Acceptability of a digital early years language support service for caregivers of children who have SLCN and/or are multilingual

Background Parent-child interaction (PCI) interventions have the potential to mitigate early-identified risks of Speech, Language and Communication Needs (SLCN). PCI interventions can be delivered at Universal, Targeted and Specialist levels, but evidence for effectiveness at the Universal level is lacking, especially for some populations. We examine the acceptability of a universal PCI intervention for two underserved groups: children who have SLCN and/or are multilingual. For the former group we also explore acceptability of a supplementary, targeted intervention.

Aim This study aimed to: (a) evaluate the acceptability of a digital early years PCI support service—comprising a universal text-message service delivering BBC Tiny Happy People videos and targeted speech and language therapy following the Early Language Identification Measure & Intervention (ELIM-I); (b) establish the interest of families with children who have, or are at risk of, SLCN (N = 61) and/or are multilingual (N = 26) in utilising the service, and explore their perceptions regarding merits and drawbacks of the service, and elicit recommendations for improvements.

Methods & Procedures We employed a mixed-methods approach. Quantitative data were collected via questionnaires based on the Theoretical Framework of Acceptability. Qualitative data were gathered through semi-structured online interviews. Families of children with SLCN provided prospective acceptability data after reviewing three videos, indicating their view of receiving similar weekly video content via text message. Those who then opted to try the text service for a month provided retrospective acceptability data, with additional questions for participants who received the targeted online ELIM-I intervention. Multilingual families received the service for three months before providing retrospective acceptability data.

Outcomes & Results Quantitative analyses revealed that all acceptability ratings were high on average, though there was individual variability. Reflexive thematic analysis of caregivers’ qualitative data identified three central themes: (a) demand for trustworthy guidance to address uncertainty; (b) positives including service suitability for busy family life, personalisation, human connection and reassurance, enjoyment and perceived efficacy; (c) a need for inclusive content, especially for children with complex SLCN.

Conclusions & Implications There is a clear desire for early digital services to help caregivers support their children's language development. Acceptability was generally high. Caregivers wanted to see their family represented in video content. This was largely successful for the multilingual group with content celebrating home languages. Caregivers of children with SLCN sometimes felt under-represented and recommended demonstrating support strategies appropriate for their child's age and stage of development.