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

This study aims 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. 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 focussed 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. Recruitment via schools was via a convenience sample (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. What is Known: • Adolescents with learning disabilities (often with co-occurring autism) and their families struggle to access practical home‑based support; robust evidence is limited .• Family‑centred, parent‑coached allied‑health interventions are promising but under‑studied for adolescents and in home/hybrid formats . What is New: • ACHIEVE—a home‑based Occupational therapy/Speech & Language Therapy, parent‑nominated goal programme—proved feasible and acceptable with strong therapeutic alliance for families of adolescents with learning disabilities with or without autism .• Exploratory improvements and a dose signal (~7–10 sessions) guide scheduling and outcomes for a future comparative trial .