Date of Paper/Work


Type of Paper/Work

Doctoral Project

Degree Name

Doctor of Occupational Therapy


Occupational Science/Occupational Therapy

First Advisor

Stephanie L. de Sam Lazaro


Doctor of Occupational Therapy


Children with special needs can present challenges to caregivers and families. Challenges may occur with daily routines such as mealtime routines, dressing routines, and play routines. These challenges may affect families in many ways and add increased stress to the child’s caregivers. Early Intervention (EI) service providers across the state of Iowa are changing their model of service delivery to address the daily challenges in families with special needs children and to comply with Part C regulations of IDEA. This model is known as Family Guided Routines Based Intervention (FGRBI). This project had two purposes, to examine whether FGRBI helped to increase caregiver satisfaction with caregiver-child routines and whether it helped to reduce caregiver stress. A case-study design was used with three caregivers over a 9-week period. Each caregiver identified three family-specific routines to target along with two routines that were the same for all families in the study. Each caregiver-rated their overall satisfaction with the five routines pre-and post-intervention on the Family Routines Rating Scale. Each caregiver also completed the PSI-4SF pre-and post to examine caregiver stress. In addition to addressing caregiver outcomes, practitioner efficacy in learning and implementing a new model of practice, FGRBI was examined. This study had positive effects on caregiver satisfaction with targeted routines. This study also indicates that caregiver stress is an important aspect to consider in EI services. Key insights into strengths and challenges of utilizing and implementing FGRBI from the OT lens were also determined. Thus, EI occupational therapists can address caregiver stress as part of their services to meet the needs of children and families enrolled in Part C services.