Children's, parents', peers' and professionals' experiences of language impairment : a multi-perspective study to identify psychosocial goals for intervention

Children with language impairment (LI) can experience a wide range of social and emotional difficulties in addition to linguistic difficulties, but there is limited understanding about how LI impacts on these broader, psychosocial aspects of children’s lives. Furthermore, psychosocial outcomes for children are not assessed routinely in speech and language therapy research and practice. Studies of experiences of disability and impairment in other areas have highlighted the importance of addressing the psychosocial beyond the medical. This study draws on interpretive phenomenological analysis (IPA) to explore children’s, parents’, peers’ and professionals’ experiences of children’s LI. Using a phenomenological methodology to explore LI from multiple-perspectives, the study sought to uncover psychosocial features of LI and identify goals for support. Four children, aged 8-10 yrs with a diagnosis of LI, were interviewed about their experiences using arts-based methods. Children’s parents, teachers, learning support assistants, speech and language therapists and siblings and/or friends were also interviewed. Analysis of the 22 interviews is presented as four case studies that include each perspective around the child. Themes were identified through coding and analysing within and across cases. A second stage literature review was undertaken to understand, theorise and discuss emerging themes. Analysis revealed three themes: Agency, Understandings and Misunderstandings, and Making Sense of Difference. Children’s experiences of agency were associated with their emotions and their engagement in classroom and social activities, and not always dependent on their communication abilities. Children with LI often had different understandings of others’ intentions, situations and instructions to that of their peers, professionals and parents. Mismatches in understandings were associated with children being considered unusual, immature, egocentric or rude by others, impacting on their risk for bullying and social exclusion. There were divergent experiences and understanding of LI. Interpretations included impaired speech, language and social communication; social and emotional immaturity; parental neglect; and other people’s attitudes and behaviours. For children, LI was predominantly relational, that is, it was mainly experienced in relationship with others. Psychosocial goals for intervention include addressing attitudes, understandings and behaviours of professionals and peers towards children, in addition to children’s understanding and use of language; promoting children’s experience of agency; and addressing children’s emotional wellbeing and risk for bullying. Good communication and understanding between children, families and professionals is essential for intervention.