Predictors of parental engagement in home-based speech therapy program for speech and language disordered children in the Klang Valley, Malaysia

Focusing on and improving parental engagement is perceived to increase the success of Speech Therapy outcome among speech-language disordered children. Despite the importance of improving parental engagement, there is a scarcity of empirical evidence examining factors related to engagement. Therefore, the current study was conducted to investigate if motivation, communication, competence, expectation and barrier are predicting parental engagement. The study adopted a cross-sectional design to address the research inquiries and to draw conclusions from the analyses. A sample of 384 respondent were selected from 7 government hospitals in Klang Valley using systematic random sampling. Six instruments were administered in this study namely Parent Motivation Inventory, Parental Expectation Scale, Therapist-Parent Communication Questionnaire, Perceived Competence Scale, Barrier to Treatment Participation Scale (Treatment Demands and Issue) and Parent Home-programme Compliance Questionnaire. Descriptive, bivariate and multivariate statistics using SPSS and Smart-PLS software were used in data analysis. This study found that 54% of the respondents reported to have low parental engagement. Findings from the independent sample t-test test indicated that there were significant difference in parental engagement between one child and more than one child in the family. The independent sample t-test test also revealed that there were significant difference in parental engagement between child with medical condition and child with no medical condition. The study’s results obtained from the Partial Least Square Structural Equation Modeling (PLS-SEM) showed there were significant positive relationship for motivation (0.568), expectation (0.485), communication (0.470), competence (0.577) with parental engagement. While significant negative relationship were revealed between barrier (-0.510) and parental engagement. Competence was the strongest predictor followed by barrier, motivation and communication with R2 value of 0.559. Additionally, barrier partially mediated the relationship between motivation and parental engagement, while competence partially mediated the relationship between communication and parental engagement. This indicate that motivation and communication not only directly affect parental engagement but indirectly through barrier and competence. Interestingly, competence fully mediated the relationship between expectation and parental engagement, which means, expectation does not directly affect parental engagement but indirectly through competence. It can be concluded that this study has critically important clinical and policy implications for efforts to improve the quality and effectiveness of care. To improve parental engagement in home-based Speech Therapy program for speech and language disordered children, parent need to be competence and strongly believe in their own capabilities. Policy maker and clinicians should offer opportunities to modify parents barrier to treatment, as well as keep motivating parents throughout intervention. Lastly, both parents and clinician need to make an effort to have good relationship and improve communication.

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