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Language development, delay and intervention – the views of parents from communities that Speech and Language Therapy managers in England consider to be under-served.

Marshall, J and Harding, S and Roulstone, S (2016) Language development, delay and intervention – the views of parents from communities that Speech and Language Therapy managers in England consider to be under-served. International Journal of Language and Communication Disorders. ISSN 1460-6984 (In Press)

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Background: Evidence Based Practice includes research evidence, clinical expertise and stakeholder perspectives. Stakeholder perspectives are important and include parental ethno-theories, which embrace views about many aspects of speech, language and communication, language development, and interventions. The Developmental Niche Framework provides a useful theory to understand parental beliefs. Ethnotheories, including those about language development, delay and interventions, may vary cross culturally and are less well understood in relation to families who may be considered ‘under-served’ or ’hard-to-reach’ by speech and language therapy services. Who is considered to be under-served and the reasons why some families are under-served, are complex. Aim: the aim of this study was to describe beliefs and reported practices, in relation to speech and language development, delay and intervention, of parents and carers from a small number of groups in England, who were perceived to be under-served in relation to SLT services. Methods and procedures: As part of a wider NIHR funded study (Child Talk), seven focus groups (with a total of 52 participants) were held with parents from three communities in England. Topics addressed included beliefs about language development, language delay and parents’ reported responses to language delay. Data were transcribed and analysed using adapted Framework Analysis, that also drew on directed content analysis. Outcomes and results: Four themes resulted, that broadly matched the topics addressed in the focus groups: language development and the environment; causes and signs of speech and language delay; responses to concerns about speech, language and communication; improving SLT. These produced some previously unreported ideas, for example about how language develops and the causes of delay. Conclusions and Implications: The findings are discussed in relation to previous literature and the Developmental Niche Framework. Clinical implications include ideas about issues for SLTs to discuss with families and the need to recognise that parents may see themselves as competent facilitators of language. Suggestions are made for future research, including; expanded investigation of a wider range of under-served groups, exploration of who parents consult when concerned about their child’s language and how key community figures advise parents in relation to language delay. What is already known on this subject? Limited data indicate that parents have a range of knowledge and beliefs about language development, delay and interventions for language delay. Some families in the UK remain under-served by SLT services. What this study adds: This study reveals some previously unknown ideas about parents’ views about language development, delay and interventions. The findings suggest the need for sensitive discussion with families in order to routinely discover this information and to increase positive engagement with SLT services.

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