Children spend longer hours with early childhood development (ECD) practitioners who are well-placed to facilitate critical early language development. ECD classrooms include a growing number of children at risk for communication delays. Greater collaboration between speech-language therapists (SLTs) and ECD practitioners is needed. Research highlights that responsivity coaching improves communication development. Therefore, responsive communication coaching was identified as a possible approach to early communication development within the classroom. This clinical perspective serves as a reflection on the programme by examining ECD practitioners’ perceptions thereof. Responsive communication coaching was identified as a means to improve practitioner–student collaboration within classrooms. This reflection aimed to describe ECD practitioners’ perceptions of responsive communication coaching implemented by student SLTs. Early childhood development practitioners were recruited from three sites in low to middle socio-economic settings, where most children were English additional language learners. Coaching was presented to 15 practitioners via 16 sessions conducted by student SLTs under supervision. Practitioners completed a custom-designed survey regarding their skill development and experiences of the coaching. All practitioners expressed benefit from coaching. Half of the practitioners (50%) rated coaching as very helpful, while 37% perceived it as helpful. The remaining practitioners (13%), based at the special needs preschool, perceived coaching as quite helpful. Thematic analysis identified the following benefits: enhanced interaction, improvements in children’s communication and the use of responsive communication strategies. Speech-language therapists need to collaborate with and support ECD practitioners in novel ways. The exploratory findings suggest that ECD practitioners benefit from SLT student-led responsive communication coaching sessions.
Undergraduate speech-language therapy (SLT) students at the University of Pretoria provide services in numerous early childhood development (ECD) settings as part of their clinical training. A traditional ‘pull-out’ approach to therapy was followed with minimal collaboration with ECD practitioners. Children showed benefits from the condition-centred intervention approach used; however, generalisation was limited because of poor ECD practitioner–student collaboration, and university examinations and holidays resulted in service delivery disruptions. Consequently, clinical supervisors recognised that the SLT services were inadequately aligned to the International Classification of Functioning and Disability – Children and Youth (ICF-CY) guidelines (World Health Organization [WHO],
Early communication skills lie at the core of ECD and later academic success (Rezzonico et al.,
Globally, there is a disparity between learning settings available to young children, predominantly related to families’ socio-economic statuses (Alderman,
Early childhood development classrooms increasingly include typically developing children and a growing number of children at risk for communication delays (Rezzonico et al.,
The need for interprofessional collaboration is further highlighted when considering the limited number of SLTs available to treat individuals requiring services (Mayosi & Benatar,
Responsive communication is described as consistent and contingent reactions of communication partners, including practitioners, to children’s verbal and non-verbal communication attempts (Flippin & Watson,
Currently, there are few programmes that guide ECD practitioner–SLT collaboration. These include
Subsequent to the implementation of interprofessional-based responsive communication coaching, there was a need to reflect on the perceived benefits of the programme. ECD practitioners are one of the primary caregivers in young children’s lives, and therefore, their perceptions of the coaching programme were reviewed.
This study aimed to reflect on ECD practitioners’ perceptions of responsive communication coaching conducted by student SLTs in underserved South African contexts. An explorative research design was implemented.
Students were already involved in service delivery at three ECD centres as part of their clinical training and convenience sampling was thus applied. Sites included a preschool in a low socio-economic suburb, a preschool in a small informal community, characterised by poverty, and a preschool catering for children with developmental and special needs. All three preschools required support from non-governmental organisations.
The children, most of whom were English additional language learners, either had or were at risk of communication delays due to environmental and biological factors including, limited maternal education, poverty, HIV and AIDS and cerebral palsy (
Overview of settings.
Characteristics | Across all sites |
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Socio-economic status | Low to middle income |
Number of children per classroom | 5–35 |
Gender | Male and female |
Age | 3 months–5 years |
Medium of instruction at ECD centre | English |
ECD, early childhood development.
The number of children per site differed significantly. At the special needs preschool, there were five children in each of the four classrooms. The preschool located in the informal settlement included 35 children in one large classroom. The preschool has subsequently expanded, and there are now more classes available and thus smaller class sizes, averaging at about 10 children per class. The suburban preschool classes contained approximately 15 children each in two classes.
Fifteen ECD practitioners that the students interacted with at varying sites provided consent to participate in the study. Three participants were educators at the suburban preschool, seven participants were from the preschool for children with special needs and five participants were from the preschool in the informal settlement. There were two ECD practitioners in each classroom, except for one classroom at the suburban preschool where there was only one practitioner. Participants were all female and aged between 20 and 50 years. Although, English was the medium of language for learning and teaching at all three preschools, it was not the first language for most practitioners, which is a common finding in South Africa (Sibomana,
The educational level and role of the practitioners differed substantially between sites. The range in levels of education, and the fact that most participants (
Level of practitioner training across settings.
The principals and ECD practitioners at all three sites provided consent to participate. The 16-week coaching programme ran from March to August 2016. The student SLTs clinical rotations lasted 6 weeks with four to five senior students in each block and one supervisor per site. Students received seminars regarding interprofessional collaboration and responsive communication coaching. Structured handover occurred between student rotations to ensure treatment fidelity.
At the beginning of the academic year, practitioners completed a checklist identifying their needs, adapted from the Teacher Input Checklist (Tennessee Department of Education,
Responsive communication strategies were selected from LLLI (Weitzman & Greenberg,
Reciprocal communication coaching sessions incorporated components of adult learning such as explaining the relevance of strategies (Friedman, Woods, & Salisbury,
Coaching sessions began with a review of previous strategies and practitioners’ application thereof to classroom settings. Thereafter, the next strategies were discussed and jointly implemented by students and practitioners during classroom routines. As outlined in Friedman and Woods (
After 16 weeks of coaching, practitioners completed a self-constructed survey regarding their skill development and experiences of the coaching programme. The survey comprised of four open-ended questions and a Likert scale, ranging from one (not helpful) to five (very helpful), rating the benefit they experienced. The survey evaluated perceived changes in communication and interaction abilities of practitioners, the quality of coaching, overall experience of the coaching process and future needs. Both quantitative and qualitative data were gathered from the survey. Descriptive statistics and thematic content analysis were used to qualitatively analyse the data obtained from the checklist, classroom observations and the survey.
Ethical clearance was obtained from the Research Committee of the Department of Speech-Language Pathology and Audiology, University of Pretoria.
In the initial checklist, practitioners identified class size, practitioner–child interaction and diverse needs within the classroom as the main challenges to successful teaching and learning. From a clinical perspective, the student SLTs reported that the unstructured classroom observations of spontaneous interactions revealed a traditional lecture style (Schwerdt & Wuppermann,
The custom-designed survey identified that half of the practitioners (50%) found the coaching very helpful, while 37% perceived it as helpful. The remaining practitioners (13%), based at the special needs preschool, perceived coaching as quite helpful. All practitioners thus expressed benefit from the programme. Research indicates that practitioners perceive a range of benefits from coaching programmes (Friedman & Woods,
The fact that most of the practitioners (
Responses from the open-ended survey questions were coded thematically. Three main themes were identified including increased interaction, improved communication abilities and helpful strategies. These themes were contrasted against the initial challenges identified during the needs analysis checklist completed by the ECD practitioners and the unstructured classroom observations by students (
Initial challenges and coaching programme outcomes.
Identified outcomes | Initial challenges |
||||||
---|---|---|---|---|---|---|---|
Class size | Practitioner–child interaction | Learners’ diverse needs | Limited responsive interaction | Busy classroom schedules | Practitioner frustration | Additional language requirements | |
Increased interaction | - | √ | - | √ | - | - | √ |
Improved communication | √ | - | - | - | - | √ | √ |
Helpful Strategies | √ | √ | √ | √ | √ | √ | √ |
Practitioners (60%) reported improved shared attention during interaction. Twenty-five per cent of practitioners perceived improvements in children’s understanding of classroom routines, and 25% felt that they could facilitate improved communication through play. These developments work towards alleviating the limited responsive interaction identified during classroom observations. Classroom-based coaching thus assists ECD practitioners in enhancing children’s communication within daily routines (Friedman & Woods,
Half of the practitioners perceived improvements in their ability to understand children’s communication attempts. Twenty per cent of practitioners noted improved anticipation of routines, and 20% reported improved communication during daily routines such as mealtimes. These developments were perceived to reduce the stress of large classroom sizes and busy schedules across the sites. Over time, these changes could contribute to improved overall communication within classrooms. Thus, facilitating the development of communication as practitioners engage children more often in responsive, language-rich interactions (Burchinal, Roberts, Zeisel, Hennon, & Hooper,
The practitioners reported using more responsive communication strategies after the coaching programme. The most useful strategies were identified as ‘observe, wait and listen (OWL)’ (67%), using visual supports to augment verbal communication (33%), providing choices (30%), and using gestures (38%) and face-to-face communication (65%) (Weitzman & Greenberg,
Practitioners expressed various needs for further coaching including skills to facilitate play and peer-interaction, and to extend the duration of communication exchanges. Results highlight practitioners’ increased awareness of their role in nurturing children’s functional communication abilities. Practitioners at the special needs preschool requested additional training in augmentative and alternative communication strategies. This indicates that the coaching programme needs to be tailored for the diverse populations at each site. Consistent with previous research, results from this study suggest that practitioners have a need for context-based practical strategies for use in the classroom (Glover et al.,
Coaching requires a paradigm shift, from traditional approaches to responsive interaction, by all parties involved and time is needed to adjust to new roles and perspectives (Rezzonico et al.,
The implementation of the coaching programme may have been disrupted by student rotations and the variation in frequency of coaching sessions across sites. The number of children in the classrooms at different sites also varied. It should be recognised that it can be extremely challenging to implement new approaches in a large class of 35 children or in a small class of 5 children, where the children have complex developmental challenges and needs. The size of the classrooms may have influenced the application of the responsive communication coaching programme.
The study did not evaluate the outcomes of the coaching programme in relation to practitioners’ respective levels of experience, and a control group of practitioners that did not receive coaching was not included. It would have been insightful to assess children’s communication abilities pre- and post-intervention. However, there was a multitude of potential contributing factors such as additional private, individual SLT. The maintenance of strategies beyond immediate coaching was not formally monitored but collaborative service delivery continued. Additionally, a future consideration is to compare the effect of coaching with in-service workshops to classroom coaching alone. Preliminary results of this study indicate that further research on responsive communication coaching for ECD in LMIC practitioners is warranted.
ECD practitioners reported that in-classroom coaching sessions led to an increased use of responsive communication strategies and improved interaction and communication with children. Upon reflection of the newly implemented approach, the clinical supervisors were encouraged to continue implementing responsive communication coaching sessions during student’s preschool-based clinical visits. Growing recognition of the link between early language abilities and later academic success emphasises the need for ICF-CY responsive (WHO,
The authors would like to thank the participating ECD centres and practitioners for participating in this study.
Data will be stored at the University of Pretoria for 15 years as per the university policy.
The authors declare that there are no competing interests in this study. The views expressed in this article are the authors’ own and not an official position of their institution.
R.M. and B.S.P. supervised the student’s practical. All authors contributed equally to the drafting of the manuscript.