Defining Communicative Participation for Children and Young People: Views of Young People, Parents, and Speech and Language Therapists

BACKGROUND: Communicating effectively in everyday life is a key outcome for children with speech, language and communication difficulties. However, we lack a clear way to describe children's everyday communication functioning-their communicative participation. Communicative participation is defined for adults, as 'taking part in life situations where knowledge, information, ideas, or feelings are exchanged', and included how communicative participation is achieved, with whom and for what purposes. AIM: This study aimed to consider communicative participation for children and young people, by using an existing definition regarding adults' communicative participation to elicit meaning from children and young people with speech, language and communication needs, and that of their parents and clinicians. METHODS AND PROCEDURES: Three focus groups with young people with speech, language, and communication needs (n = 6, ages 14-16 year old), parent carers (n = 5), and speech and language therapists (n = 19) and two semi-structured interviews, one with a parent of a young child with complex communication needs and one with a parent and their daughter with developmental language disorder, were conducted online, audio recorded and transcribed verbatim. Participants were shown an existing definition of communicative participation (originally intended to be applied to adults) and discussed the appropriateness of each section of the definition for children and young people. Transcripts were analysed following the Framework Analysis Approach. RESULTS: Participants broadly agreed with the existing definition but highlighted the changing nature of communicative participation throughout childhood. They thought that a definition of communicative participation should include interaction for joy, where closeness rather than meaning is shared, and reference to play and education as key communicative participation situations. Participants highlighted the importance of skilled partners in meaning making for children with developmental communication difficulties, and the fundamental role of technology in communicative participation. They also discussed the impacts of successful communicative participation on children's social and emotional development, seeing communicative participation as a driver to protect mental health and wellbeing, build independence, develop trusting relationships and stay safe. CONCLUSIONS AND IMPLICATIONS: Communicative participation develops across childhood and differs to that in adulthood in some important respects. The broad boundaries of the construct provided in this study can inform further development of the construct with potential impact for developing assessments and interventions related to communicative participation for children. WHAT THIS STUDY ADDS: What is already known on this subject Communicative participation has been defined as 'taking part in life situations where knowledge, information, ideas, or feelings are exchanged' (Eadie et al. 2006, 311) and 'understanding and being understood in a social context, by applying verbal and nonverbal communication skills' (Singer et al. 2020, 1801) What this paper adds to the existing knowledge Communicative participation changes across childhood. It includes interaction for closeness, without a message being conveyed; play; education; and social and emotional development. Skilled interaction partners are vital for the development of communicative participation for children and young people with speech, language and communication needs (SLCN). The extended boundaries for communicative participation developed in this study can inform the development of new measurement tools. What are the potential or actual clinical implications of this work? Communicative participation is a prized outcome for children and young people with SLCN and their parents. Speech and language therapists should investigate children's communicative participation and intervention should be directed toward participation goals.