Parent and professional perspectives of communication in developmental treatment settings

Abstract

The focus of this study was the communication process between parents of children with developmental delays and disabilities who are seeking services for their child and the professional providers in developmental treatment centers who provide services to them. The purpose of the study was to begin development of middle range substantive theory of parent-provider communication in the developmental treatment setting. The specific aims of the study were: to explore both parent and provider perceptions of the communication process in developmental treatment settings, to identify concepts relevant to this parent provider communication process, and to further suggest relationships between the identified concepts. The design for this study was exploratory and interpretive. It was based on symbolic interactionism and used modified grounded theory methods to attempt to answer the central question, "What is it like for parents and providers to communicate with one another in developmental treatment settings?" In keeping with the grounded theory approach, multiple data sources were used, including formal unstructured interviews with both parents and professional service providers, participant observation by the investigator in the treatment setting, and professional and lay literature. The sample in this study was a convenience sample from two developmental treatment centers to which I had access. Fourteen families and fifteen providers participated in this study.The core concept identified from this study was Striving for Therapeutic Relationships Within a Context of Uncertainty. Conditions for the core concept were Identification of Child Delay and Referral for Treatment. The context was Provider Uncertainty and Parent Uncertainty. Intervening Conditions were Differing Parent and Provider Perspectives and Change Over Time. Strategies for Action/Interaction were Balancing, Questioning, Reading the Cues, Managing the Sessions and Managing Uncertainty. The strategy of Balancing was further categorized as Balancing Competing Needs, Balancing Competence and the Need for Intervention, Balancing the Here and Now and the Future, and Balancing Parent and Provider Roles. The consequences identified for the core phenomenon were Parent-Provider Relationship Perceived as Therapeutic, Child-Provider Relationship Perceived as Therapeutic, Parent Perception of Competence in Parent Role, Provider Perception of Competence in Provider Role and Changes in Child Competence.