e-ISSN 2231-8534
ISSN 0128-7702

Home / Regular Issue / JSSH Vol. 29 (3) Sep. 2021 / JSSH-8142-2021


Perceived Competence as a Mediator in Parental Engagement in Speech Therapy

Nurfariha Mdshah, Zainal Madon and Nellie Ismail

Pertanika Journal of Social Science and Humanities, Volume 29, Issue 3, September 2021


Keywords: Competence, parental engagement, speech and language disorder, speech therapy

Published on: 27 September 2021

Parental engagement has been recognised as a critical factor in providing optimal speech therapy services to children. However, it continues to be challenging for clinicians to effectively engage parents in speech and language intervention for their children. Therefore, this study was conducted to investigate the roles of parental expectation and parent-therapist communication on parental engagement in speech therapy and to determine the contribution of the parent’s perceived competence as a mediator. A total of 389 respondents were selected from government hospitals in Malaysia for this cross-sectional study. Four instruments were administered: Parental Expectation Scale, Therapist-Parent Communication Questionnaire, Perceived Competence Scale, and Parent Home-programme Compliance Questionnaire. In addition, descriptive, bivariate, and mediation analyses were performed using SPSS and Smart-PLS software to address the study objectives. The results showed that perceived competence partially mediated the relationship between communication and expectation on parental engagement. Thus, it can be concluded that to ensure parental engagement in a child’s intervention which is vital for a better outcome. Parents need to be competent and believe strongly in their capabilities to practise in speech and language intervention. Moreover, policymakers and clinicians should focus on strategies that can improve parental expectations and communication.

  • American Speech-Language-Hearing Association. (2008). Roles and responsibilities of speech-language pathologists in early intervention: Guidelines. Early communication intervention.

  • Arellano, A., Denne, L. D., Hastings, R. P., & Hughes, J. C. (2019). Parenting sense of competence in mothers of children with autism: Associations with parental expectations and levels of family support needs. Journal of Intellectual and Developmental Disability, 44(2), 212-218.

  • Auert, E. J., Trembath, D., Arciuli, J., & Thomas, D. (2012). Parents’ expectations, awareness, and experiences of accessing evidence-based speech-language pathology services for their children with autism. International Journal of Speech-Language Pathology, 14(2), 109-118.

  • Bachner, Y. G., Carmel, S., Lubetzky, H., Heiman, N., & Galil, A. (2006). Parent-therapist communication and satisfaction with the services of a child development center: A comparison between Israeli parents - Jews and Bedouins. Health Communication, 19(3), 221-229.

  • Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Prentice-Hall, Inc.

  • Baydar, N., Reid, M. J., & Webster-Stratton, C. (2003). The role of mental health factors and program engagement in the effectiveness of a preventive parenting program for head start mothers. Child Development, 74(5), 1433-1453.

  • Bercow. (2018). Bercow : Ten years on. Royal College of Speech and Language Therapists, March, 1-6.

  • Cadman, D., Rosenbaum, P., Walter, S., & McNamee, J. (1986). Community professionals’ compliance with consultants’ recommendations for developmentally disabled children. Journal of Developmental and Behavioral Pediatrics, 7(1), 21-26.

  • Carroll, C. (2010). It’s not everyday that parents get a chance to talk like this: Exploring parents’ perceptions and expectations of speech-language pathology services for children with intellectual disability. International Journal of Speech-Language Pathology, 12(4), 352-361.

  • D’Arrigo, R., Ziviani, J., Poulsen, A. A., Copley, J., & King, G. (2017). Child and parent engagement in therapy: What is the key? Australian Occupational Therapy Journal, 64(4), 340-343.

  • Davies, K. E., Marshall, J., Brown, L. J. E., & Goldbart, J. (2017). Co-working: Parents’ conception of roles in supporting their children’s speech and language development. Child Language Teaching and Therapy, 33(2), 171-185.

  • Division for Early Childhood. (2014). DEC recommended practices in early intervention/early childhood special education.

  • Ebert, K. D. (2018). Parent perspectives on the clinician-client relationship in speech-language treatment for children. Journal of Communication Disorders, 73(March), 25-33.

  • Eisner, M., & Meidert, U. (2011). Stages of parental engagement in a universal parent training program. Journal of Primary Prevention, 32(2), 83-93.

  • Freckmann, A., Hines, M., & Lincoln, M. (2017). Clinicians’ perspectives of therapeutic alliance in face-to-face and telepractice speech–language pathology sessions. International Journal of Speech-Language Pathology, 19(3), 287-296.

  • Garbacz, S. A., Mcintyre, L. L., & Santiago, R. T. (2017). Family involvement and parent-teacher relationships for students with autism spectrum disorders. School Psychology Quarterly, 31(4), 478-490.

  • Haine-Schlagel, R., & Walsh, N. E. (2015). A review of parent participation engagement in child and family mental health treatment. Clinical Child and Family Psychology Review, 18(2), 133-150.

  • Hair, J. F., Hult, J. G. T. M., Ringle, C. M., & Sarstedt, M. (2017). A Primer on Partial Least Squares Structural Equation Modeling (PLS-SEM). Journal of Chemical Information and Modeling, 8(9), 1-58.

  • Johnson, C. J., Beitchman, J. H., & Brownlie, E. B. (2010). Twenty-year follow-up of children with and without speech-language impairments: Family, educational, occupational, and quality of life outcomes. American Journal of Speech-Language Pathology, 19(1), 51-65.

  • King, G., Chiarello, L. A., Ideishi, R., Ziviani, J., Phoenix, M., McLarnon, M. J. W., Pinto, M., Thompson, L., & Smart, E. (2021). The complexities and synergies of engagement: an ethnographic study of engagement in outpatient pediatric rehabilitation sessions. Disability and Rehabilitation, 43(16), 2353-2365.

  • King, G., Chiarello, L. A., McLarnon, M. J. W., Ziviani, J., Pinto, M., Wright, F. V., & Phoenix, M. (2021). A measure of parent engagement: Plan appropriateness, partnering, and positive outcome expectancy in pediatric rehabilitation sessions. Disability and Rehabilitation, 1-10.

  • Klatte, I. S., Harding, S., & Roulstone, S. (2019). Speech and language therapists’ views on parents’ engagement in Parent–Child Interaction Therapy (PCIT). International Journal of Language & Communication Disorders, 54(4), 553-564.

  • Law, M., & King, G. (1993). Parent compliance with therapeutic interventions for children with cerebral palsy. Developmental Medicine & Child Neurology, 35(11), 983-990.

  • Lewis, C. C., Scott, D. E., Pantell, R. H., & Wolf, M. H. (1986). Parent satisfaction with children’s medical care. Medical Care, 24(3), 209-215.

  • Lyons, R., O’Malley, M. P., O’Connor, P., & Monaghan, U. (2010). “It’s just so lovely to hear him talking”: Exploring the early-intervention expectations and experiences of parents. Child Language Teaching and Therapy, 26(1), 61-76.

  • Macintyre, S. (2018). Parents’ expectations and experiences of child-focused speech-language therapy in New Zealand (Issue August) [Master’s thesis, University of Canterbury].

  • Mauricio, A. M., Tein, J. Y., Gonzales, N. A., Millsap, R. E., Dumka, L. E., & Berkel, C. (2014). Participation patterns among Mexican–American parents enrolled in a universal intervention and their association with child externalizing outcomes. American Journal of Community Psychology, 54(3-4), 370-383.

  • McConnell, D., Savage, A., & Breitkreuz, R. (2014). Resilience in families raising children with disabilities and behavior problems. Research in Developmental Disabilities, 35(4), 833-848.

  • Melvin, K., Meyer, C., & Scarinci, N. (2019). What does “engagement” mean in early speech pathology intervention? A qualitative systematised review. Disability and Rehabilitation, 42(18), 2665-2678.

  • Melvin, K., Meyer, C., & Scarinci, N. (2021). Exploring the complexity of how families are engaged in early speech–language pathology intervention using video‐reflexive ethnography. International Journal of Language & Communication Disorders, 56(2), 360-373.

  • Oono, I. P., Honey, E. J., & McConachie, H. (2018). Parent-mediated early intervention for young children with autism spectrum disorders (ASD). Cochrane Database of Systematic Reviews, 10(4), 1-12.

  • Phoenix, M., Jack, S. M., Rosenbaum, P. L., & Missiuna, C. (2018). A grounded theory of parents’ attendance, participation and engagement in children’s developmental rehabilitation services: Part 2. The journey to child health and happiness. Disability and Rehabilitation, 42(15), 1464-5165.

  • Phoenix, M., Jack, S. M., Rosenbaum, P. L., & Missiuna, C. (2019). Parents’ attendance, participation and engagement in children’s developmental rehabilitation services: Part 1. Contextualizing the journey to child health and happiness. Disability and Rehabilitation, 42(15), 1464-5165.

  • Pickard, K. E., Kilgore, A. N., & Ingersoll, B. R. (2016). Using community partnerships to better understand the barriers to using an evidence-based, parent-mediated intervention for autism spectrum disorder in a medicaid system. American Journal of Community Psychology, 57(3-4), 391-403.

  • Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40(3), 879-891.

  • Qi, C. H., Van Horn, M. L., Selig, J. P., & Kaiser, A. P. (2020). Relations between language skills and problem behaviour in preschool children. Early Child Development and Care, 190(16), 2493-2504.

  • Shigenobu, T. (2007). Evaluation and usability of back translation for intercultural communication. In Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics): Vol. 4560 LNCS (Issue Part 2, pp. 259-265).

  • Sieck, C. J., Walker, D. M., Retchin, S., & McAlearney, A. S. (2019). The patient engagement capacity model: What factors determine a patient’s ability to engage? NEJM Catalyst, 1-10.

  • Skeat, J., & Roddam, H. (2019). What do parents think about their involvement in speech-language pathology intervention? A qualitative critically appraised topic. Evidence-Based Communication Assessment and Intervention, 13(1-2), 15-31.

  • Stahmer, A. C., Brookman-Frazee, L., Rieth, S. R., Stoner, J. T., Feder, J. D., Searcy, K., & Wang, T. (2016). Parent perceptions of an adapted evidence-based practice for toddlers with autism in a community setting. Autism, 21(2), 217-230.

  • Sugden, E., Munro, N., Trivette, C. M., Baker, E., & Williams, A. L. (2019). Parents’ experiences of completing home practice for speech sound disorders. Journal of Early Intervention, 41(2), 159-181.

  • Toseeb, U., Gibson, J. L., Newbury, D. F., Orlik, W., Durkin, K., Pickles, A., & Conti‐Ramsden, G. (2020). Play and prosociality are associated with fewer externalizing problems in children with developmental language disorder: The role of early language and communication environment. International Journal of Language & Communication Disorders, 55(4), 583-602.

  • Williams, G. C., Freedman, Z.R., & Deci, E. L. (1998). Perceived competence scales. Diabetes Care, 21(1996), 3.

  • Wolf, M. H., Putnam, S. M., James, S. A., & Stiles, W. B. (1978). The medical interview satisfaction scale: Development of a scale to measure patient perceptions of physician behavior. Journal of Behavioral Medicine, 1(4), 391-401.

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