Access to Speech and Language Therapy for preschool children suspected or diagnosed autistic

Abstract

Speech and Language Therapy (SLT) is a service commonly accessed by young autistic children. Despite the importance of early communication support, access to SLT is challenging for autistic children and their families. Long waiting times and unmet needs are reported. Access to healthcare is a complex process influenced by individual, service and contextual factors. However, few studies have explored access to SLT in depth, and from different stakeholder perspectives. This study aimed to explore and identify factors relating to children, families and SLT services that influence access to SLT for preschool autistic children.

A qualitative instrumental case-study methodology was used to facilitate a holistic, in-depth understanding of access to SLT. Semi-structured interviews were conducted with 23 individuals including parents/carers, Speech and Language Therapists, early years health, education, and social care staff, and leads, managers and commissioners of SLT services. Data were analysed using reflexive thematic analysis.

The study identifies several barriers to accessing SLT services. Despite SLT services being highly regarded and focused on supporting children’s communication in everyday contexts, demand outstripped capacity and resulted in prolonged waits for families. Service changes aimed at increasing productivity had unintended impacts on quality of care and on service accessibility. Additionally, SLTs’ uncertainty about their role in supporting autistic children influenced clinical decisions and service delivery models, further impacting access to SLT. Some families received no or insufficient service due to high demand and many faced practical and emotional challenges in trying to gain access to SLT.

To ensure early access to communication support for autistic children and their families, several barriers need to be addressed. The study highlights the importance of recognising that access is influenced by a parent’s ability to advocate for their child and suggests further exploration of how SLTs perceive their roles and make decisions when working with autistic children in real-world situations. Improving service access is a complex process, but doing so has the potential to lead to positive change for autistic children and their families in areas that are important and meaningful in their everyday lives.

More information

Identifiers

ORCID for Iona Wood: orcid.org/0009-0000-3545-7084

ORCID for Richard Wagland: orcid.org/0000-0003-1825-7587

Catalogue record

Export record