Abstract
BackgroundThe Bercow review found a high level of public dissatisfaction with speech and language services for children. Children with speech, language, and communication needs (SLCN) often have chronic complex conditions that require provision from health, education, and community services. Speech and language therapists are a small group of Allied Health Professionals with a specialist skill-set that equips them to work with children with SLCN. They work within and across the diverse range of public service providers. The aim of this review was to explore the applicability of Normalisation Process Theory (NPT) to the case of speech and language therapy.MethodsA review of qualitative research on a successfully embedded speech and language therapy intervention was undertaken to test the applicability of NPT. The review focused on two of the collective action elements of NPT (relational integration and interaction workability) using all previously published qualitative data from both parents and practitioners' perspectives on the intervention.ResultsThe synthesis of the data based on the Normalisation Process Model (NPM) uncovered strengths in the interpersonal processes between the practitioners and parents, and weaknesses in how the accountability of the intervention is distributed in the health system.ConclusionsThe analysis based on the NPM uncovered interpersonal processes between the practitioners and parents that were likely to have given rise to successful implementation of the intervention. In previous qualitative research on this intervention where the Medical Research Council's guidance on developing a design for a complex intervention had been used as a framework, the interpersonal work within the intervention had emerged as a barrier to implementation of the intervention. It is suggested that the design of services for children and families needs to extend beyond the consideration of benefits and barriers to embrace the social processes that appear to afford success in embedding innovation in healthcare.
Highlights
The Bercow review found a high level of public dissatisfaction with speech and language services for children
I wanted to find out: whether the definitions as described within the original version of the Normalisation Process Model (NPM) could be applied to a new data set based on a synthesis of qualitative research from previously published research on a successfully embedded speech and language intervention; whether the application of the model could uncover new understanding of how the interpersonal work done by the participants of the intervention gave rise to its successful embedding in practice; and whether new testable propositions could be made about the factors that are likely to support the potential for embedding new interventions in the context of speech and language therapy
Research question one Are the definitions as described within the original version of the NPM applicable to a new data set based on a synthesis of qualitative research from previously published research on the Hanen Parent Programme (HPP)?
Summary
The Bercow review found a high level of public dissatisfaction with speech and language services for children. Language, and communication needs (SLCN) often have chronic complex conditions that require provision from health, education, and community services. In his review of the services for children with speech, language, and communication needs (SLCN) in England and Wales, Bercow [1] said that, ‘The requirements of children and young people with SLCN and their families will be met when, and only when, appropriate services to support them, across the age range and spectrum of need, are designed and delivered in a way that is accessible to them.’. It is an opportune time to consider the complex context in which speech and language interventions are delivered to explore: how intervention research should be designed so that interventions can be integrated across and within the diverse public service delivery context; and how interventions can be designed to better meet the specific needs and expectations of the families themselves
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