Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

7-8-2021

Graduate Advisor

Cathy Koetting, DNP, APRN, CPNP-PC, PMHS, FNP-C

Committee

Cathy Koetting, DNP, APRN, CPNP-PC, PMHS, FNP-C

Anne Thatcher, DNP, MSW, APRN, PMHNP-BC, LMSW

Tiffany Tobkin, M.Ed.

Abstract

Problem. Parents with children who have neurodevelopmental disorders, such as autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) experience high levels of parenting stress. The prevalence of ASD is on the rise in the United States. As a result, there has been an increase in the use of treatment modalities, in effort to better understand which modalities have the most positive impact on children and their parents. DIRFloortime® is a developmental treatment modality used to help strengthen the parent-child bond and used to decrease parental-child stress. The Autism Parenting Stress Index (APSI) measures the impact of an intervention on parental stress levels.

Methods. A Plan-Do-Study-Act (PDSA) model was utilized, and data was obtained over a three-month period. An observational cohort design was utilized using a questionnaire. A purposive sample of parents of children with neurodevelopmental disorders (ASD and ADHD) aged 4 to 14-years-old who are enrolled in the DIRFloortime® program at a small rural midwestern non-profit agency participated.

Results. The total monthly APSI questionnaire scores for each parent decreased an average of six and a half points after three months (N=6).

Implications for Practice. Additional PDSA cycles are needed to assess for efficacy and trends of the DIRFloortime®program. Limitations of this quality improvement project include small sample size and short length of time.

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