A nonrandomised feasibility evaluation of a home‑based intervention for parents of adolescents with learning disabilities, with or without autism

Purpose To determine the feasibility and acceptability of delivering ACHIEVE—a home‑based, parent‑coached OT/SLT intervention—in everyday UK practice and to describe recruitment/retention, data completeness, working alliance, delivery logistics, and exploratory changes in parent‑reported functional, behavioural, communication and stress outcomes. Methods Single‑arm, non‑randomised feasibility study aligned with CONSORT pilot/feasibility guidance. Thirty‑six families of adolescents (11–19 years) with moderate–severe learning disabilities (many also autistic) were recruited via three special schools. Individually tailored OT/SLT sessions focused on parent‑nominated goals in self‑care/daily living, communication and behaviour. Hybrid delivery (home visits + secure video); feasibility and acceptability were primary outcomes; exploratory secondary outcomes included DBC, HSQ, APSI, COPM and GAS. Results Recruitment via schools was practicable (36 families). Attendance was high (159/190 sessions; 83.7%) with 99 home and 59 video sessions. Endpoint data were obtained for 22 families. Parents reported strong alliance (WAI median 89.5, IQR 73.0–91.0). Exploratory signals suggested improvement: DBC T‑score − 3.90 (p = 0.004; n = 19); HSQ mean severity − 0.71 (p = 0.018; n = 19); APSI total − 6.80 (p = 0.046; n = 20). COPM median change + 3.0 (performance) and + 4.0 (satisfaction) (both p < 0.001; n = 17). GAS modelling suggested dose effects: ~7 sessions linked to ~ 80% probability of achieving expected goals, and ~ 10 to exceeding them (n = 31). Conclusion ACHIEVE was feasible and acceptable in UK practice with high engagement and manageable data collection. Dose–response signals and alliance strength support a minimum session count and continued coaching emphasis. Findings inform outcome selection, dose and schedules for a definitive trial; clinical changes remain exploratory.