Speech and language therapists’ decision-making process: exploring factors behind intervention decisions for children with developmental language disorder in Turkey

Durgungoz, Fatma Canan (2019) Speech and language therapists’ decision-making process: exploring factors behind intervention decisions for children with developmental language disorder in Turkey. PhD thesis, University of Nottingham.

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Abstract

Introduction and Aim: This is a qualitative study which explores how speech and language therapists (SLTs) make decisions. The purpose is to investigate the factors which influence SLTs’ decision-making processes when they engage with children with developmental language disorder (DLD). There is a lack of research and evidence about how SLTs come to a decision to administer a particular therapy session. SLTs’ therapy practices might vary for similar cases and such diverse practices might stem from SLTs’ clinical reasoning processes.

Methodology: This research was based on an interpretivist paradigm. In accordance with a qualitative case-study approach, multiple data generation methods were used in order to gain an in-depth understanding of SLTs’ decision-making processes from various perspectives. An inductive data-driven approach was employed to analyse the data generated from sixteen Turkish SLTs.

Results: The findings of this study suggest that there are three main steps by which Turkish SLTs’ decisions are formed. The first step is the evaluation of cases. The SLTs’ decisions relied on formal evaluation methods such as formal tests and clinical guidelines, and informal evaluations such as the SLT’s informal observations, self-made tests, beliefs and intuition. The second decision step which affects the flow of the therapy is whether to administer a child-centred or a therapist-driven approach. The SLTs’ past experiences, beliefs, research evidence of which they were aware, and cases with which they had engaged were found to influence the way in which they designed the therapy. The third and final decision step is whether to involve parents in the therapy. It was found that the SLTs’ decisions were affected by the presence and attitudes of parents. Although the SLTs’ past practices and their evidence-based knowledge affected their approach to parents, the level of motivation and the willingness of parents did have a significant effect on the SLT’s intervention decisions.

The findings of this study resonate with the cognitive continuum theory (CCT). This suggests that professionals’ reasoning is of a dynamic nature and continually changes on a continuum, rather than a static process which is completely, for instance, intuitive or analytical. These findings underline that the SLTs’ decision-making process drifted within this continuum according to various factors, such as the use of formal/informal resources, parents’ motivation, and SLTs’ past experience or beliefs. It is recommended that in order to enhance the quality of therapy, SLTs’ awareness should be increased by studying the advantages and disadvantages of the steps within the cognitive continuum theory which is formed in this thesis.

Item Type: Thesis (University of Nottingham only) (PhD)
Supervisors: Emerson, Anne
Sellman, Edward
Keywords: Speech and language therapy, Developmental language delay, Decision-Making theory, Intervention, SLT
Subjects: R Medicine > RC Internal medicine
Faculties/Schools: UK Campuses > Faculty of Social Sciences, Law and Education > School of Education
Item ID: 56601
Depositing User: Durgungoz, Fatma
Date Deposited: 06 Aug 2019 10:50
Last Modified: 07 May 2020 11:00
URI: http://eprints.nottingham.ac.uk/id/eprint/56601

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