A qualitative study on perspective of parents of children with autism on the nature of parent-professional relationship in Kerala, India.
Parents in Kerala sit on the sidelines of their child’s therapy—shift to equal partner from day one.
01Research in Context
What this study did
Ramachandran (2020) talked with parents of children with autism in Kerala, India.
The team asked how parents feel about their therapy team and who makes choices.
They used open interviews so parents could speak freely.
What they found
Parents said therapists rarely asked their opinion.
They felt left out of goals and methods.
Many doubted they could help their own child.
How this fits with other research
Bejarano-Martín et al. (2020) saw the same parent-professional gap across 14 EU countries.
Patterson et al. (2012) showed parent-training works, but only when parents feel skilled.
Schaaf et al. (2015) warned that one-sided models fail; Kerala proves they do.
Marsack-Topolewski et al. (2025) shows the gap lasts even when the child becomes an adult.
Why it matters
If parents feel powerless, home programs stall.
Start each case by asking parents what goals matter to them.
Give clear, small tasks they can succeed at tonight.
Praise their first attempts to build the confidence Rajani says is missing.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Open the next parent meeting with: "What two things would you like your child to do this month?" Write their answer at the top of the behavior plan.
02At a glance
03Original abstract
This study explored the nature of relationship between parents of children with autism and professionals who provide therapy-based services for autism in Kerala, India. Given the shortage of professionally qualified therapists and educators (particularly in the case of autism) in low- and medium-income countries, parent-mediated interventions where professionals and parents work as partners are recommended as an effective means to meet the demand. However, for parent-mediated interventions to be effective, we first need to understand the customary nature of parent-professional relationship and develop the intervention accordingly. It is within this context that parents of 21 children with autism whose age ranged between 5.8 and 17.3 years were interviewed in order to understand the customary nature of parent-professional relationship. There was a dearth of scheduled, in-depth, and personalized one-on-one interaction between the parent and the professional. Though parents were involved hands on in their child's training under professional direction, they remained mere information providers in decision making. The parent-professional relationship did not nurture parent's self efficacy. This led to parents feeling inadequate to provide for their child's developmental needs and being apprehensive about adulthood. The customary nature of parent-professional relationship observed may be a reflection of the collectivist culture in India. The findings suggest that parent-mediated interventions will need to focus on enabling parents to break cultural barriers that might be holding them back from partnering with professionals as equals.
Autism : the international journal of research and practice, 2020 · doi:10.1177/1362361320912156