Rannard Anne, Lyons Christina, Glenn Sheila
School of Nursing, Midwifery and Social Work, University of Manchester, Preston.
Br J Gen Pract. 2005 Sep;55(518):710-4.
GPs and health visitors are usually the first to be approached by parents concerned about their child's speech and language development in the early years. The role health professionals play in early detection of speech and language difficulties is therefore crucial to ensure timely referral for speech and language therapy.
To examine parental accounts of health visitor and GP involvement in the assessment and diagnosis of their children's speech and language impairment.
Qualitative retrospective interviews.
Two Local Education Authorities in Merseyside.
In-depth interviews were conducted with 40 parents. Interviews were transcribed and thematically analysed. Twenty per cent of interviews were analysed by an independent researcher and consensus reached on thematic content.
In many cases, parents were the first to realise that there was something wrong with the speech and language development of their child. Parents reported that health professionals tended to underestimate speech and language problems, and failed to take parental views into account. In some cases, parents found that attending a specialist unit or hospital resulted in the children reaching school age before referral to speech and language therapy was made. In other cases, health professionals appeared to rely on the possibility of spontaneous recovery, and gave inappropriate advice to parents, which resulted in delayed referral to speech and language therapists.
Health professionals failed to use systematic, evidence-based approaches in responding to early parental concerns. For this group of parents, such an approach resulted in long delays in referral for specialist intervention.
全科医生(GPs)和健康访视员通常是早期那些担心孩子言语和语言发展的家长首先接触的对象。因此,健康专业人员在早期发现言语和语言困难方面所起的作用对于确保及时转介接受言语和语言治疗至关重要。
研究家长对健康访视员和全科医生参与评估和诊断其子女言语和语言障碍情况的描述。
定性回顾性访谈。
默西塞德郡的两个地方教育当局。
对40位家长进行了深入访谈。访谈内容进行了转录并进行了主题分析。20%的访谈由一名独立研究人员进行分析,并就主题内容达成了共识。
在许多情况下,家长是最先意识到孩子的言语和语言发展存在问题的人。家长报告称,健康专业人员往往低估言语和语言问题,且未考虑家长的意见。在某些情况下,家长发现孩子在转诊接受言语和语言治疗之前就已达到上学年龄,因为他们去了专科机构或医院。在其他情况下,健康专业人员似乎寄希望于自发恢复的可能性,并给家长提供了不恰当的建议,这导致转诊给言语和语言治疗师的时间延迟。
健康专业人员在回应家长早期的担忧时未采用系统的、基于证据的方法。对于这组家长而言,这种方法导致专科干预的转诊出现了长时间的延迟。