Parents’ and speech and language therapists’ roles in intervention for pre-school children with speech and language needs

Background: Policy and practice in early years provision in education, health and social care has advanced in recent times to emphasise parents as partners in supporting children’s learning. Speech and language therapists (SLT) work closely with parents of pre-school children with language learning difficulties to enable them to promote language development in the home. There is growing evidence that indicates that parents can be taught how to become effective facilitators of language skills. Nevertheless, little is known about parents’ or SLTs’ conceptions of their roles when working together, and how these may change during intervention. Aims: To explore parents’ and SLTs’ conceptions of their respective roles in intervention for pre-school children with primary speech and language needs and to determine the extent to which parents’ conceptions of roles change whilst working with SLTs . Methods: A two phase, mixed methods study was conducted using semi structured interviews and questionnaires, with parents and SLTs in England. A smaller subset of parents participated in a longitudinal study to track any changes in their conceptions during intervention. The data were analysed using thematic network analysis for first level themes, framework analysis for comparing themes over time and statistical analysis for the questionnaire responses. Over 65 parents and 70 SLTs participated in the study during both phases, providing the perspectives of a wide range of participants. Results: Findings suggested that before involvement with speech and language therapy, parents had a clear conception of their advocacy role, which prompted them to secure help. However, they did not have a firm conception of their role in supporting their children’s language learning and did not anticipate adopting an intervener role. Parents expressed considerable variation in their conception of their intervener role. During intervention, some parents described changing this conception and adopting an increasingly involved role as implementer and adaptor of intervention. Moreover, in some cases, they described substantial changes in their approach to parenting, suggesting wider changes in their conception of role. SLTs had clearly formulated conceptions of their own roles as assessor, intervener and negotiator, but varied in the extent to which they involved parents as co-workers in intervention. SLTs had two conceptions of their own role as intervener: treat and plan and advise/coach. SLTs expressed intentions to help parents change their understanding of their role, but the parent education role remains largely implicit in SLT practice. Conclusions and implications: Parents described conceptions of their roles as advocate, intervener and taking responsibility. They described important changes in their conceptions of roles, suggesting that a process of conceptual change occurred associated with greater involvement in intervention. SLTs varied in their own role conception, with intervener roles that related to lower or high level of parent involvement. Implications for the SLT practice include developing a more explicit role as parent educators, in order to enhance parental understanding as well as behaviour in supporting their children’s language development. This report presents independent research funded by the National Institute for Health Research (NIHR) reference number RP-PG-0109-10073. The views and opinions expressed by author in this publication are those of the author and do not necessarily reflect those of the NHS, the NIHR, NIHR CCF, the Programme Grants for Applied Research programme or the Department of Health. The views and opinions expressed by the interviewees in this publication are those of the interviewees and do not necessarily reflect those of the author, those of the NHS, the NIHR CCF Programme Grants for Applied Research programme or the Department of Health