Retamal-Walter Felipe, Waite Monique, Scarinci Nerina
School of Health and Rehabilitation Sciences, The University of Queensland, QLD, Australia.
Int J Lang Commun Disord. 2022 May;57(3):645-659. doi: 10.1111/1460-6984.12714. Epub 2022 Mar 26.
Engagement of the child, parent and professional may facilitate positive outcomes for young children with communication disorders receiving early intervention (EI) via telepractice. Despite reported positive outcomes of engagement in a family-centred model of EI, there is limited research exploring the nature engagement in the telepractice environment and guiding professionals on how to best interact with young children and their families.
To identify a set of critical behaviours for building engagement in telepractice EI.
METHODS & PROCEDURES: A two-round modified e-Delphi study was conducted. Participants were international experts in the field of paediatric communication disorders and telepractice EI from diverse allied health and education backgrounds. The experts used a nine-point Likert scale to rate the importance of a predetermined set of critical behaviours for building engagement in telepractice EI across three different aspects of the telepractice interaction: (1) getting to know each other; (2) family-centred telepractice; and (3) telepractice specific considerations.
OUTCOMES & RESULTS: A total of 30 experts completed round 1, with 21 participants from round 1 completing round 2 (70% response rate). Across the two rounds, a total of 64 of the 109 items presented (58.71%) achieved consensus as critical behaviours for building engagement in telepractice EI.
CONCLUSIONS & IMPLICATIONS: The present study identified a set of individual aspects of the telepractice interaction that participants, particularly professionals, may need to intentionally address to engage with families of young children with communication disorders receiving EI via telepractice. The results from this study will contribute to the development of an observational tool to measure engagement in the telepractice EI environment.
What is already known on the subject A growing body of research suggests telepractice is a feasible alternative for families of young children with communication disorders who lack access to high-quality EI. The engagement of families through family-centred care has long been recommended for children enrolled in EI. Although there is growing uptake of telepractice EI, limited research is available guiding professionals on how to engage with families of young children with communication disorders via telepractice. What this paper adds to existing knowledge This study provides a set of 64 telepractice-specific behaviours deemed critical to engagement for all participants of the telepractice interaction. The display of these behaviours could assist professionals to better engage with families of young children within the telepractice environment. What are the potential or actual clinical implications of this work? The findings of this study provide a set of telepractice-specific behaviours that professionals may need to deliberately display and encourage while interacting with young children with communication disorders and their families. Professionals displaying these behaviours could potentially enhance the engagement of families receiving EI services via telepractice. This set of critical behaviours will be refined with the aim of developing an evidence-based observational tool to measure engagement in the context of telepractice EI.
儿童、家长和专业人员的参与可能有助于患有沟通障碍的幼儿通过远程医疗实践接受早期干预（EI）并取得积极成果。尽管有报道称在以家庭为中心的EI模式中参与能带来积极成果，但探索远程医疗实践环境中参与的本质以及指导专业人员如何与幼儿及其家庭进行最佳互动的研究却很有限。
确定一套在远程医疗实践EI中建立参与度的关键行为。
进行了两轮改良的电子德尔菲研究。参与者是来自不同联合健康和教育背景的儿科沟通障碍和远程医疗实践EI领域的国际专家。专家们使用九点李克特量表，对一组预先确定的关键行为在远程医疗实践互动的三个不同方面（1）相互了解；（2）以家庭为中心的远程医疗实践；（3）远程医疗实践的特殊考虑因素）中对建立远程医疗实践EI参与度的重要性进行评分。
共有30位专家完成了第一轮，第一轮的21位参与者完成了第二轮（回复率70%）。在两轮中，109个项目中有64个（58.71%）达成共识，成为在远程医疗实践EI中建立参与度的关键行为。
本研究确定了远程医疗实践互动的一系列个体方面，参与者，尤其是专业人员，可能需要有意关注这些方面，以便与通过远程医疗实践接受EI的患有沟通障碍的幼儿家庭进行互动。本研究的结果将有助于开发一种观察工具，以衡量在远程医疗实践EI环境中的参与度。
关于该主题已知的情况越来越多的研究表明，对于无法获得高质量EI的患有沟通障碍的幼儿家庭来说，远程医疗实践是一种可行的替代方案。长期以来，一直建议为参加EI的儿童提供以家庭为中心的护理，以促进家庭参与。尽管远程医疗实践EI的应用越来越广泛，但指导专业人员如何通过远程医疗实践与患有沟通障碍的幼儿家庭进行互动的研究却很有限。本文对现有知识的补充本研究提供了一套64种特定于远程医疗实践的行为，这些行为被认为对远程医疗实践互动的所有参与者的参与至关重要。展示这些行为可以帮助专业人员在远程医疗实践环境中更好地与幼儿家庭进行互动。这项工作的潜在或实际临床意义是什么？本研究的结果提供了一套特定于远程医疗实践的行为，专业人员在与患有沟通障碍的幼儿及其家庭互动时可能需要刻意展示和鼓励这些行为。展示这些行为的专业人员可能会提高通过远程医疗实践接受EI服务的家庭的参与度。这组关键行为将进一步完善，旨在开发一种基于证据的观察工具，以衡量在远程医疗实践EI背景下的参与度。
