Grammaticale ontwikkeling van zich normaal ontwikkelende kinderen en kinderen met TOS in de leeftijd van 7 tot 10 jaar

Dit artikel beschrijft de bevindingen uit een explorerend literatuuronderzoek naar de grammaticale ontwikkeling van Nederlandstalige kinderen tussen 7 en 10 jaar met en zonder een taalontwikkelingsstoornis (TOS). De resultaten worden ook in een klinische context geplaatst, met als doel logopedisten te ondersteunen in de behandeling van grammaticale problemen bij kinderen met TOS in deze leeftijdsgroep. Grammaticale problemen zijn een kernprobleem van kinderen met TOS en behandeling van deze grammaticale problemen is daarmee een kerntaak van de logopedist. De verwervingsvolgorde van grammaticale structuren bij Nederlandstalige kinderen met een normale taalontwikkeling is redelijk duidelijk tot een leeftijd van 5 á 6 jaar. Voor oudere kinderen is dit veel minder het geval. Deze informatie is echter wel van belang om passende grammaticale behandeldoelen te kunnen selecteren en prioriteren

Using co-design to develop a tool for shared goal-setting with parents in speech and language therapy

Background Despite the compelling case for engaging parents in speech and language therapy, research indicates that speech and language therapists (SLTs) currently have a leading role in the goal-setting process of therapy for children with developmental language disorder (DLD). Therefore, we set out to develop a tool that aims to support the dialogue between SLTs and parents and enhance shared decision-making about children's communicative participation goals. We used co-design techniques with SLT–practitioners to include their perspectives throughout the design process. Although co-design has been used for some years in healthcare research, it is still a relatively new research methodology in the field of speech and language therapy. Aims To provide a detailed description of the co-design process that led to the development of a physical artefact that can support SLTs to engage parents of children with DLD in collaborative goal-setting. Methods & Procedures The Design Council's Double Diamond model was used to develop a tool in co-design, together with eight SLTs, who participated in all stages of the development process. Usability was tested in actual goal-setting conversations between four SLTs and 11 parents of a child with DLD resulting in stepwise improvements. In addition, usability of the first and final prototypes was tested with five usability criteria that were rated on a 10-point scale by 64 SLTs. Outcomes & Results The co-design process resulted in the development of a physical prototype of the tool called ‘ENGAGE’, consisting of a metal ‘tree trunk’ on which parents can stick magnetic ‘leaves’ containing potential participation goals for their child. The ‘tree’ shape represents a child's development and opportunities for growth. This first prototype received marks between 7.0 and 8.0 out of 10 on attractiveness, user-friendliness, safety, functionality and affordability. After several iterations, there were significantly higher marks for attractiveness, user-friendliness and safety in favour for the final prototype. Marks for functionality and affordability did not change significantly. Conclusions & Implications As researchers we usually develop pen-and-paper tools, interview protocols, apps or questionnaires to support clinical practice. Including the SLTs’ perspectives in the design process resulted in a tree-shaped physical artefact that, according to the SLTs, helps to order information and encourages and guides their dialogue with parents. We strongly advocate the inclusion of end-users in developing innovative user-centred tools for speech and language therapy and we hope that this will become widespread practice. WHAT THIS PAPER ADDS What is already known on the subject Collaborative goal-setting is at the heart of family-centred speech and language therapy. However, research indicates that goal-setting processes for children with DLD are currently predominantly therapist-led, instead of family-centred. Reasons for the lack of parental engagement are that effective communication with parents throughout the goal-setting process appears to be complex, and parents are not always invited and supported to engage in this. We used co-design to develop a tool that aims to support SLTs in their dialogue about therapy goals with parents. What this paper adds to existing knowledge This paper provides an example of applying a co-design approach for the development of a shared goal-setting tool for SLTs and parents of young children with DLD. The co-design approach enabled us to incorporate needs, experiences and ideas of SLTs in the design process. We report the four stages in the co-design process from (1) discovering the needs, wants and desires of the people involved, (2) defining the problem that SLTs experience, (3) developing several solutions and selecting the best solution, and (4) developing and testing the prototype. The detailed description of this process can add to an understanding of the advantages and disadvantages of a design process that includes the perspective of end-users. The result is a physical artefact representing a tree, which aims to support the conversation between SLTs and parents about a child's communicative participation. Items describing facets of communicative participation are printed on ‘leaves’ that can be hung on a tree trunk by parents. The tree shape is a positive metaphor for the growth and development of a child. What are the potential or actual clinical implications of this work? This study describes how SLTs can be meaningfully involved as partners in a co-design research approach. Incorporating experience from clinical practice was highly relevant since our study aimed to create a solution that would support goal-setting and service delivery by SLTs. We want to show that it is inspiring and beneficial for SLTs to partner with researchers in innovation of their own clinical practice and provide examples of co-design activities that illustrate the involvement and influence of end-users in a design process. Including the perspective of SLTs in the development of a new tool to facilitate the dialogue between SLTs and parents of children with DLD regarding therapy goal-setting is expected to add value and enhance its implementation in clinical practice

“So, I told him to look for friends!” Barriers and protecting factors that may facilitate inclusion for children with Language Disorder in everyday social settings:cross-cultural qualitative interviews with parents

Purpose: Although researchers have explored parental perspectives on childhood speech and language disorders, this work has mostly been conducted in English-speaking countries. Little is known about parental experiences across countries. Participation in the COST Action IS1406 ‘Enhancing children’s oral language skills across Europe and beyond’ provided an opportunity to conduct cross-cultural qualitative interviews. The aims were to explore how parents construe inclusion and/or exclusion of their child and how parents involve themselves in order to facilitate inclusion. Method: Parents from nine countries and with a child who had received services for speechlanguage disorder participated in semi-structured qualitative interviews. We used thematic analysis to analyze the data. Results: Two overarching themes were identified: ‘Language disabilities led to social exclusion’ and ‘Promoting pathways to social inclusion’. Two subthemes were identified Interpersonal relationships are important and Deliberate proactiveness as stepping stones for social inclusion. Conclusions: Across countries, parents report that their children’s hidden disability causes misunderstandings that can lead to social exclusion and that they are important advocates for their children. It is important that the voices and experiences of parents of children with developmental disabilities are understood and acknowledged. Parents’ recommendations about how to support social inclusion need to be addressed at all levels of society

ENGAGE- a Delphi study to define construct Communicative Functioning

Children with Language Impairments (LI) have difficulties understanding and using language. Due to their language problems, LI children experience difficulties in communication in all aspects of life. They are at risk of behavioural problems, emotional and psychosocial difficulties, and they perform poorly in school. In the Dutch educational and therapeutic setting, the Dutch construct “communicatieve redzaamheid” (CR) is used to describe communication problems. CR can be loosely translated to English as communicative participation, competence or functioning. CR is used to describe the activity limitations and participation restrictions a LI child experiences. It determines whether a child is eligible for educational support. Also, the description of problems in CR is used to set treatment goals on the ICF component of participation. Consensus on what CR is and how it can be described is lacking. This hinders communication between professionals and parents about the child’s diagnosis and treatment. This study aims to reach consensus between professionals working with LI children and their parents about the construct and operationalization of CR, using a Delphi Study. This poster shows the first two steps of the conducted Delphi Study

Reportage dyslexiezorg Nederland

Klatte, I. & Gerrits, E. (2017). Reportage dyslexiezorg Nederland. Van Horen Zeggen, 85(5), 6-

The practical side of working with parent–child interaction therapy with preschool children with language impairments

A common early intervention approach for preschool children with language problems is parent–child interaction therapy (PCIT). PCIT has positive effects for children with expressive language problems. It appears that speech and language therapists (SLTs) conduct this therapy in many different ways. This might be because of the variety of approaches available, the diverse set of families SLTs work with or the different organizational structures. Understanding the critical components of PCIT would enable SLTs to map the variations that are implemented and researchers to evaluate the effects of such variation. This study aimed to identify the potentially critical components of PCIT based on the practical experience of SLTs and to identify SLTs’ rationales for the way they structure PCIT. Both parameters are important for the long term goal, that is, to develop a framework that can be used to support practice. Semi-structured interviews were conducted with 10 SLTs who had at least one year experience in delivering PCIT with preschool children with language impairment. The interviews were transcribed and analysed, using thematic analysis. Analysis of the SLT interview data identified four potentially critical components that underpin the teaching of strategies to parents: parents’ engagement, parents’ understanding, parents’ reflection and therapists’ skills. SLTs suggested that all four components are needed for the successful delivery of PCIT. The reasons that SLTs give for the way in which they structure PCIT are mainly based on organizational constraints, family needs and practicalities. SLTs consider PCIT to be valuable but challenging to implement. A framework that makes explicit these components may be beneficial to support practice

Speech and language therapists’ views on parents’ engagement in Parent–Child Interaction Therapy (PCIT)

Background Parents’ play an essential role in Parent–Child Interaction Therapy (PCIT) as the primary agent of intervention with their child. Unfortunately, speech and language therapists (SLTs) report that parents’ engagement is challenging when conducting PCIT. Although focusing on and stimulating the engagement of parents, when needed, can increase the success of PCIT, little is known about what factors influence parent engagement. Aims To explore SLTs’ views about the factors that facilitate or pose barriers to parents’ engagement in PCIT. Methods & Procedures A secondary analysis of 10 interview transcripts about SLTs’ views on delivering PCIT with parents of children with developmental language disorder (DLD) was conducted. Codes from the original analysis where checked for their relevance to parents’ engagement by the first author. Potential themes were identified iteratively with all authors. Outcomes & Results Four themes were identified in the SLTs’ description of their experiences with the engagement of parents: mutual understanding, creating a constructive relationship between the SLT and parent, parental empowerment, and barriers. It became clear that SLTs were focusing on different aspects of engagement. Conclusions & Implications This study makes an initial contribution to our understanding of SLTs’ view of parents’ engagement and about what stimulates parent engagement or effects disengagement. SLTs play an important role in supporting parents to engage and stay engaged with therapy. Training SLTs on how best to engage parents, focusing on mutual understanding, creating constructive relationships between the SLT and parent, parental empowerment, and barriers, is necessary. However, more research is needed on how to train relevant skills in SLTs. Clearer definitions of engagement would improve understanding and judgements about how best to support parents

Taalontwikkelingsstoornissen en dyslexie

Klatte, I., Singer, I. & Gerrits, E. (2017). Taalontwikkelingsstoornissen en dyslexie. Vlaams Tijdschrift voor Logopedie, 4, 5-9

Grammaticale ontwikkeling van zich normaal ontwikkelende kinderen en kinderen met TOS in de leeftijd van 7 tot 10 jaar

Dit artikel beschrijft de bevindingen uit een explorerend literatuuronderzoek naar de grammaticale ontwikkeling van Nederlandstalige kinderen tussen 7 en 10 jaar met en zonder een taalontwikkelingsstoornis (TOS). De resultaten worden ook in een klinische context geplaatst, met als doel logopedisten te ondersteunen in de behandeling van grammaticale problemen bij kinderen met TOS in deze leeftijdsgroep. Grammaticale problemen zijn een kernprobleem van kinderen metTOSen behandeling van deze grammaticale problemen is daarmee een kerntaak van de logopedist. De verwervingsvolgorde van grammaticale structuren bij Nederlandstalige kinderen met een normale taalontwikkeling is redelijk duidelijk tot een leeftijd van 5 á 6 jaar. Voor oudere kinderen is dit veel minder het geval. Deze informatie is echter wel van belang om passende grammaticale behandeldoelen te kunnen selecteren en prioriteren

ENGAGE: De positieve invloed van het opstellen van behandeldoelen met ouders

Het betrekken van het gezin en ouders in de logopedische behandeling wordt steeds belangrijker gevonden. Een vorm van betrokkenheid is het gezamenlijk opstellen van doelen voor de logopedische behandeling. Dit gaat niet altijd vanzelf; een logopedist kan sturend zijn en/of een ouder afwachtend omdat niet duidelijk is welke rol/inbreng wordt verwacht. Keuzetools, zoals de tool ENGAGE, hebben als doel de logopedist en ouders van kinderen met TOS te ondersteunen in het gezamenlijk opstellen van doelen. In evaluatiegesprekken met logopedisten die ENGAGE hebben gebruikt werd een positief effect op de samenwerking met ouders genoemd. In deze studie is via interviews met logopedisten nagegaan wat de verandering in de samenwerking inhield, en hoe en wanneer deze verandering plaatsvond. Uit de analyse van de interviews komen verschillende contextfactoren, mechanismen en uitkomsten naar voren die door logopedisten gelinkt worden aan ouderbetrokkenheid. Er lijken drie effecten te zijn die bijdragen aan de ervaren positieve samenwerking: 1) een open en luisterende houding van de logopedist en hierdoor een grotere inbreng van ouders in het gesprek, 2) meer uitwisseling en kennis en hierdoor meer wederzijds begrip tussen logopedist en ouders en passende en relevante doelstellingen en 3) het proces van gezamenlijk opstellen van doelen en hierdoor meer ervaren ouderbetrokkenheid