Date of Award

December 2013

Degree Type


Degree Name

Master of Science


Occupational Therapy

First Advisor

Kris Barnekow

Committee Members

Joyce Engel, Carol Haertlein-Sells


Co-Occupation, Early Intervention, Educational Program, Maternal Self-efficacy, NICU, Post-Partum Depression


OBJECTIVE: To report on the feasibility and preliminary outcomes from a pilot study of the SMILE curriculum, a new educational program designed to enhance the mother-infant relationship by focusing on improvement of co-occupational engagement within daily routines.

METHOD: Six mothers, each with an infant diagnosed with special medical needs who received services in a local birth-to-three program, participated in an exploratory design study. Each mother was assigned to a SMILE curriculum intervention group or a waiting-list control group. Mothers were evaluated pre- and post-intervention using the Perceived Maternal Parenting Self-Efficacy (PMP-SE) Scale for measurement of maternal self-efficacy and the Center for Epidemiological Studies of Depression (CES-D) Scale to assess the risk for post-partum depression (PPD). Additional data collection included responses from a phone interview, a demographic survey, and a parent feedback form of the SMILE curriculum.

RESULTS: Preliminary outcomes from this pilot study indicate that the SMILE curriculum is a feasible educational program for use in early intervention programs. Although initially designed for use working with mothers in a NICU setting, parental feedback on the SMILE curriculum suggests that this program may be further adapted for use in an early intervention setting.

CONCLUSION: The findings support the need for effective educational programs that enhance the mother-infant relationship in an early intervention setting. Such programs may increase maternal self-efficacy during engagement in co-occupations, especially if the infant has a special need. Further research on the SMILE curriculum in a larger and well-controlled replication study is indicated for assessment in both NICU and early intervention settings.