Diagnostic Procedures of Paediatric Speech and Language Therapists in the United Kingdom: Enabling and Obstructive Factors

Harvey, Hannah (2023) Diagnostic Procedures of Paediatric Speech and Language Therapists in the United Kingdom: Enabling and Obstructive Factors. International Journal of Language and Communication Disorders. ISSN 1368-2822

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Abstract

Background: Extensive variation in the terminology that is used for paediatric diagnoses across speech and language therapy research literature is an internationally recognised problem. Little is known however, about how and how often diagnoses are given in a clinical context. In the UK, speech and language therapists (SLTs) identify and support children who have speech and language needs. There is a need for explorations of how diagnosis is operationalised in order to understand and address clinically rooted terminological issues that may directly impact clients and families.

Aim: To identify, from the perspective of SLTs, areas that present as enabling and obstructive factors to conducting diagnosis in clinical practice.

Methods & Procedures: Taking a phenomenological approach, 22 paediatric SLTs were interviewed using a semi-structured format. Thematic Analysis revealed a number of factors which were either classified as ‘enabling’ or ‘obstructive’ to their diagnostic processes.

Outcomes & Results: Participants were often hesitant to provide a diagnosis to families and universally reported the need for targeted guidance, which accounts for the demands of current clinical practice, to guide their diagnostic process. Four enabling factors were identified from participant data: 1) working to a medical model, 2) the availability of collegiate support, 3) recognising benefits of diagnosis and 4) relating to the needs of the family. Six themes portrayed obstructive factors in practice: 1) insufficient training, 2) the complex presentation of clients, 3) participants’ uncertainty about diagnostic criteria, 4) the risk of giving a “wrong” diagnosis, 5) concerns about stigma and 6) not having enough clinical time. Obstructive factors created dilemmas for participants and resulted in hesitancy to give a diagnosis, potentially contributing to delays in diagnosis experienced by families as reported in previous literature.

Conclusions & Implications: Of paramountcy to SLTs were the individual needs and preferences of their clients. Practical barriers and areas of uncertainty increased hesitance to diagnose, which may inadvertently preclude families from accessing resources. Recommendations include wider provision of training in diagnostic practice, guidelines to support clinical decision-making, and a greater understanding of client preferences with regard to terminology and its potential relationship with social stigma.

Item Type:	Article
Identification Number:	10.1111/1460-6984.12871
Dates:	Date Event 6 March 2023 Accepted 31 March 2023 Published Online
Uncontrolled Keywords:	clinical practice, developmental language disorder, diagnosis, paediatric language, speech and language therapy, speech-sound disorder
Subjects:	CAH02 - subjects allied to medicine > CAH02-06 - allied health > CAH02-06-01 - health sciences (non-specific)
Divisions:	Faculty of Health, Education and Life Sciences > College of Health and Care Professions
Depositing User:	Hannah Harvey
Date Deposited:	07 Mar 2023 14:39
Last Modified:	12 Apr 2023 09:28
URI:	https://www.open-access.bcu.ac.uk/id/eprint/14225

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