ASHA journals
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Inpatient child–parent–provider interactions (Gormley & Light, 2020)

journal contribution
posted on 2020-12-14, 22:18 authored by Jessica Gormley, Janice Light
Purpose: Children with complex medical needs often require extensive hospitalizations in the first years of life. Many of these children also experience complex communication needs and use augmentative and alternative communication (AAC) strategies to interact with health care staff. Unfortunately, suboptimal communication experiences have been reported among these children, their families, and hospital staff; however, no studies have described the patterns of interactions beyond measures of self-report. The purpose of this study was to describe child–parent–provider interaction patterns that occurred in an inpatient unit.
Method: Observational techniques were used to systematically describe the interactions of a 28-month-old child with complex communication needs, her parents, and 26 health care providers on an inpatient rehabilitation unit over 10 days.
Results: Results indicated that substantial variability in the child’s routine occurred across days and providers. Interactions were generally short and occurred for only a small proportion of the child’s waking hours. The child and her mother actively communicated to varying degrees across sessions, yet health care providers often dominated interactions. The child used multiple modes of communication in each interaction; however, no aided AAC systems were used despite availability.
Conclusions: Training is urgently required to equip health care providers to (a) incorporate the use of aided AAC strategies during inpatient interactions and (b) increase the active participation of both children with complex communication needs and their parents during these interactions.

Supplemental Material S1. Codebook of child–parent–provider locations and activities.

Supplemental Material S2. Operational definitions of intentional child communicative behaviors.

Gormley, J., & Light, J. (2020). Child–parent–provider interactions of a child with complex communication needs in an inpatient rehabilitation facility: A pilot study. American Journal of Speech-Language Pathology. Advance online publication.


This study was completed in partial fulfillment of the PhD program at Pennsylvania State University by the first author. This study was supported by funding from (a) a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (Grant 90RE5017) to the Rehabilitation Engineering Research Center on Augmentative and Alternative Communication; (b) a grant from the U.S. Department of Education (Grant H325D170024, The Penn State AAC Doctoral Leadership Project); and (c) the Hintz Family Endowed Chair for Children’s Communicative Competence.