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

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This paper describes the practical side of working with Parent-child interaction therapy (PCIT), based on experiences of therapists. PCIT is a common approach in speech and language therapy for preschool children with language problems. During this therapy a speech and language therapist (SLT) gives advice and therapy to parents with children with language problems. The parents learn strategies how to communicate with their child in the best way in order to stimulate their child’s language development. PCIT has positive effects for children with expressive language problems. It appears that 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 organisational structures. If therapists adapt a therapy that is proven to be effective, the effectiveness of such a therapy can’t be secured anymore. Knowledge about the critical components of PCIT is needed so that therapists can conduct PCIT in the best way by using these components, and at the same time, they are able to adapt the therapy to their client, their expertise and their organisation. This study aimed to identify the potentially critical components of PCIT based on the practical experience of SLTs and to identify SLT’s rationales for the way they structure PCIT. Both parameters are important for the long term goal, that is, to develop a framework which can be used to support practice. Ten SLT’s participated in this study. The researcher conducted a semi-structured interview with each of the participants. The interviews were transcribed and analysed by the researcher. 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. For example, engaged parents are essential for successful PCIT sessions, since they are expected to adapt their communication style when communicating to their child.  It appears that many parents are not that engaged in this therapy. Sometimes, it is hard work for therapists to engage these parents to the therapy. SLTs suggested that all four components are needed for the successful delivery of PCIT. The reasons SLTs give for the way they structure PCIT are mainly based on organisational constraints, family needs and practicalities. SLTs consider PCIT to be valuable but challenging to implement. A framework may be beneficial to support practice that makes explicit these components.

Authors

I.S. Klatte; S. Roulstone

Abstract

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.