‘I wouldn’t want one or the other’: Understanding parents’ preferences for direct support or parent coaching for young autistic children

There has been considerable research into the barriers and facilitators of coaching parents of autistic children. However, little is known about parents' preferences for this approach <i>compared</i> to support provided directly by a clinician to an autistic or potentially autistic child. This study aimed to examine parents' relative preferences for parent coaching and direct clinician support. A total of 22 families who had received both approaches for their autistic child quantitatively indicated which they preferred. We then used semi-structured interviews with 11 of these participating parents to further investigate the reasons underlying these preferences. We used multiple methods to ensure trustworthiness and credibility. Four themes were identified through template analysis: (1) 'I wouldn't want one without the other', (2) 'It forced me outside my comfort zone', (3) 'It's just about different types of learners' and (4) 'If our child is happy, then we are happy'. Overall, results indicated that parents appreciated characteristics of both approaches and felt that they complimented each other in helping themselves and their child. However, when forced to choose, parents generally expressed a preference for direct support. Many parents discussed their belief that their child experienced more enjoyment and progressed further through direct support. These findings emphasise the importance of honouring families' preferences in the delivery of supports.Lay abstractProfessionals often support autistic children by working with them directly (direct support) or by coaching their parents. We know a lot about what parents think about parent coaching, but we do not know as much about what they think about direct support. We also do not know whether parents prefer parent coaching or direct support. The current study involved 22 parents who each received 2 h a week of direct support for their autistic child and up to 1 h a week of parent coaching for 6 months. At the end of 6 months, all these parents indicated in a survey whether they preferred parent coaching or direct support. Eleven of these participating parents also chose to take part in an interview to understand more about these preferences. Our findings suggest that parents generally liked both supports and believed they worked well together; however, they preferred direct support over parent coaching. While parents think that both approaches are beneficial, there are strengths and challenges of each. These findings emphasise the importance of parent choice in the delivery of support. It may also be possible to adapt both approaches to address some of the identified challenges and improve the whole family's experience.