Striving for Triadic Collaboration in Pediatric Speech Sound Disorder Intervention: Grounded Theory Study.

Abstract

Background: Collaboration between speech-language pathologists (SLPs) and parents is central to pediatric speech sound disorder (SSD) intervention. Prior research has emphasized the relational and home-practice components of collaboration; however, little is known about the enactment, organization, and maintenance of collaborative processes across SLP sessions and home practice in relation to speech sound generalization.

Objective: This study examined the enactment and organization of collaboration between SLPs and parents in pediatric SSD intervention, with attention to children's participation. Using a grounded theory approach, it aimed to develop an empirically grounded conceptual account of how collaboration is organized in relation to speech sound generalization.

Methods: This qualitative study adopted a Strauss and Corbin-oriented grounded theory approach. Semistructured interviews were conducted with 12 SLPs and 10 parents of children aged 4 to 7 years receiving SSD intervention in South Korea. Data collection and analysis proceeded iteratively using open, axial, and selective coding with constant comparison. A paradigm model explicated relationships among categories, and selective coding integrated categories around a core category.

Results: The central phenomenon was conceptualized as striving for triadic collaboration, reflecting SLPs' and parents' efforts to coordinate roles, expectations, and practice while supporting children's participation across SLP sessions and home practice. Three interrelated action/interaction strategies were identified: SLP-led monitoring strategies, parent-led home-based intervention strategies, and gradual motivation strategies. These collaborative processes were shaped by background and practice-level constraints. A category integration diagram was developed to represent how the core category, action/interaction strategies, and contextual concerns were organized around triadic collaboration.

Conclusions: The findings suggest that collaboration in pediatric SSD intervention is a contextually embedded process in which SLPs and parents coordinate roles and practices across SLP sessions and home practice while supporting children's participation. The category integration diagram represents how collaborative processes were organized across settings in relation to the gap between structured target sound production and everyday speech use. These findings highlight the relevance of coordinated collaboration for supporting practice across settings in relation to speech sound generalization.