Are We Truly Hearing What Children Have to Say?
Listening to children’s voices is more than a courtesy; it is a fundamental step towards ensuring that therapy meets their genuine needs. Often, busy schedules and clinical protocols risk overshadowing the child’s direct perspective. This section aims to highlight why giving children an equal voice in their speech-language pathology journey is an invaluable component of high-quality therapeutic practice.
What Was the Focus of the Study?
The article “Children’s views of communication and speech-language pathology” (Merrick & Roulstone, 2011) explored how children aged 7–10 years, each presenting with speech, language, and communication needs, perceived both their own communication challenges and the therapy designed to assist them. This was a qualitative, non-randomised observational study in which participants engaged in open-ended interviews, along with non-verbal activities like drawing and photography. These methods encouraged children to express themselves freely and reduced the reliance on structured adult-led questioning.
The research uncovered three principal ways in which children spoke about their communication experiences:
-
Communication as an impairment:
Children in this category focused on what they could not do, such as difficulty articulating certain sounds or keeping up with verbal exchanges. -
Communication as learning:
Those who took this perspective emphasised their efforts to improve and referred to themselves as ‘learners’ in the process of mastering communication skills. -
Communication as behaviour:
Some children discussed communication in terms of behavioural needs or environmental adjustments, including issues around turn-taking or misinterpretations by peers.
Why Are Children’s Voices so Important in Speech-Language Pathology?
A child’s self-concept and motivation to participate in therapy is strongly influenced by how they view their communication. When they see it purely as an ‘impairment,’ they may feel stigmatised or hesitant. If they envisage it as a ‘learning process,’ they might engage more willingly, adopting a growth mindset geared towards improvement. And if they define it through ‘behaviour,’ the focus shifts to social interactions and contexts that can be adapted to support better communication outcomes.
These insights support a family-centred or child-centred approach, reminding clinicians, parents, and educators that children’s subjective understanding is central to therapy success. By acknowledging children’s interpretations, therapy goals and strategies can be tailored to align with the child’s own viewpoint. Such an approach can increase buy-in and long-term gains.
How Do the Three Perspectives Compare?
Below is a simple table depicting how each conceptualisation—impairment, learning, and behaviour—might shape children’s self-perception and engagement.
| Perspective | Key Focus | Impact on Therapy Engagement |
|---|---|---|
| Impairment | Challenges, deficits | May feel stigmatised or ‘broken’; therapy may feel mandatory rather than collaborative. |
| Learning | Growth, improvement | Often shows curiosity, motivation, and a positive attitude towards developing skills. |
| Behaviour | Social, environmental | Highlights situational aspects; may look for adjustments in communication partners’ behaviour. |
Appreciating these nuanced viewpoints can help speech pathologists refine intervention plans. For instance, if a child views communication as an impairment, clinicians could employ strategies to build self-esteem and emphasise strengths alongside skill development. Alternatively, if a child frames it as a learning challenge, reinforcing their progress and validating small achievements can boost motivation. If the child sees it mainly as a behavioural or contextual issue, therapy can focus on situational strategies and environmental supports.
What Are the Real-World Implications for Parents, Carers, and Professionals?
These research findings can reshape how we approach speech-language pathology in practice. Parents and carers have the opportunity to listen deeply to their children’s views, thereby strengthening the home-based support system. For speech pathologists, understanding the child’s perspective acts as a guide for setting meaningful goals. Allied health professionals, teachers, and caregivers can also use this knowledge to create supportive social contexts that encourage children’s confidence in communication.
In essence, the research encourages everyone—parents, educators, clinicians—to work synergistically. By acknowledging that children have valuable insights into their own progress and challenges, we can create tailored interventions that not only address speech and language targets but also foster a healthy sense of self.
Translating Children’s Perspectives into Meaningful Change
When children feel heard, therapy outcomes are often enhanced. Discovering whether a child interprets their communication needs through an impairment lens, a learning lens, or a behavioural lens helps us customise interventions that sync with their worldview. In addition, seeking their input regularly—by asking open-ended questions and providing non-verbal avenues for expression—can improve collaborative practice.
By doing so, we are more likely to cultivate an environment in which children feel safe, motivated, and empowered. Ultimately, this study underscores how small yet strategic shifts in clinical practice—such as sustained child-led dialogue—can yield significant benefits for the child’s overall communicative, social, and emotional well-being.
If you or your child need support or have questions, please contact us at Speech Clinic.
Are young children really able to articulate how they feel about their communication challenges?
Absolutely. Even younger children can share valuable insights—particularly when provided with supportive, child-friendly formats such as drawing, role-play, or photographic activities.
How can parents encourage children to express their views on therapy?
Creating an open, blame-free space where children feel comfortable discussing difficulties and successes can help. Simple questions such as “How did you feel about today’s session?” and “Is there something you wish had gone differently?” often prompt meaningful responses.
Do these insights alter the type of therapy a child receives?
They can. By understanding a child’s viewpoint, therapists may adapt intervention goals, incorporate a child’s personal interests, or adjust how therapy tasks are explained to maximise engagement and progress.
What if a child views communication purely as an impairment?
In that case, combining confidence-building exercises with skill development is important. Reinforcing small steps and focusing on what the child can do shifts the perspective from limitation to possibility.
How can allied health professionals best collaborate with speech pathologists using these findings?
Sharing observations, focusing on the child’s strengths, and nurturing consistent, supportive environments across different settings—home, school, or therapy—are crucial. Working together ensures that each perspective seamlessly contributes to the child’s communication growth.
