Using co‐design to develop a tool for shared goal‐setting with parents in speech and language therapy

Abstract

Background Despite the compelling case for engaging parents in speech and language therapy, research indicates that speech and language therapists (SLTs) currently have a leading role in the goal‐setting process of therapy for children with developmental language disorder (DLD). Therefore, we set out to develop a tool that aims to support the dialogue between SLTs and parents and enhance shared decision‐making about children's communicative participation goals. We used co‐design techniques with SLT–practitioners to include their perspectives throughout the design process. Although co‐design has been used for some years in healthcare research, it is still a relatively new research methodology in the field of speech and language therapy. Aims To provide a detailed description of the co‐design process that led to the development of a physical artefact that can support SLTs to engage parents of children with DLD in collaborative goal‐setting. Methods & Procedures The Design Council's Double Diamond model was used to develop a tool in co‐design, together with eight SLTs, who participated in all stages of the development process. Usability was tested in actual goal‐setting conversations between four SLTs and 11 parents of a child with DLD resulting in stepwise improvements. In addition, usability of the first and final prototypes was tested with five usability criteria that were rated on a 10‐point scale by 64 SLTs. Outcomes & Results The co‐design process resulted in the development of a physical prototype of the tool called ‘ENGAGE’, consisting of a metal ‘tree trunk’ on which parents can stick magnetic ‘leaves’ containing potential participation goals for their child. The ‘tree’ shape represents a child's development and opportunities for growth. This first prototype received marks between 7.0 and 8.0 out of 10 on attractiveness, user‐friendliness, safety, functionality and affordability. After several iterations, there were significantly higher marks for attractiveness, user‐friendliness and safety in favour for the final prototype. Marks for functionality and affordability did not change significantly. Conclusions & Implications As researchers we usually develop pen‐and‐paper tools, interview protocols, apps or questionnaires to support clinical practice. Including the SLTs’ perspectives in the design process resulted in a tree‐shaped physical artefact that, according to the SLTs, helps to order information and encourages and guides their dialogue with parents. We strongly advocate the inclusion of end‐users in developing innovative user‐centred tools for speech and language therapy and we hope that this will become widespread practice. WHAT THIS PAPER ADDS What is already known on the subject Collaborative goal‐setting is at the heart of family‐centred speech and language therapy. However, research indicates that goal‐setting processes for children with DLD are currently predominantly therapist‐led, instead of family‐centred. Reasons for the lack of parental engagement are that effective communication wi...

Communication in Daily Life of Children With Developmental Language Disorder: Parents' and Teachers' Perspectives

“…Our study sheds new light on the communication of children with DLD both in their home environment and at school, and it provides information on aspects of communicative participation. We agree wholeheartedly with previous studies that collaboration with key informants in the home and school environments of a child with DLD is crucial for identifying problems with communicative participation and determining what is needed in intervention (Kwok et al, 2022;Singer et al, 2022). Parents' and teachers' perspectives are invaluable.…”

“…The items that apply may vary from child to child. An item bank with computerized adaptive testing such as that being developed for patientreported outcome measures (Patient-Reported Outcomes Measurement Information System; Alonso et al, 2013) could also be useful for conversations with parents of children with DLD about communication in daily life, just as could the ENGAGE conversation tool (Singer et al, 2022).…”