Child–parent–provider interactions of a child with complex communication needs in an inpatient rehabilitation facility: A pilot study

Jessica Gormley, Janice Light

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Purpose: Children with complex medical needs often require extensive hospitalizations in the first years of life. Many of these children also experience complex communication needs and use augmentative and alternative communication (AAC) strategies to interact with health care staff. Unfortunately, suboptimal communication experiences have been reported among these children, their families, and hospital staff; however, no studies have described the patterns of interactions beyond measures of self-report. The purpose of this study was to describe child–parent–provider interaction patterns that occurred in an inpatient unit. Method: Observational techniques were used to systematically describe the interactions of a 28-month-old child with complex communication needs, her parents, and 26 health care providers on an inpatient rehabilitation unit over 10 days. Results: Results indicated that substantial variability in the child’s routine occurred across days and providers. Interactions were generally short and occurred for only a small proportion of the child’s waking hours. The child and her mother actively communicated to varying degrees across sessions, yet health care providers often dominated interactions. The child used multiple modes of communication in each interaction; however, no aided AAC systems were used despite availability. Conclusions: Training is urgently required to equip health care providers to (a) incorporate the use of aided AAC strategies during inpatient interactions and (b) increase the active participation of both children with complex communication needs and their parents during these interactions.

Original languageEnglish (US)
Pages (from-to)105-118
Number of pages14
JournalAmerican journal of speech-language pathology
Issue number1
StatePublished - Jan 2021

All Science Journal Classification (ASJC) codes

  • Otorhinolaryngology
  • Developmental and Educational Psychology
  • Linguistics and Language
  • Speech and Hearing


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