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ACQ
Volume 12, Number 3 2010
ACQ
uiring knowledge in speech, language and hearing
Discussion
This quality assurance study investigated parent (mother)
satisfaction concerning 11 aspects of service delivery, with
the intention of using the results to enhance the speech-
language therapy service provided. Results indicated the
majority of mothers gave an overall satisfaction rating of
extremely satisfied. No mothers expressed dissatisfaction.
While this is a pleasing result, useful information can be
gained by examining the 11 result areas individually to tease
out areas of weakness, as well as noting which procedures
were appreciated.
Most mothers expressed high levels of satisfaction with
the initial phone contact. Perhaps the length of time spent
during the initial contact and the amount of information
shared helps build rapport and trust. From the clinician’s
perspective, this in turn reduces non-attendance.
The assessment process is one such area where changes
can be made based on parent responses. The assessment
process used by the author includes many of the family-
friendly features described by Watts Pappas and McLeod
(2008), such as explaining jargon, explaining the therapy
process, asking whether it is okay to speak about the child
in front of the child, asking whether parents agree with the
findings, giving feedback immediately after testing, and
giving a prognosis. Survey results validate the assessment
process used, as most respondents (32/33) indicated they
were satisfied (3), very satisfied (10) or extremely satisfied
(19). However, results indicated that
anticipated length of
time in therapy
is an area that could be discussed more
openly and routinely with parents, possibly with examples
from previous cases. As in a study conducted by Crais and
Belardi (1999), there was also some dissatisfaction (three
mothers) with regard to
agreement about test findings
,
although no mother made mention of this in the open-ended
section of the survey. In order to rectify this, parents could
be offered a checklist to complete as a way of gathering
more information to support test findings or show evidence
contrary to test findings (Crais and Belardi, 1999). Crais
and Belardi also suggest giving parents the chance to
view assessment reports before their finalisation. This step
may be adding to the assessment/reporting process to
raise the status of parents in the partnership and to ensure
agreement.
Parental involvement and support in planning are critical
to achieving outcomes in this clinic. Parents like to feel
they have been listened to and their concerns given due
consideration (Watts Pappas & McLeod, 2008). Mirabito and
Armstrong (2005) stress the important contribution parents
make to the intervention process through collaborative
relationships, especially in terms of making activities relevant
and meaningful for the child, assisting in the generalisation
of skills, and monitoring progress. Parental responses in
the current study indicated high levels of satisfaction, with
most parents stating they were more than satisfied that
their knowledge and skills had increased (14 mothers very
satisfied, 17 mothers extremely satisfied). Most also felt that
they could transfer therapy into everyday settings (10 very
satisfied, 21 extremely satisfied) and most felt involved in
their child’s sessions (8 very satisfied, 22 extremely satisfied).
Qualitative responses from the open-ended statements also
supported these quantitative results with parents writing
that the therapist “assisted me to learn” and that “practical
activities” were used.
Satisfaction with therapy outcomes and the child’s
enjoyment are key goals for any paediatric SP. Most mothers
home practice (6 satisfied, 14 very satisfied, 11 extremely
satisfied, and 1 somewhat dissatisfied).
Cost
No participant expressed any dissatisfaction with the cost of
therapy and one parent was somewhat dissatisfied with the
cost of the initial assessment ($200.00 per hour).
Reporting
One mother was somewhat dissatisfied with the reporting
process. One mother was satisfied, 7 mothers were very
satisfied and 17 mothers were extremely satisfied. There was
a group of mothers for whom a written report was not
applicable due to cost factors or minor nature of the
communication problem.
SP qualities
Most mothers (32) were extremely satisfied with the
therapist’s interpersonal skills in relation to themselves, the
therapist’s competency and professionalism. No parents
expressed any dissatisfaction.
Teacher consultation
Regarding teacher consultation, similar satisfaction levels
were reported across the three levels, i.e., 9 mothers
expressing satisfaction, 7 being very satisfied, and 8 being
extremely satisfied. One parent was somewhat dissatisfied.
Hence, this is an area that could be improved upon. Eight
mothers either left this section blank or wrote N/A.
Health rebates
Parents claimed rebates either through their private health
fund or through the Australian government’s Medicare
Enhanced Primary Care program which provides rebates of
$49.00 for each of five sessions. Six parents expressed
dissatisfaction with rebates they received while 25 parents
expressed satisfaction. Nine parents were extremely satisfied
with their rebates, 4 were very satisfied and 11 were
satisfied.
Cancellation policies
While no parents indicated any level of dissatisfaction with
cancellation policies, 4 parents did not respond to this
section of the survey. Fewer parents expressed high levels of
satisfaction compared with other sections of the survey, i.e.,
11 parents were extremely satisfied and 9 parents were very
satisfied. Prior to this project, parents were usually though
not routinely asked to give reasonable notice if they were
unable to attend.
Overall satisfaction
Results indicated most mothers (23) were extremely satisfied
with the service they received. Eight mothers were very
satisfied and 2 expressed satisfaction. No parents expressed
any level of dissatisfaction.
Open–ended statements
Twenty- five mothers completed this section of the survey.
Analysis of qualitative responses supported the current
approach being used with regard to listening to parent
opinion, as 9 parents wrote they liked that the therapist
“listened to my input”. Parents also wrote they liked the
“positive approach”, that their “skills had improved” and that
their child “had fun while learning”. The qualitative comments
also supported the need for parent–teacher consultation. For
example, mothers indicated they would like the SP to
develop “more integration with schools”, and to provide a
“brief report to school”.