Parental Perspectives and Experiences of Working With Speech and Language Therapists to Support Home Practice for Their Child With a Speech Sound Disorder: A Qualitative Study.

چکیده اصلی

BACKGROUND: Speech sound disorder (SSD) is broadly defined as difficulty producing speech sounds in childhood. It can have a lasting impact on academic outcomes and well-being, making effective early intervention vital. Speech and language therapists (SLTs) consider parental involvement-particularly supporting their child with home practice-as essential to a child's progress. Relationships between SLTs and parents are known to facilitate this engagement. However, there is a significant gap in the literature regarding parents' perspectives, and little is known about what parents perceive to be most effective in supporting home practice. Understanding these perspectives is crucial for designing interventions that are both feasible and meaningful for families. AIM: To explore the perspectives of parents of children with SSD aged ≤5;11, about their experiences with speech and language therapy intervention sessions and home practice. METHODS AND PROCEDURES: This study used qualitative methodology. Nine parents, recruited via social media, professional networks and a university clinic, participated in focus groups or 1:1 interviews. A group of children, aged 4-6, who had lived experience of SSD, speech and language therapy and home practice were consulted to design the topic guide and inform data analysis. Discussions were recorded, transcribed verbatim and analysed using Reflexive Thematic Analysis. OUTCOMES AND RESULTS: Four main themes were constructed as follows: (1) Building positive therapeutic relationships is fundamental to families' experiences and creates the foundation for successful home practice. (2) SLTs need to employ a wide range of skills and knowledge, including a multi-modal approach to empower parents and develop their capability. (3) Clear communication is key for shared power, understanding of roles, active involvement and effective home practice. (4) Factors outside an individual's control can impact parents' attitudes towards, and engagement with, home practice. CONCLUSIONS AND IMPLICATIONS: We conclude that relationships between SLTs and parents, and the skills required to build these, underpin parental motivation to engage in home practice. To maximise parental capability, SLTs ensure that parents understand not only what to do but why they are doing it, utilising a variety of methods. Whilst some barriers for home practice are out of the SLT's control, using all opportunities to develop the motivation and capability of the parents is required. To achieve this, service delivery models may need to be reconsidered. WHAT THIS PAPER ADDS: What is already known on this subject SSD that persists into school years can have lasting implications for a child's academic outcomes and well-being. Effective and efficient early intervention is essential. SLTs and parents agree that working together, including parental delivery of home practice, is important for a child's progress. Little is known about how parents experience and perceive what SLTs do within intervention sessions to ensure parents feel confident and capable of delivering effective home practice. What this paper adds to existing knowledge This is the first study to explore parents' perceptions and experiences of what SLTs do within direct intervention sessions for young children with SSD and how this supports parents to become implementors of intervention for their child at home. Findings suggest that parents benefit from SLTs using a range of teaching and coaching approaches, including clear instructions and active involvement, to ensure parents feel confident and capable at home. Relationships between the parent, SLT and the child are highly valued by parents, and are fundamental for parental engagement with home practice. What are the potential or actual clinical implications of this work? SLTs prioritising building effective relationships with parents and children can support parental motivation for home practice. SLTs can work with parents to increase opportunities for home practice by building it into their daily lives, including working with other family members. To maximise parental capability, it is important to ensure that parents understand not only what to do but why they are doing it, utilising a variety of methods. To achieve this, service delivery models may need to be reconsidered.

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