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Processes and challenges in clinical decision‐making for children with speech‐sound disorders.
- Source :
- International Journal of Language & Communication Disorders; Nov2018, Vol. 53 Issue 6, p1124-1138, 15p, 1 Diagram, 2 Charts
- Publication Year :
- 2018
-
Abstract
- Background: Children with speech‐sound disorders (SSD) constitute a significant proportion of speech–language pathologists' (SLPs) caseloads. Previous research has investigated the clinical practice of SLPs intervening with children with SSD; however, little is known about the clinical decision‐making underpinning their practice. Aims: The clinical decision‐making of SLPs working with children with SSD was explored to understand how their clinical decisions were influenced by: (1) beliefs about what works in therapy; (2) prior clinical experience; and (3) client and service‐related variables. Methods & Procedures: Semi‐structured, individual, in‐depth interviews were conducted with 11 SLPs. Inductive thematic analysis was used to identify and explore key ideas and themes. Outcomes & Results: Four themes emerged: (1) clinical decision‐making procedures were highly individualized; (2) parental involvement was viewed as central to the success and progression of therapy; (3) therapy procedures were influenced by practice‐setting constraints; and (4) engaging in evidence‐based practice within clinical settings was perceived as challenging. Conclusions & Implications: In clinical settings, a range of factors influence decision‐making and therapy provided by SLPs to children with SSD. These SLPs had a high regard for clients' values and preferences. Prior clinical experiences also shaped clinical practice. Clinical decision‐making was influenced by practice‐setting constraints. SLPs are under pressure in their workplaces and are struggling to manage the competing demands on their time. Large clinical caseloads, heavy workloads, current service‐delivery models and changing family structures are all impacting on the provision of therapy to children with SSD and therapy outcomes. As a profession, there is a need to consider these barriers and identify ways to overcome them in order to assist SLPs to routinely adopt the highest standards of clinical practice for children with SSD. [ABSTRACT FROM AUTHOR]
- Subjects :
- ARTICULATION disorders
INTERVIEWING
PHENOMENOLOGY
RESEARCH methodology
PARENTING
RESEARCH funding
SPEECH therapists
EVIDENCE-based medicine
DECISION making in clinical medicine
QUALITATIVE research
PROFESSIONAL practice
JUDGMENT sampling
THEMATIC analysis
PATIENT-centered care
DATA analysis software
WORK experience (Employment)
CHILDREN
THERAPEUTICS
Subjects
Details
- Language :
- English
- ISSN :
- 13682822
- Volume :
- 53
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- International Journal of Language & Communication Disorders
- Publication Type :
- Academic Journal
- Accession number :
- 132783328
- Full Text :
- https://doi.org/10.1111/1460-6984.12426