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Working with families
78
ACQ
Volume 12, Number 2 2010
ACQ
uiring knowledge in speech, language and hearing
Family-centred practice
Family-centred practice involves a number of values,
attitudes and approaches to working with children with
special needs and their families (Moore & Larkin, 2005). In
family-centred practice, the family, rather than just the child,
is the focus of intervention. The family is recognised as “the
expert” in relation to the child and the constant in the child’s
life. A family-centred approach not only treats families with
dignity and respect, but works in partnership with families by
ensuring they have the information they need to make
decisions about service provision (Dunst, Trivette, & Hamby,
2007).
Family-centred practice can be widely applied in speech
pathology. In regards to alternative and augmentative
communication, it is seen as vital in working with both
adults and children, and may reduce issues such as speech
generating device abandonment (Goldbart & Marshall, 2004;
Johnson, Bloomberg, Perry, & Reilly, 2003). It applies in the
area of paediatric swallowing, in which a family commonly
experiences grief and loss associated with feeding difficulties
in the child (Mathisen, 2009). It is consistent with the
principle that, in dealing with complex communication needs,
“training and support should be available for all regular and/
or significant communication partners” (Johnson et al., 2003,
p. 2).
In particular, family-centred practice is seen as critical in
the area of special needs (Goldbart & Marshall, 2004). Over
the last twenty years, the rights of a person with special
needs have been recognised and legalised internationally
(Caudrey & Dissinger, 2007), reminding healthcare providers
of the centrality of the rights of their clients, and of the
importance of developing mutual respect in client–clinician
relationships. When working with children, this legislation
reminds practitioners of the importance of respecting the
needs, rights and expertise of the family as a whole.
Treating the whole family as the client is seen as central
to family-centred practice. The family is a child’s primary
environment and plays a vital role in child development
(Watts Pappas, McLeod, & McAllister, 2009). Improving the
way individuals function in their natural environment is not
only a target of speech pathology, but also a measure of
quality of life (Cruice, 2008).
The relationship between parents and clinicians is also
a central theme in family-centred practice; incorporating
mutual respect and participation. Within this partnership,
the right of the parent to make decisions is valued and
respected (Watts Pappas et al., 2009). Parental decision-
The Special Needs Unlimited Group (SNUG)
program of the University of Newcastle’s
Family Action Centre conducts camps for
children with special needs and their families
in rural NSW. At the camps, families access
much-needed respite, support and healthcare.
SNUG also provides undergraduate speech
pathology students with the opportunity to
augment their clinical education by becoming
SNUG volunteers. Through the camps
students experience strength-based, family-
centred practice and gain insights into the
lives of families living with special needs. This
paper addresses the theoretical framework
and skills required by SNUG volunteers, and
the potential benefits for students in an
intensive non-traditional learning environment.
T
he importance of family-centred practice in healthcare
is now widely acknowledged (Watts Pappas &
McLeod, 2009). An increase in community-based
care, the complexity of client needs, and a deeper
understanding of the needs of families have contributed to
the relevance of family-centred practice in health service
provision in Australia (Caudrey & Dissinger, 2007; Goldbart &
Marshall, 2004; McAllister, 2005).
A strength-based approach enhances family-centred
practice by recognising that parents have many strengths
and resources that support their child’s development
(Johnson, Cournoyer, et al., 2003). Incorporating both
these approaches to healthcare delivery is associated with
fewer hospital visits and fosters independence in families,
facilitating self-sustaining healthcare benefitting both families
and service providers (Caudrey & Dissinger, 2007; Goldbart
& Marshall, 2004; Warmington, 2003). The Special Needs
Unlimited Group (SNUG) combines these approaches
in residential camps for families of children with special
needs run by The Family Action Centre at the University of
Newcastle and supported by student volunteers.
Student learning and professional development is
supported by practical experience to facilitate an integrated
understanding of practice known as deep learning
(Fieldhouse & Fedden 2009). This paper addresses the
theoretical framework and skills required as a SNUG student
volunteer in a family-centred, strength-based and non-
traditional setting.
Emma Grace
top), Bernice
Mathisen (centre)
and Graeme
Stuart
This article
has been
peer-
reviewed
Keywords
clinical
education
family-centred
practice
rural and
remote
practice
SNUG
strength-
based practice
Students’ experiences of
family-centred strength-
based practice in a non-
traditional clinical setting
Emma Grace, Bernice Mathisen, Graeme Stuart, and Heather Hawes