention such as advanced skill targets.

Following the identification of barriers to delivering home-based EIBI, two further questionnaire studies sought to clarify the nature of perceived therapeutic self-efficacy and explore predictors of therapists’ beliefs.  Factor analyses of therapists’ responses identified two dimensions of perceived therapeutic self-efficacy relating to (i) teaching a child who is difficult to engage with and (ii) teaching a child whilst being observed.  Subsequent regression analysis revealed the former dimension was predicted by therapists’ perceptions of their own experiences, general self-efficacy and supervision frequency.  There was also evidence to suggest that general self-efficacy beliefs act as a protective factor in this domain when therapists experience difficulties.  The latter dimension was predicted by therapists’ perceptions of their own experiences, general self-efficacy beliefs and knowledge of behavioural principles.

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