Articles

Importance of Involving Caregivers in Speech Language Intervention

By Ms. Marlyn Mathew : Speech Language Pathologist

Parental involvement provides a continuity and prolongation of therapeutic benefits for both the parents and the child. It has been a common observation that the speech language therapy offered by the professional has more lasting effects when the parents are involved in the therapeutic intervention. The benefits of involving parents in the intervention program include maintenance of specific skills taught to the child, greater parental awareness and understanding of the child’s problem and the difficulties encountered before, during and after intervention. One major factor that must be considered is that the child spends relatively less amount of time in the therapy session when compared to the time he spends elsewhere with the teacher, caregivers in his life. It is important that the caregivers and the other communication partners with whom the child spends major part of his/her time play a very important role in the development of his communication skills. Caregivers should know about the different strategies used by the therapist as this will help them to generalize the communicative behaviour outside the therapy session.
Kiernan (1981) pointed out that despite the clear advantages of involving parents; occasionally a drawback is that parents themselves may be reluctant to participate because of their own sense of inadequacy in their ability to understand and respond to the child’s needs.
The child’s actions are to an extent, governed by characteristics of the social situation he/she is exposed to. He/she may be responding to stresses within the family unit or his disability may be a matter of concern or frustration to the other members in the family which can have a negative impact on the child. Hence, parents can do much to contribute to the child’s language or speech development by providing the support and reassurance the child needs. They can also bring in the needed modifications in the child’s linguistic environment to help him communicate more easily.
It has been an experience that involving parents in the therapy helps reduce parents’ anxieties regarding the child’s improvement. Becoming involved and being able to contribute to a common goal, that is, helping the child communicate more easily, also creates a sense of family community and provides the much needed support for a young family member learning to overcome his/her language disability.
Parental involvement helps the clinicians to:
• Educate parents regarding the present strategies and methods used in intervention
• Provide realistic expectations for improvement
• Provide an established system for support and trust so that parents can feel comfortable to contact the clinician in the future when the need arise.

Some of the reasons why parents are not able to participate in therapy:
(a) Both parents work
(b) The child lives in a single parent household wherein the parent will not be able to give much time for the child
(c) Financial strain- the primary focus of parent(s) may be providing food, shelter and safety and so they might place the child’s communication problem at a lower priority
(d) English could be the second language of the parents, which might make it difficult for the mono linguistic clinician to establish a good working relationship with the parents
(e) Disinterest from the side of the parents to provide the child with the necessary facilities to overcome his/her problem
In these instances, parental involvement may be achieved through the scheduling of evening or weekend parent groups.
When parental involvement is not possible, decisions regarding therapy should be based on the age of the child and a full assessment of his or her level of independence and problem solving skills. Mannle and Tomarello (1987) suggested the bridge hypothesis to explain how mothers, fathers and siblings may differ in their linguistic interactions with young children and how young children may respond to these differences. They propose that while mothers may be flexible conversational partners, fathers and siblings may be more challenging partners requiring children to adjust their language. These differences will influence the conversational aspects of communication, such as the way that the language is interpreted in a given context, rather than the grammatical structure of the utterance. It is unclear how these conversational and linguistic dynamics may interact and change across child’s communication with the family members and how they may influence child’s ability to adopt the right strategies to enhance his/her communication skills. Hence, it can be said that development of the child’s speech and language skills depends to an extent on the child’s interaction with his social environment and many of the changes in the way he communicates depends on the amount of family support and acceptance that he experiences.
Mother’s behavioural and verbal responsiveness during interactions have frequently been shown to be positively associated with their children’s subsequent competence in every area, including language development. Though it is important for clinicians to share their ideas and skills with the child’s parents, siblings and the other concerned family members, they often find this difficult, as perhaps they see themselves as experts who know and should be able to provide the answers. Therefore, it is of vital importance to have parents, siblings and the significant others to be involved in therapeutic intervention since it would help in generalizing the communicative behaviour across different daily life situations and help the child interact better with his environment.