Parental participation in Speech & Language Therapy (SLT) treatments in young children with Speech, Language and Communication Needs (SLCN):levels, predictors and relations with child outcome
Between 5-8% of young children have Speech, Language, Communication Needs (SLCN); persisting SLCN has long-term effects on social, emotional and educational development. Speech and Language Therapy (SLT) is central to the diagnosis and of therapy for such children. Efficacious interventions require that a participant is both present and engaged and in young children parental involvement is necessary, however, little is known about parent participation in SLT. This PhD comprised a 3-phase study designed to identify levels of parental participation in SLT interventions with children (<5 years); identify predictors, and explore child outcome-participation relationships following therapy.Phase 1 was a qualitative interview study with parents classified as consistent or inconsistent attenders, to explore parental engagement. Three super-ordinate themes were identified capturing all views relating to parents beliefs, emotions and experiences. Differences between groups indicated that early recognition, active referral-seeking and a parental belief in their role in the cause and solution may motivate attendance. Some degree of self-doubt about parenting skills may have been a motivating factor.Phase 2 involved the development and piloting of the IPQR-SLCN, a self-efficacy measure, satisfaction scales and an assessment of the appropriateness of the main outcome measures to be used in Phase 3.Phase 3: This cohort study explored the predictors of attendance, adherence and relationships with child outcome. Parents completed a range of questionnaires at two time points (baseline N=199, follow-up N=148) to assess the influence of factors within the domains of parents beliefs (illness perceptions, self-efficacy), personal circumstances (socio-demographics, family functioning) treatment experience and child factors, on participation and child outcome. Predictors of attendance, adherence and outcome were identified through multiple regression analyses. The main predictors of attendance included maternal age, education level and two factors within the parent beliefs domain. Parental rating of the importance of a recommendation and specific self-efficacy beliefs predicted adherence. Child factors, parent beliefs and satisfaction with treatment predicted child outcome. Neither attendance nor adherence predicted child outcome.This thesis presented the first evidence for what motivates parents to participate in their child’s SLT. Further research is required for the generation of a comprehensive model of participation in SLT and to development interventions for enhancing participation. This thesis raised questions for the SLT profession about the assessment of young children, the identification of those who require specialist interventions and the issue of dosage
