Barriers prevent family-centered services for children with speech disabilities

While speech-language pathologists support the concept of family-centered services when working with children who cannot meet their communication needs through their own speech due to autism or other disorders, a Penn State study shows that there are barriers to meeting this goal.

Specifically, the study used an online focus group to examine the beliefs and practices of school-based speech-language pathologists who work with children who use Augmentative and Alternative Communication (AAC) and assistive technologies, which often include computers, tablets or mobile devices. AAC systems help children better communicate with their families and peers.

For speech-language pathologists, using a family-centered approach means understanding the priorities of the family, focusing on the strengths of the family, and considering the family as the primary decision maker. Family members are the child’s most frequent and significant communication partners because they interact with the child the most, so ideally speech-language pathologists want family members to be able to communicate with the child successfully. 

Kelsey Mandak, a doctoral student in communication sciences and disorders at Penn State, and Janice Light, professor of communication sciences and disorders and Hintz Family Endowed Chair in Children's Communicative Competence at Penn State, found that while all participants believed family-centered services were important, there were several barriers in place that limited delivery of such services.

Barriers included limited time daily to reach out to families as much as they wanted to; too large of a caseload; scheduling conflicts with parents; and differing opinions with parents as to what was the appropriate approach with the child. Additionally, many participants noted that they had not received adequate training to provide the family-centered services they desired to deliver.

The findings, which are published early online in the Augmentative and Alternative Communication Journal, align with other studies that show an implementation gap across health care services, Mandak said.

“For children who use AAC, there’s a lot of research that shows outcomes are dependent on families’ involvement and collaboration with speech-language pathologists,” Mandak said. “If the family and child don’t have a collaborative relationship with the speech-language pathologist, then it is less likely the child will reach the positive outcomes they desire, which is often greater communication success.”

Separate from this study, Mandak is developing an online training to teach speech-language pathologists relational and active listening skills along with how to demonstrate empathy and effectively communicate with parents.