Involving parents in the speech and language therapy of children with cochlear implants

AbstractThis article examines the professional practices of a speech and language therapist in multiparty interaction with children with cochlear implants and their parents. The study aims to provide a more detailed picture of multiparty therapy interaction and to describe shifts in participation during the therapy process. The speech and language therapy sessions of three children, each accompanied by a parent, were video recorded and examined using conversation analysis. The focus of the analysis was on co-operation between the therapist, the parent and the child in task sequences. Sequential structure and turn allocation in multiparty interaction were studied. The analyses showed how the participation and roles of the therapist and the parent developed during the therapy process from therapist-driven task interaction to shared practices between the therapist and parent and finally to parent-driven task interaction. The study reveals the real-life practices of speech and language therapy and introduces the ways in which parents are involved in therapy.KEYWORDS: COCHLEAR IMPLANT; CONVERSATION ANALYSIS; PARENT PARTICIPATION; SPEECH AND LANGUAGE THERAPY1. IntroductionOver the past few years, active parent participation has been acknowledged as an important part of both the rehabilitation of children with cochlear implants (CI) (Punch and Hyde, 2010), and the rehabilitation of children with all kinds of developmental disabilities. This article studies the ways in which parents of CI-children participate in speech and language therapy sessions.Studies describing multiparty speech therapy interaction are rare. In contrast, dyadic therapy interaction has been described in many previ- ous studies (e.g. Gardner, 2005; Tykkylainen, 2005, 2010; Ferguson, 1998; Silvast, 1991; Horton and Byng, 2000; Sellman, 2008; Mahon, 2009; Radford and Mahon, 2010). Speech therapy interaction is institutional in nature. Institutional interaction involves participants with specific goal orientations (Drew and Heritage, 1992). In speech therapy sessions, therapists are guided by previously determined institutional aims and use techniques aimed at therapeutic goals (Gardner, 2005; Horton and Byng, 2000; Sellman, 2008). A typical feature for dyadic therapy interaction is the three part structure of the interaction (e.g. Panagos et al., 1986), also called a remedial sequence. In the first part the therapist requests, in the second part the client responds, and in the third part the therapist evaluates the client's response. This struc- ture usually aims at eliciting talk, and it is also typical in classroom inter- action (e.g. Nassaji and Wells, 2000). In speech and language therapy, the therapist generally regulates the flow of the conversation and has a scaffold- ing role in the interaction (Ferguson, 1998; Silvast, 1991), which leads to an asymmetrical interactional profile.Another feature that is typical for speech and language therapy interac- tion is therapists' recipient-oriented participation in conversation. Therapists formulate their turns in a manner suitable to the child's linguistic and commu- nication skills. Recipient design (Sacks et al., 1974), which highlights the way in which talk is designed for particular recipients in particular contexts, arises at different levels of talk, including word selection, topic selection and the ordering of sequences. It can also operate in terms of how speakers use their nonverbal actions, such as gaze and body movements, as indicators of their orientation towards the recipient (Goodwin, 1981). In speech and language therapy, the use of non-verbal communicative means and prosodic cues, as well as the formulation of the linguistic message, make the therapist's partici- pation specifically recipient-oriented (e.g. Gardner, 2005; Ronkainen, 2011; Tykkylainen, 2005; Mahon, 2009). Therapists direct children's attention and segment and emphasize the critical substance of turns by lengthening sounds and words, changing speech tempo, and increasing speech volume, stress, and pausing. …