Background: Collaboration between parents and speech and language therapists (SLTs) is seen as a key element in family-centred models. Collaboration can have positive impacts on parental and children’s outcomes. However, collaborative practice has not been well described and researched in speech and language therapy for children and may not be easy to achieve. It is important that we gain a deeper understanding of collaborative practice with parents, how it can be achieved and how it can impact on outcomes. This understanding could support practitioners in daily practice with regard to achieving collaborative practice with parents in different contexts. Aims: To set a research agenda on collaborative practice between parents and SLTs in order to generate evidence regarding what works, how, for whom, in what circumstances and to what extent. Methods & Procedures: A realist evaluation approach was used to make explicit what collaborative practice with parents entails. The steps suggested by the RAMESES II project were used to draft a preliminary programme theory about collaborative practice between parents and SLTs. This process generates explicit hypotheses which form a potential research agenda. Discussion & Conclusions: A preliminary programme theory of collaborative practice with parents was drafted using a realist approach. Potential contextual factors (C), mechanisms (M) and outcomes (O) were presented which could be configured into causal mechanisms to help explain what works for whom in what circumstances. CMO configurations were drafted, based on the relevant literature, which serve as exemplars to illustrate how this methodology could be used. In order to debate, test and expand our hypothesized programme theory for collaborative practice with parents, further testing against a broader literature is required alongside research to explore the functionality of the configurations across contexts. This paper highlights the importance of further research on collaborative practice with parents and the potential value of realist evaluation methodology
Lopend onderzoek in het kader van de onderzoekslijn Kind, Taal & Ontwikkeling. Deze onderzoekslijn maakt deel uit van het Lectoraat Transparante Zorgverleningen en het Lectoraat Integraal Jeugdbeleid. Language problems have impact on school succes (Beichtman et al., 1996, Nelson et al., 2006), behavior (Coster et al., 1999), and quality of life (Van Agt, 2011). Also the comorbidity with other developmental disorders like dyslexia, ADHD and ASS is high (Gerrits, 2011). Psychological wellbeing depends on the interaction with others (Steenbeek & Geert, 2007), in which speech and language are important tools. Identification of children at risk for speech and language delays and related problems may lead to appropriate follow-up and interventions at a young age, when chances for improvement are best (Nelson, 2006). Therefore, it is of great importance to monitor the speech and language development and its consequences during early childhood. In the Netherlands, several protocols exist to detect children with speech and language delay and to guide them to appropriate care. Though, the balance between health benefits, costs, scope and adverse results of these protocols are not evaluated. In 2009, the RIVM and the NCJ formulated a practice based guideline for the screening of children with speech and language delays in Child Health Care (CHC). This position statement is based on consensus in the field. The goal of this study is to collect evidence for the scientific underpinnings of the current practice-based guidelines of the NCJ. We want to evaluate the improvements of speech and language outcomes as well as non speech and language outcomes a year after CHC-screening 2-year-old children.
Children with developmental language disorders (DLDs) may experience barriers to communicative participation. Communicative participation is defined as ‘participation in life situations in which knowledge, information, ideas or feelings are exchanged’. Barriers experienced in communicative participation cannot be explained by language competence alone and are thought to be influenced by contextual factors. A better understanding of these factors will contribute to tailored speech and language therapy services for children with DLD. We conducted a focus group study with 13 speech and language therapists’ (SLTs) to explore their perspectives on contextual (environmental and personal) factors in early childhood that are associated with communicative participation in children with DLD. The personal factor of child well-being, and the environmental factors of familial support and SLT service provision were developed through thematic analysis. The potential mediating role of these factors on communicative participation implies that it is important to address contextual barriers and facilitators in speech and language therapy services.
communicative participation, language disordersOBJECTIVE(S)/RESEARCH QUESTION(S) Speech and language therapists (SLTs) are the primary care professionals to treat language and communication disorders. Their treatment is informed by a variety of outcome measures. At present, diagnosis, monitoring of progress and evaluation are often based on performance-based and clinician-reported outcomes such as results of standardized speech, language, voice, or communication tests. These tests typically aim to capture how well the person can produce or understand language in a controlled situation, and therefore only provide limited insight in the person’s challenges in life. Performance measures do not incorporate the unobservable feelings such as a patient's effort, social embarrassment, difficulty, or confidence in communication. Nor do they address language and communication difficulties experienced by the person themselves, the impact on daily life or allow patients to set goals related to their own needs and wishes. The aim of our study is give our patients a voice and empower SLTs to incorporate their patient's perspective in planning therapy. We will Aangemaakt door ProjectNet / Generated by ProjectNet: 08-12-2020 12:072Subsidieaanvraag_digitaal / Grant Application_digitaalDossier nummer / Dossier number: 80-86900-98-041DEFINITIEFdevelop a valid and reliable patient-reported outcome measure that provides information on communicative participation of people with communication disorders and integrate this item bank in patient specific goal setting in speech and language therapy. Both the item bank and the goal setting method will be adapted in cocreation with patients to enable access for people with communication difficulties.STUDY DESIGN Mixed methods research design following the MRC guidance for process evaluation of complex interventions, using PROMIS methodology including psychometric evaluation and an iterative user-centered design with qualitative co-creation methods to develop accessible items and the goal setting method.RESEARCH POPULATION Children, adolescents and adults with speech, language, hearing, and voice disorders.OUTCOME MEASURES An online patient-reported outcome measure on communicative participation, the Communicative Participation Item Bank (CPIB), CPIB items that are accessible for people with language understanding difficulties, a communicative-participation person-specific goal setting method developed with speech and language therapists and patients and tested on usability and feasibility in clinical practice, and a course for SLTs explaining the use of the goal-setting method in their clinical reasoning process.RELEVANCE This study answers one of the prioritized questions in the call for SLTs to systematically and reliably incorporate the clients’ perspective in their daily practice to improve the quality of SLT services. At present patient reported outcomes play only a small role in speech and language therapy because 1) measures (PROMS) are often invalid, not implemented and unsuitable for clinical practice and 2) there is a knowledge gap in how to capture and interpret outcomes from persons with language disorders.
