Marginalised communities in children’s speech and language therapy: the experiences of primary carers living with social and economic disadvantage

Suphi, Aydan (2025) Marginalised communities in children’s speech and language therapy: the experiences of primary carers living with social and economic disadvantage. Doctoral thesis (PhD), Manchester Metropolitan University.

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Abstract

Background Previous studies have suggested that some communities are ‘under-served’ by UK speech and language therapy (SLT) services. Missing out on SLT has been linked to poorer long-term outcomes for children with communication difficulties. Although family views are an acknowledged component of evidence-based practice, the experiences of primary carers (PC) of children from under-served communities are inadequately represented in SLT research. This thesis aims to address this gap by (1) identifying communities that may be under-served by children’s SLT services, and (2) understanding the SLT experiences of PCs of one such community. Methods In phase one, semi-structured interviews were carried out with providers of, and referrers to children’s SLT. Data were analysed through qualitative content analysis. Phase two consisted of semi-structured interviews with seven mothers who self-identified as living with social and economic disadvantage (SaED). Data were analysed qualitatively through Interpretative Phenomenological Analysis. Both phases were preceded by a literature review, demonstrating the need for the study and providing context for interpretation of findings. Reflexivity was employed throughout. Findings Communities identified as being under-served by children’s SLT services were families living with SaED, ethnically and/or linguistically marginalised families, and those with transient residences, such as children in care. Analysis of the experiences of PCs living with SaED led to three Group Experiential Themes: making sense of my child’s speech and language development, an unpredictable journey, and experiencing powerlessness in the relationship with SLT. These are discussed in relation to existing literature. Implications This study amplifies the voices of PCs from an under-represented community, offering insight into how children’s SLT services are experienced by marginalised groups. Implications include calls for clinicians to reflect on their positionality, deliver family-centred care, and prioritise trust and emotional safety. Further research exploring the experiences of other marginalised groups, including those with intersectional identities is indicated.