Designing a parent-driven coaching system for indirect speech therapy

Abstract

Based on UK Department of Education annual report 2017, seven percent of preschool children experience speech and language developmental delays. The report goes on to argue that these delays negatively impact success at school. Such delays are more common amongst children with cerebral palsy or autism. Early intervention therapy is recognised as being vital in minimising the long-term impact of such delays and the responsibilities for delivering such therapies most often lies with parents or primary carers. Therapists typically support parents by providing speech and language therapy sessions. The primary goal of these sessions are; to teach the parents techniques to promote the children’s communication skills, identify communication opportunities, and adopt and adapt learned communication strategies in their everyday interactions with the children in their natural environment. While parent-delivered therapies can alleviate the demand on therapists and healthcare services by reducing the amount of professional contact time, they can also create an overwhelming burden on parents. This thesis is an in-depth exploration of early speech therapy programs and identifies the values and support needs that can used to understand the parents’ and therapists’ experiences as well as identify indictors to improve therapy adoption in this context. Additionally, this research investigates the role of coaching technology in improving communication and collaboration between parents. New parent-driven coaching technologies to support reflections on home practices and address the challenges of home therapy delivery is also presented. A case study approach is undertaken to explore this area with two different clinical partners and therapy protocols. Each study commences with a contextual investigation and moves toward co-design and evaluation of digital solutions with therapists and parents. The first case study, eSALT, presents the design of KeepCam, a parent-led selective data capture and sharing tool to support parents of children with cerebral palsy. The second case study presents the design of ePACT, a self-reflection tool to support parents of children with autism. This thesis reports on how mobile video coaching tools can be used as an external drive for continuous engagement with therapy programs and facilitate social support. It also identifies opportunities for technology to play important roles in supporting early therapy programs. The thesis draws upon these case studies to inform the design of a responsive model of support for indirect therapies, through which the role of design and power relations in healthcare are explored.