A comprehensive service delivery model for preschoolers with special educational needs: Its characteristics and effectiveness

A realist synthesis of interprofessional collaborative practices in early intervention for children with speech, language and communication needs

BACKGROUND

Interprofessional collaborative practices (IPCP) are considered to be a crucial factor in the optimal support of young children (3-6 years) with speech, language and communication needs (SLCN) in inclusive early childhood education and care (ECEC).

AIMS

To investigate IPCP in interventions using a collaborative approach for young children with SLCN in ECEC, by identifying mechanisms within IPCP and how these mechanisms relate to specific context factors and professional and child-related outcomes.

METHODS

A realist review of 22 empirical intervention studies, published between 1994 and 2019, was conducted to synthesise context-mechanism-outcome (CMO) configurations, combining context factors, IPCP mechanisms and outcomes at staff and child level.

MAIN CONTRIBUTION

Reciprocal IPCP mechanisms were reported together with interprofessional intervention practices, whereas one-directional IPCP mechanisms were restricted to gains in professional development. Our review further suggests that collective ownership of intervention goals, combined with personal cooperation and communication skills of staff, is vital for inclusive practices and functional communication of children with SLCN.

CONCLUSION

Our review has revealed indications for effective IPCP mechanisms, context factors at staff level, and positive outcomes for the professional development of staff working with children with SLCN. In addition, our findings support a link between IPCP and child-related outcomes regarding speech, language and communication development. Future studies should increase our insight into how practitioners, children and families profit from daily collaborative practices.

WHAT THIS PAPER ADDS

What is already known on this subject Interventions using a collaborative approach for young children (3-6 years) with SLCN in ECEC are considered to be part of the optimal support of these children. What this paper adds to existing knowledge Conducting a realist review of 22 empirical studies on collaborative intervention offered the possibility to identify specific context factors, IPCP mechanisms and professional and child-related outcomes and to synthesise CMO configuations. Findings suggest multiple routes from effective delivery of SLCN services to improvement of speech, language and communication development, supporting the suggested beneficial function of collaboration between multiple professions. Collective ownership of intervention goals, combined with personal cooperation and communication skills of staff, seems to be vital for inclusive practices and functional communication of children with SLCN. Reciprocal IPCP mechanisms were reported together with interprofessional intervention practices, whereas one-directional IPCP mechanisms were restricted to gains in professional development. What are the potential or actual clinical implications of this work? High-quality collaborative intervention for children with SLCN in requires awareness of and critical reflection on IPCP mechanisms in order to improve outcomes for both professionals and children. Both, institutional structural support and individual communicative and cooperative skills are required to increase interprofessional collaboration with the aim to meet the needs of every individual child with SLCN.

Cognitive and Academic Outcomes of Fundamental Motor Skill and Physical Activity Interventions Designed for Children with Special Educational Needs: A Systematic Review

This systematic review aimed to investigate the methodological quality and the effects of fundamental motor skills and physical activity interventions on cognitive and academic skills in 3- to 7-year-old children with special educational needs. The review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) statement. A literature search was carried out in April 2020 (updated in January 2022) using seven electronic databases, including ERIC, Scopus, Web of Science, PsycINFO, CINAHL, PubMed, and SPORTDiscus. The methodological quality of the studies was assessed with Effective Public Health Practice Project (EPHPP) Quality Assessment Tool. Cohen’s d effect sizes and post-hoc power analyses were conducted for the included studies. Altogether 22 studies (1883 children) met the inclusion criteria, representing children at-risk for learning difficulties, due to family background (n_studies = 8), children with learning difficulties (n_studies = 7), learning disabilities (n_studies = 5), and physical disabilities (n_studies = 2). Two of the included 22 studies displayed strong, one moderate, and 19 studies weak methodological quality. The intervention effects appeared to be somewhat dependent on the severity of the learning difficulty; in cognitive and language skills, the effects were largest in children at-risk due to family background, whereas in executive functions the effects were largest in children with learning disabilities. However, due to the vast heterogeneity of the included studies, and a rather low methodological quality, it is challenging to summarize the findings in a generalizable manner. Thus, additional high-quality research is required to determine the effectiveness of the interventions.