Expertise in research-informed clinical decision making: Working effectively with families of children with little or no functional speech

Abstract

In this article, we consider what is known about how to work effectively with families of children with disabilities, including those with little or no functional speech. Existing evidence about what families want from services is considered, along with information about how expert therapists practice. Our review indicates the importance of understanding family needs, preferences, and priorities, and of being sensitive to the demands of interventions on family life. The augmentative and alternative communication (AAC) literature is linked to the broader literature, confirming what is known about how to work effectively with families and illuminating the contribution of AAC research to this area of knowledge. In general, the AAC literature highlights the importance of the parent-practitioner relationship, of parental involvement and engagement in the intervention process, and of considering the demands that interventions place on families. We conclude that AAC intervention will benefit from continuing therapist efforts to strengthen the client–practitioner relationship through greater situational understanding and appreciation of family perspectives and life circumstances. Therapists’ efforts should also focus on customizing intervention strategies in order to optimize clients’ sense of control, meaningfulness, and engagement.

Keywords:

• Expertise
• family
• worldviews
• family-centered service
• AAC
• severe communication impairments

Acknowledgments

Appreciation is extended to the funders of the research studies reported here (the Canadian Institutes of Health Research and the Hospital for Sick Children Foundation) and to the Ontario Mental Health Foundation, for supporting the preparation of this article through a Senior Research Fellowship awarded to G. King.

Declaration of Interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.