Acceptability, Feasibility, and Potential Impact of a Telecoaching Intervention for Parents of Children with Autism Spectrum Disorder in Palestine: A Mixed-Methods Pilot Randomized Controlled Trial. رسالة دكتوراة

Abstract

Families of children with Autism Spectrum Disorder (ASD) in Palestine face barriers to accessing specialized early intervention services, including geographical, political, and economic constraints. This study evaluated the acceptability, feasibility, and potential impact of an Occupational Performance Coaching (OPC) based parent telecoaching intervention delivered remotely via Zoom and supported by the Sanad Al Hayaa platform. The study examined changes in parental outcomes and children’s achievement of parent-selected goals. An explanatory sequential mixed-methods design was used, combining a pilot randomized controlled trial with a waitlist control group (n = 24) and post-intervention qualitative interviews. The study was conducted in the West Bank, Palestine, between February and July 2025. The intervention consisted of eight weeks of individual telecoaching sessions delivered via videoconferencing. Quantitative data were collected using the Canadian Occupational Performance Measure (COPM), Saudi Telehealth Acceptance Scale (STAS), Childhood Autism Rating Scale-2 (CARS-2), Autism Treatment Evaluation Checklist (ATEC), Parenting Competence Scale-ASD (PCS ASD), Arabic Quality of Life in Autism (A-QoLA), and WHOQOL-BREF. Qualitative data were gathered through semi-structured interviews with parents in the intervention group and analyzed to explain and contextualize quantitative patterns. Acceptability showed strong signals, with higher STAS total and facilitating conditions scores and very large gains in COPM satisfaction. Feasibility benchmarks V were met for retention (92.3%), platform account creation and library access, randomization integrity, questionnaire completion (baseline 100%, post 92.3%), intervention fidelity (88.9%–100%), and safety, with one moderate event that resolved without medical action. Recruitment was partially achieved within the planned timeframe. Signals of potential impact were strongest for child participation outcomes, reflected by large improvements in COPM performance and improved ATEC sensory and cognitive subscale scores, while changes in autism severity (CARS-2) were borderline. For parent outcomes, autism-specific quality of life improved (A-QoLA Part B), whereas parental competence and generic quality of life showed modest, mostly non-significant changes. Qualitative findings aligned with these patterns, highlighting privacy, reduced burden, routine-based implementation, and parent empowerment through reflective problem-solving under Palestinian constraints. OPC-based parent telecoaching appears acceptable and feasible in Palestine, with signals of potential benefit. A larger, adequately powered trial with longer follow-up and strengthened recruitment procedures is recommended.