Resources

Baby care assessment tool

Christi Tuleja, parenting equipment specialist and project manager at Through the Looking Glass, California, USA, talks about delivering training with a new baby care assessment tool developed for occupational therapists.

The first group of occupational therapists has been trained in Through the Looking Glass’s (TLG) Baby care assessment for parents with physical limitations or disabilities.

In January 2007, I led a two-day training course for ten occupational therapists from the Rehabilitation Institute of Chicago about how to conduct the baby care assessmenttool.

This tool was developed under a grant from National Institute on Disability and Rehabilitation Research (NIDRR), US Department of Education, and was based on TLG’s 14 years of clinical experience and a series of previously funded NIDRR grants for adaptive baby care equipment. The Chicago group of occupational therapists was the first to be trained since the assessment tool was completed in January 2006.

The training provided participants with the necessary background information, administrative procedures and observational skills to perform the assessment with a parent with a physical disability.

Training topics included appropriate assessment of parent-child interaction; screening for parental depression; visual training of the many and diverse ways parents with physical disabilities can care for babies; identifying obstacles to baby care functioning and many more. In addition, the training provided an opportunity to discuss adaptive equipment and techniques, as well as solutions to participants’ current parenting issues.

As a part of the final certificate process, the participants will conduct an evaluation with a parent in the home, provide videotape of the parent performing baby care tasks and compile an assessment report with intervention recommendations.

Assessment tool description

Baby care assessment for parents with physical limitations or disabilities is an occupational therapy performance evaluation of baby care functioning for parents with minimal to significant physical disability. It provides an extensive review of all baby care functioning within the home and community relative to the parent’s needs and/or wishes. The tool emerged from the disability community and, therefore, incorporates disability ideals; autonomy versus independence, adaptation versus inability; strengths versus weaknesses.

Independent performance is only valued as much as the parent needs or desires it. Adapting the environment and looking to strengths to build upon are primary. This thinking is infused throughout the assessment tool and is felt to be an appropriate and valued approach to the assessment process.

The tool brings together the parent’s perspective and the occupational therapist’s skill in task analysis and contextual adaptation. It identifies the parent’s strengths and highlights the obstacles that are interfering with his or her ability to complete the task in the least demanding, most efficient, safe and ergonomic manner and in a way that supports the parent-child relationship.

It is the intention of the authors that the assessment be an accurate, respectful approach to identifying the parent’s needs and the obstacles that prevent reaching his or her baby care potential or goals.

The baby care assessment is not a complete parenting evaluation since baby care is only one component of parenting. However, the tool is a thorough evaluation of a parent’s baby care functioning and was designed to be utilised in mandatory assessment situations such as child custody disputes and child protection situations in conjunction with assessments from other professionals such as psychologists or social workers.

Due to continued scarce resources for parents with physical disabilities, the occupational therapist is also provided with some intervention solutions in the manual and the training, such as adaptive baby care equipment and techniques, to reduce the obstacles in parents’ environments. The importance of providing solutions to barriers before assessing a parent’s care capabilities is felt to be best practice.

Until recently, the field of occupational therapy and other related rehabilitation literature has paid little attention to this important activity of daily living: providing care for babies and young children when the caregiver has a physical limitation or disability.

For the most part, parents have been caring for their babies and young children without any special devices and have relied on their own ingenuity (Kirshbaum 1988). Yet, modified baby care equipment and adaptive techniques can be essential for parents with severe disabilities to be involved in baby care.

It has been shown that modified baby care equipment in the context of occupational therapy can have a positive impact on parent-child interaction and can reduce difficulty, pain and fatigue (Tuleja and DeMoss 1999; Tuleja et al 1998). Equipment can also improve a parent’s body mechanics thereby reducing his or her vulnerability to secondary disability such as back injury.

Adaptive equipment can ultimately boost the parent’s baby care self-confidence and solidify his or her baby care role within the family. However, no occupational therapy assessment tool previously existed to identify strengths and needs of parents caring for their young children.

Background needed

An occupational therapist who has successfully completed the baby care assessmenttraining from TLG is qualified to administer the baby care assessment. Therefore, occupational therapists cannot purchase the assessment without first completing the training and post-certificate process.

For more information, please contact Christi Tuleja at Through the Looking Glass:

Tel: + 1 800 644 2666 ext 119 (US only)

email: christi@lookingglass.org

or visit our website at www.lookingglass.org

References

Kirshbaum M. 1988. Parents with physical disabilities and their babies. Zero to ten: a bulletin of the National Center for Clinical Infant Programs, VII (5) 8–15.

Tuleja C and DeMoss A. 1999. Baby care assistive technology. Technology and Disability, 11(1,2), 71–78.