How speech and language therapists and parents work together in the therapeutic process for children with speech sound disorder: A scoping review.
Speech sound disorders (SSDs) are broadly defined as difficulty producing speech sounds in childhood. Reported prevalence of SSD varies from 2.3% to 24.6%, depending on how SSD is defined and the included age range. SSDs that do not resolve before age 8 can have a lasting impact on a child's academic achievements. The intensity of intervention for SSD is important to ensure effectiveness. However, there is a gap between the evidence base for intensity and speech and language therapists' (SLTs) clinical practice. One way that SLTs try to bridge this gap is by working with parents. SLTs believe that working with parents/caregivers is vital for a child with SSD to make progress.
To conduct a scoping review of the literature to provide a comprehensive picture of the perceptions, experiences and strategies underpinning collaborative working between SLTs and parents/caregivers of children (aged ≤ 5 years 11 months) with SSD to increase intervention intensity at home.
This scoping review was completed in accordance with PRISMA-ScR guidelines. A systematic search of PubMed, PsycInfo, CINHAL, Web of Science, EBSCOhost and EThOS was conducted using synonyms of three key terms: SSD, Therapy, Parents. Key journals and papers were hand searched for unique papers. A total of 29 papers were included for review. Data were analysed using thematic synthesis to develop themes. These themes are discussed using the PAGER framework to identify advances, gaps, evidence for practice and areas for future research.
Seven key themes were identified: individualization, setting expectations, daily life, parental knowledge, parental involvement, therapeutic relationships and supporting parents to deliver home practice. There has been an acceleration of research around working with parents of children with SSD, with increased consideration of effective adult coaching techniques. Parents value the parental and child relationship with the SLT and feel this supports the success of home practice. There is a need for further research, and guidance for SLTs working with parents of children with SSD to enable them to support parents to deliver home practice effectively.
Emerging evidence supports the value of SLTs and parents working together to support home practice for children with SSD. The review highlighted the importance of SLTs allocating time to build positive therapeutic relationships with parents to support engagement in therapy. Approaching intervention, in particular, home practice, flexibly and in collaboration with parents, allows parents to fit home practice into their daily lives. Providing clear information to parents supports the fidelity of, and engagement in, home practice.
What is already known on the subject There is a gap between what is recommended in the evidence base for intervention intensity for children with SSD and current clinical practice worldwide. SLTs try to bridge this gap through home practice and believe that working with parents/caregivers is vital for children with SSD to make progress. However, little is known about the best ways for SLTs to work with parents for this population. What this paper adds to the existing knowledge Training parents to be implementers of intervention in a personalized and flexible way is important and valued by parents and SLTs. Parents value understanding the clinical rationale behind the intervention approach and benefit from explicit instructions for home practice, including discussion, written information, observation and feedback. Therapeutic relationships take time to develop and impact parental engagement in home practice. What are the potential or actual clinical implications of this work? The findings of this study highlight existing knowledge which will support SLTs to work optimally with parents to implement home practice for their child with SSD. It highlights the importance of taking time to foster working relationships with parents to support effective home practice. The review identifies gaps in the current skills and knowledge of SLTs, highlighting the need for further research, support and guidance for SLTs in their work with parents, as well as implications for the development of the SLT pre-registration curriculum.
Pritchard K
，Stojanovik V
，Titterington J
，Pagnamenta E
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Children's and parents' experiences of home care provided by hospital staff: A scoping review.
To describe what is known from existing scientific literature on children's and parents' experiences of hospital-based home care and to identify future research areas.
The scoping review design used adheres to the methodological framework of Arksey and O'Malley, and to the PRISMA-ScR checklist.
A systematic search was conducted, and peer-reviewed scientific papers were screened through the application of Rayyan software. Data were extracted and presented in table and synthesised thematically as narrative text.
Searches were carried out November 2021 and updated November 2022 in the CINAHL, MEDLINE, Embase, Cochrane, Scopus, Web of Science, Academic Search Elite, and Amed databases and Google Scholar.
A total of 1950 studies were screened and assessed for eligibility. Eight studies met the inclusion criteria by reporting on parents' experiences, whereas five out of these eight studies also reported on the experiences of children. Parents of children with cancer and preterm children reported feeling more in control, being empowered, and being more connected to their children's care team when their children were receiving hospital-based home care. The family's own resources were activated, and they felt more involved in their children's care compared to being in an inpatient setting. Children with cancer, acute infection, chronic disease, and/or a syndrome reported feeling safer and more comfortable in their home environment and experienced better interaction with their care providers. Some aspects of the children's health-related quality of life (HRQOL) were improved.
The identified studies indicate that hospital-based home care is a valued alternative to traditional inpatient care by both parents and children. The mode of care has no crucial negative effects. Future studies should encompass the experiences of children with different diagnoses and syndromes and compare patients treated in a traditional hospital setting with those in a hospital-based home-care programme.
Children's and parents' experiences of HBHC indicate that it offers a good solution if parents are well prepared and feel in control. In addition, certain structural conditions must be in place before this type of care can be established: there must be a certain number of patients and the hospital must not be too far away. In the field of neonatal home care, professionals should be more responsive to fathers' needs and tailor support by focusing on their individual experiences and needs. Our findings may guide and inform best practice for present and future providers of HBHC.
Hospital-based home care can offer families a greater degree of autonomy, more flexible care options, improved family functioning, improved communication with care providers, and more control over the child's care. When certain structural conditions are met, such as a certain number of patients, the hospital not being too far away, and parents being well prepared and feeling in control, then hospital-based home care is valued as an alternative to traditional inpatient care. Specific aspects of children's HRQOL may improve, and the psychosocial burden on the family does not increase.
HBHC provides a valued alternative to traditional inpatient care and allows families to receive care in the comfort of their own home. Our findings may guide and inform best practice for present and future providers of hospital-based home care.
In this scoping review, we have adhered to the Preferred Reporting Items for Systematic reviews and Meta Analyses Extension for Scoping Reviews checklist.
There has been no direct patient or public contribution to the review.
Not required.
Beisland EG
，Drageset J
，Blindheim MG
，Jorem GT
，Moi AL
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ResearchGate
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