Help-seeking behaviors, engagement in therapy and personal growth among parents of children with developmental delay and parents of children with ASD (0-6 years) : a theory of planned behavior perspective (Hebrew)

Background: Children with developmental delays and those with Autism Spectrum Disorder (ASD) require numerous medical and developmental interventions. Early intervention and parental engagement in therapy increase the developmental potential of these children. Due to the importance of early intervention and the limited research on this topic, especially among parents of children with developmental delays and ASD, there was a need to examine factors that promote help-seeking behaviors and engagement in therapy among parents of children with developmental delays and ASD. The Theory of Planned Behavior, which aims to explain behaviors in various domains, was found relevant in explaining help-seeking behaviors and engagement in therapy. Parenting children with developmental disabilities, particularly ASD, presents long-term physical and emotional challenges that affect parents' quality of life. In this context, help-seeking and engagement in therapy may contribute to parents' personal growth.

The operational objectives of the study were to examine: a) Whether correlations exist between components of the Theory of Planned Behavior (attitude, subjective norms, and perceived control) and help-seeking behaviors and engagement in therapy among parents of early childhood children (0-6 years) with developmental delays and ASD; b) Whether behavioral intentions mediate between attitude, subjective norms, and perceived control, and help-seeking behaviors and engagement in therapy, according to the theory of planned behavior. The research model was examined differentially among parents of early childhood children (0-6 years) with developmental delays and ASD; c) Whether correlations exist between help-seeking behaviors and engagement in therapy and personal growth of parents of early childhood children (0-6 years) with developmental delays and ASD. In addition, the research question was to investigate, for the first time, whether differences exist between parents of early childhood children (0-6 years) with developmental delays and those with ASD in attitudes, subjective norms, perceived control, intentions, help-seeking behaviors, engagement in therapy, and personal growth.

Method: 143 parents of children with developmental disability in early childhood (0-6 years) participated in the study: parents of children with developmental delay (N = 63, 44.1%) and parents of children with ASD (N = 80, 55.9%). The data was collected through an online survey. Six questionnaires were used to examine the research variables.

Results: Due to the abundance of findings, only the main ones are presented. The hypothesis that behavioral intentions for engagement in therapy would mediate between attitude, subjective norms, and perceived control and engagement in therapy was confirmed. The hypothesis that help-seeking behavioral intentions would mediate between attitude, subjective norms, and perceived control and help-seeking behaviors was not confirmed. The hypothesis that a correlation would be found between engagement in therapy behaviors and personal growth was confirmed. The hypothesis that a correlation would be found between help-seeking behaviors and personal growth was not confirmed, except for one measure.

Discussion and Implications: The findings indicate that the Theory of Planned Behavior explains behaviors related to engagement in therapy. Regarding personal growth, it was found that parents' engagement in therapy contributes to their personal growth. Explanations were provided, such as the role of parent guidance in therapy and the partnership that enhances parents' sense of self-efficacy. Help-seeking behaviors among parents of children with developmental delays and ASD were not adequately explained by the theory. However, demographic factors were found to explain help-seeking behaviors. No differences were found between parent groups in most research variables. Explanations were given based on personal traits, self-efficacy, functioning levels, belief in cooperation, stigma, and the broad definition of developmental disabilities, which essentially provides similarities in characteristics and shared challenges that parents of children with developmental disabilities face. The current research has both theoretical and practical contributions. From a theoretical perspective, this study added to the existing knowledge in the field of developmental disabilities by demonstrating for the first time that the Theory of Planned Behavior explains

behaviors of engagement in therapy, thus expanding the theory to a specific domain of parental behaviors in the context of children with developmental disabilities. Additionally, the theory's applicability to explaining complex and sensitive decision-making processes such as help-seeking and engagement in therapy among parents of young children with developmental disabilities was examined for the first time. Furthermore, psychological mechanisms shaping help-seeking behaviors among parents of children with developmental disabilities were understood more deeply. Regarding practical contributions, since treatment engagement contributes to personal growth, it is worthwhile to expand engagement in therapy among parents of children with developmental delays and ASD. This can be done by developing positive attitudes, developing a sense of control, and increasing the sense of competence among parents through explaining treatment goals, providing hope, demonstrating activities, and giving parents experience in treatment. Since the Theory of Planned Behavior did not explain help-seeking behaviors, there is a need for further research to understand the factors that promote and inhibit help-seeking behaviors, to expand the body of knowledge and enable optimal treatment.