Parent concerns and professional responses: The case of specific language impairment

Background: GPs and health visitors are usually the first to be approached by parents concerned about their child's speech and language development in the early years. The role health professionals play in early detection of speech and language difficulties is therefore crucial to ensure timely referral for speech and language therapy. Aim: To examine parental accounts of health visitor and GP involvement in the assessment and diagnosis of their children's speech and language impairment. Design of study: Qualitative retrospective interviews. Setting: Two Local Education Authorities in Merseyside. Method: In-depth interviews were conducted with 40 parents. Interviews were transcribed and thematically analysed. Twenty per cent of interviews were analysed by an independent researcher and consensus reached on thematic content. Results: In many cases, parents were the first to realise that there was something wrong with the speech and language development of their child. Parents reported that health professionals tended to underestimate speech and language problems, and failed to take parental views into account. In some cases, parents found that attending a specialist unit or hospital resulted in the children reaching school age before referral to speech and language therapy was made. In other cases, health professionals appeared to rely on the possibility of spontaneous recovery, and gave inappropriate advice to parents, which resulted in delayed referral to speech and language therapists. Conclusions: Health professionals failed to use systematic, evidence-based approaches in responding to early parental concerns. For this group of parents, such an approach resulted in long delays in referral for specialist intervention. © British Journal of General Practice 2005.