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JCPSLP
Volume 17, Number 3 2015
Journal of Clinical Practice in Speech-Language Pathology
topic under investigation through the development of
categories and the emergence of themes from the data
(Braun & Clarke, 2006). The following steps were undertaken
to produce a thematic analysis: 1) coding the interview
transcripts (labelling the features of the interview data
related to the research question), 2) grouping similar codes
in categories, and 3) collating categories with a shared
central concept into themes. Interview transcripts were
coded inductively and categorised using NVivo 10 (QSR
International, 2012). To ensure robust analysis and that
participant experiences were represented accurately
(Creswell, 2014), the first and second authors completed
dual coding and cross-checked themes with the third author.
Discrepancies were discussed and consensus reached.
Results and discussion
Thematic analysis revealed two themes related to the research
question:
Supporting difficult conversations
and
Challenges
.
Supporting difficult conversations
The educators in the study reported the CHR to be a
valuable support for conversations with parents in a variety
of ways. Four categories, examined below, emerged from
the data, outlining how educators were supported in these
situations (see Figure 1).
Australia, participated in this study. Upon receiving ethical
approval, educators were recruited to the study through
purposive sampling. Purposive sampling was employed to
ensure participants recruited could share meaningful data
on the research topic (Creswell, 2014). The eligibility criteria
based on the research objective were (a) educators who
were working in a childcare centre, (b) educators who had
worked directly with children and families at the centre, and
(c) educators who had developmental concerns about a
child in their care. Upon receiving consent to participate,
pseudonyms were allocated to participants to ensure
confidentiality.
A predetermined sample size was not established for this
research. This allowed for gradual selection of participants
to the study (i.e., recruiting educators who met eligibility
criteria while continuing the preliminary analysis as per
established qualitative methods). Gradual selection of
participants occurred until saturation of data was reached.
Guidelines and descriptions relating to how saturation may
be determined in qualitative methods of inquiry other than
grounded theory are not consistently documented in the
literature (Guest, Bunce, & Johnson, 2006). Data saturation
in this study was defined as the point when participants
raised no new themes/topics in interviews (Guest, Bunce, &
Johnson, 2006) and at this point data collection ceased.
Procedure
Participating educators each identified a child for whom
they had developmental concerns. Educators approached
families to consent to involvement in the study and families
were informed that their participation would involve 1)
completing the developmental milestone sections of latest
CHR (2013 version) and 2) a discussion with the educator
around their child’s development, progress, and concerns.
Consenting families received a copy of the latest
CHR from their educator and were given time to
provide developmental information in the
My Health and
Development
section of the South Australia CHR about
their child (e.g., talking and connecting skills, movement
and activity skills, fine motor skills, problem solving skills,
socialisation skills). Families returned the CHR to the
educator. Educators used the information in the completed
section of the CHR in preparation for a conversation with
parents to communicate their concerns regarding the
child’s development.
Educators each organised a time with their participating
family to discuss the information provided in the CHR
regarding the child’s development and their concerns. Staff
were encouraged to adopt their own professional approach
when engaging in the conversations with parents regarding
the child’s development. Concerns raised with parents by
the educators were primarily regarding communication
skills/development.
Following the conversation with each family, each
educator participated in a face-to-face interview with the
first author, exploring the utility of the South Australia CHR
when conveying developmental concerns to parents. A
semi-structured format with interview guide was used (see
Appendix). Interview length ranged from 11 to 31 minutes.
Interview duration varied with each educator, depending
on the depth of information each educator provided and
their experience with identifying concerns. Interviews were
audio-recorded on a Sony ICD-AX412F portable digital
recorder and transcribed orthographically by the first author.
Analysis
Interview data were analysed using Braun and Clarke’s (2006)
framework for thematic analysis. This qualitative analytic
technique establishes description and understanding of the
Supporting difficult
conversations
Educator
feelings
Conversation CHR content
Experience
with parents
Figure 1. Theme 1 – Categories within the theme Supporting
difficult conversations
First, the participating educators reported experiencing
positive feelings associated with having the CHR
available as a resource to refer to during conversations
with the parents. In comparison to previous experiences
communicating concerns to parents they reported feeling
supported and more confident to engage in conversations
with the CHR present.
I get quite a bit of anxiety before speaking to parents
so this way I just had the reassurance myself of what
I was doing and what I am trying to achieve... it just
gave me a little bit of confidence or more confidence
going up to the parent.
(Carly)
Other benefits reported by the educators included being
“on the same page as parents” due to referring to the same
resource and information, allowing gaps in development to
be easily identified by both parties, and that the information
and examples in the CHR facilitated parents’ understanding
of their message(s). They described the CHR as allowing
the focus of the conversation to gradually reach their
concerns. This contributed to having more successful and
constructive conversations as well as feeling supported.
Having the book
1
with me when we were having the
conversation ... was a good sort of talking point.
(Sally)
Participating educators recognised the CHR content
as being useful, particularly the parent-friendly, shared
language that facilitated understanding and enhanced
interactions.
I think having the blue book as a tool to start with really
helped break down barriers, so we had something in
common to look at to share the information and I think