Input to Implementation: Leveraging Parent Perspectives to Make Meaningful Clinical Change
Belinda L. Daughrity, Ph.D., CCC-SLP, Assistant Professor, Department of Speech-Language Pathology,
California State University, Long Beach
As a bilingual speech-language pathologist with decades of experience working with families of children with autism, I can attest to the critical need to place parents at the center of your clinical care. Research evidence supports this claim that best practices include adapting interventions to meet the unique needs of each client and family. While most interventionists would agree with this sentiment, it can be challenging to consistently implement this approach into clinical practices. At times, our views of best practices might not align with parent perspectives especially when working with culturally, linguistically diverse families and/or encountering families at various stages of the initial diagnostic process. While the initial inclination may be to reference your clinical and/or research expertise, I challenge you to center the views of your parents instead. This approach is critical because your experience is rendered useless without parent trust and buy in. Essentially, you must consider the importance of building relationships, rather than simply relying on your extensive clinical skills as a rationale for parents to follow your lead. So, what can you start doing today to make meaningful clinical change with your clients’ parents?
Focus on Partnership, Rather than Power: The clinician: family relationship is a dynamic that significantly impacts the quality of care. In the midst of your clinical responsibilities, make sure to prioritize your families at the forefront of your practice. Value your parents’ input and perspectives. Directly ask them What are your priorities in intervention? What goals would you like to target? By incorporating parent objectives into your intervention directly or indirectly, you communicate that their needs are important to you and that you value their input.
Holistic Care is Best: Treat the needs of the whole family as much as your scope will allow. Often, when working with clients with autism, clinicians will focus solely on the child without recognizing that the entire family unit is impacted. Keep a list of appropriate referrals. Often, families may feel isolated especially if they have few connections with other families of neurodiverse children. Refer to parent groups, respite care services, and mental health services as needed. By considering the needs of the caregivers, you can often improve the home dynamic and healthy parents can be more fully present in their child’s care.
Support the Needs of Diverse Families: Many culturally, linguistically diverse families report additional barriers in working with interventionists who do not understand their background. For families who do not speak English as a first language, seek out the inclusion of interpreters or bilingual support staff when available to help bridge the language divide. Alternatively, provide parent friendly written material in the family’s first language. Importantly, when working with families who do not share your cultural background, DO THE WORK of researching best practices specific to their culture, while keeping in mind to individualize intervention because diverse groups are not monolithic. Simply put, best practices are not one size fit all. Seek out evidence-based practices to deliver the best clinical care. This includes mindfully including elements of the client’s culture into intervention when appropriate because representation is frequently reported as a top priority of parents. Do your therapy materials reflect the clients you are serving? Are your clients represented in the books, toys, and images you use during your clinical sessions?
Use Parent Friendly Language: If your parents are not in your sessions directly observing, at minimum you should have regular debriefing sessions to explain what you are working on and provide suggestions on carryover activities they can do at home to facilitate learning in the natural environment. Make sure to use language that is clear and simple for parents to understand. Terms used frequently in the field like “joint attention” or “social communication” might not be as meaningful to parents. Rather, explain terms in clear language and let parents observe during sessions so you can show them examples of the behavior.
Overall, valuing parent perspectives is key to building a relationship of mutual respect that prioritizes parents being active participants in their child’s clinical care. Parents who feel valued in your space are more likely to voice their concerns, complete suggested carryover activities, and advocate for their needs across clinical contexts. Along with your clinical expertise, cultural competence must be reflected in all aspects of your practices for your care to be effective. The American Speech-Language Hearing Association (ASHA) defines cultural competence as understanding and appropriately responding to the cultural variables and range of diversity that both the professional and client/family bring to interactions. Listening to parents and providing culturally responsive care contributes to optimal outcomes for clients with autism and their families.
Belinda Daughrity, Ph.D., CCC-SLP is an Assistant Professor in the Department of Speech-Language Pathology at CSULB. She completed her B.A. in English and Spanish at Spelman College. She earned her M.A. in Speech-Language Pathology and Audiology at NYU and her Ph.D. in Education with a specialization in Human Development and Psychology at UCLA. Her research interests include social skills and parent involvement in children with autism spectrum disorders, as well as barriers to early access to diagnosis and treatment of autism in communities of color. Additionally, she is interested in issues of cultural competence for speech-language pathologists.