Preschool children's engagement in speech and language therapy

TitlePreschool children's engagement in speech and language therapy
Publication TypeConference Proceedings
Year of Conference2013
AuthorsHarding, S, Coad, J, Hambly, H, Morgan, L, Parker, N, Daykin, N, Roulstone, S
Conference Name29th World Congress of the IALP
Date Published08/2013

Traditionally, childhood and children’s lives have been explored solely through the views and understanding of their adult carers (parents/ grandparents/ guardians/ teachers etc) who claim to speak for children.  This excludes the child from the research process.  This view is being challenged by researchers and practitioners who acknowledge children’s right to be heard and believe that their voice should be valued in its own right. Children possess distinctive cognitive and social developmental characteristics which the researcher, wishing to use child informants, must consider during the research design and methodology.  This can be challenging with very young children.  
It is important that children are recognised as integral to the process and practice of the speech and language therapy (SLT) interventions they receive and therefore that their views and experiences are understood.  Although practitioners evaluate children’s engagement in interventions as an on-going part of their assessment and evaluation, it is unusual for this to be an explicit part of their work.  This study aimed to explore preschool children’s engagement with SLT interventions.
Twenty-four children aged between 2;2 and 4;00, who had not received SLT input met in groups of four, in their usual preschool setting.  Selected SLT interventions were undertaken with the groups.  The environment and activities were video and audio recorded and an additional camera was worn by the children (on a headband), to provide a ‘child’s eye view’.  These recordings were subsequently analysed for behavioural markers of levels of engagement (e.g. eye contact).  Following the SLT intervention, the children participated in a play-based/creative arts session, facilitated by an Arts Therapy Practitioner, involving methods such as music making or storytelling.  The aim of this was to explore the children’s reflections on the SLT intervention.  The SLT techniques were chosen following consideration of the cultural context, familiarity and likely responsiveness of the children and were those that SLTs had previously described during focus group sessions that are part of a broader programme of research to investigate SLT practice with preschool children.  Each child attended a modal average of 4 (range 1 - 4) sessions, each lasting one hour.
In excess of 72 hours of digital video data, field notes and audio files were collected.  Framework Analysis was used to describe the children’s engagement using categories identified through the analysis process.  Three iterations of analysis produced themes and contextual effects which form an overarching model of the children’s engagement in relation to the activities and resources used during the SLT interventions.  The categories that emerged focused on elements of engagement including the children’s vocalisations, body language, watching and listening, as well as active and passive attention.
The presentation will discuss:

  • How to understand the child’s experience through observation
  • Which strategies SLTs use to obtain and maintain engagement
  • How these vary depending on the child’s developmental level
  • How specific activities can be modified to increase engagement 

It will conclude with a discussion with delegates of the implications of the study’s findings for SLT practice and service provision with preschool children.