A methodological reflection on investigating children’s voice in qualitative research involving children with severe speech and physical impairments

Figures & data

Table 1. Participant profiles.

Name	Age	Gender	Description of communication and other assistive equipment used
Noah	6	M	Uses 5-10 intelligible words and symbol communication system on touch screen tablet, accessed through hand swiping and support to finger point. Uses partner assisted manual wheelchair with trunk and head support.
Maya	7	F	Uses eye-pointing to direct others to interest and looks away to indicate negation, e.g. ‘I don’t like it’/’no’. Uses symbol communication system on an eye gaze controlled device, mounted to her wheelchair. Uses partner assisted manual wheelchair with full head, torso, trunk and foot support. Partly enterally fed via g-tube and j-tube. Sometimes uses neck brace and oxygen to support her breathing. Has uncontrollable repetitive movements.
Clara	7	F	Uses 5-10 intelligible words and can combine 2 manual signs or gestures but signing is unclear owing to coordination difficulties. Becomes very anxious with unexpected events and opts out by self-harming and moving away. Uses symbol communication system on a touch screen tablet with a key guard. Walks unaided but unsteadily. Sometimes uses a walking frame outdoors and wears helmet.
Oscar	8	M	Uses 3-5 intelligible words and some hand gesturing/signing with right hand. Uses a symbol communication system on a touch screen tablet. Walks a few steps unaided and uses a walking frame and helmet, weaker muscles on his right side.
Grace	9	F	Eye pointing, facial expression and tone of voice are clearest form of unaided expressive communication. Uses a symbol communication system on an eye gaze controlled device that is mounted to her wheelchair. Uses partner assisted manual wheelchair with head, torso, trunk and foot support. Likes to use her arms and fist to point to things and also has strong, uncontrollable movements.

Table 2. Summary of methods.

Method	Generated data
Observation	20 class-based video recordings: 10 ½ hrs
Fieldnotes	33 field note entries relating to varied setting and activities (e.g. classroom, playground, lunchtime, assembly etc)
Photo capturing & retelling	594 lifelogging images (automatically captured by wearable camera) captured by ‘Maya’ documenting children’s everyday lives. 921 lifelogging images captured by ‘Grace’ documenting children’s everyday lives. 197 class-based photos captured by researcher
Design workshops	3 workshop sessions for each participant: 2 collage making sessions on children’s likes/dislikes, 1 storyboard making session on children’s interests, 1 persona editing session to verify researcher’s interpretations of children’s communication profiles.
Stakeholder involvement	9 face-to-face or telephone interviews with 5 parents and 2 teachers to inform planning of other materials.

Figure 1. Transcription conveyed line drawing and adult’s and child’s use of speech, eye gaze and hand movements occurring simultaneously on the same line, broadly capturing events over a longer period of time.

Figure 2. Transcription conveyed line drawing and detailed record of bodily action, gaze and vocal actions of all parties. Simultaneous actions occur within the same column. Transcription convention used for RQ2 included more detail over a shorter period of time.

Figure 3. Line drawing from video still of Grace (right) resisting physical help from the researcher (left), Grace vocalises ‘I do it!’.

Figure 4. Clara’s consent board using Talking Mats approach (Murphy 1998) and collage materials.

Figure 5. Life logging image captured of Grace at home. Grace sits in her wheelchair at the side of the room whilst her two younger brothers lie on the floor looking up at the TV.