ACQ Vol 12 No 3 2010

Discussion This quality assurance study investigated parent (mother) satisfaction concerning 11 aspects of service delivery, with the intention of using the results to enhance the speech- language therapy service provided. Results indicated the majority of mothers gave an overall satisfaction rating of extremely satisfied. No mothers expressed dissatisfaction. While this is a pleasing result, useful information can be gained by examining the 11 result areas individually to tease out areas of weakness, as well as noting which procedures were appreciated. Most mothers expressed high levels of satisfaction with the initial phone contact. Perhaps the length of time spent during the initial contact and the amount of information shared helps build rapport and trust. From the clinician’s perspective, this in turn reduces non-attendance. The assessment process is one such area where changes can be made based on parent responses. The assessment process used by the author includes many of the family- friendly features described by Watts Pappas and McLeod (2008), such as explaining jargon, explaining the therapy process, asking whether it is okay to speak about the child in front of the child, asking whether parents agree with the findings, giving feedback immediately after testing, and giving a prognosis. Survey results validate the assessment process used, as most respondents (32/33) indicated they were satisfied (3), very satisfied (10) or extremely satisfied (19). However, results indicated that anticipated length of time in therapy is an area that could be discussed more openly and routinely with parents, possibly with examples from previous cases. As in a study conducted by Crais and Belardi (1999), there was also some dissatisfaction (three mothers) with regard to agreement about test findings , although no mother made mention of this in the open-ended section of the survey. In order to rectify this, parents could be offered a checklist to complete as a way of gathering more information to support test findings or show evidence contrary to test findings (Crais and Belardi, 1999). Crais and Belardi also suggest giving parents the chance to view assessment reports before their finalisation. This step may be adding to the assessment/reporting process to raise the status of parents in the partnership and to ensure agreement. Parental involvement and support in planning are critical to achieving outcomes in this clinic. Parents like to feel they have been listened to and their concerns given due consideration (Watts Pappas & McLeod, 2008). Mirabito and Armstrong (2005) stress the important contribution parents make to the intervention process through collaborative relationships, especially in terms of making activities relevant and meaningful for the child, assisting in the generalisation of skills, and monitoring progress. Parental responses in the current study indicated high levels of satisfaction, with most parents stating they were more than satisfied that their knowledge and skills had increased (14 mothers very satisfied, 17 mothers extremely satisfied). Most also felt that they could transfer therapy into everyday settings (10 very satisfied, 21 extremely satisfied) and most felt involved in their child’s sessions (8 very satisfied, 22 extremely satisfied). Qualitative responses from the open-ended statements also supported these quantitative results with parents writing that the therapist “assisted me to learn” and that “practical activities” were used. Satisfaction with therapy outcomes and the child’s enjoyment are key goals for any paediatric SP. Most mothers

home practice (6 satisfied, 14 very satisfied, 11 extremely satisfied, and 1 somewhat dissatisfied). Cost No participant expressed any dissatisfaction with the cost of therapy and one parent was somewhat dissatisfied with the cost of the initial assessment ($200.00 per hour). Reporting One mother was somewhat dissatisfied with the reporting process. One mother was satisfied, 7 mothers were very satisfied and 17 mothers were extremely satisfied. There was a group of mothers for whom a written report was not applicable due to cost factors or minor nature of the communication problem. SP qualities Most mothers (32) were extremely satisfied with the therapist’s interpersonal skills in relation to themselves, the therapist’s competency and professionalism. No parents Regarding teacher consultation, similar satisfaction levels were reported across the three levels, i.e., 9 mothers expressing satisfaction, 7 being very satisfied, and 8 being extremely satisfied. One parent was somewhat dissatisfied. Hence, this is an area that could be improved upon. Eight mothers either left this section blank or wrote N/A. Health rebates Parents claimed rebates either through their private health fund or through the Australian government’s Medicare Enhanced Primary Care program which provides rebates of $49.00 for each of five sessions. Six parents expressed dissatisfaction with rebates they received while 25 parents expressed satisfaction. Nine parents were extremely satisfied with their rebates, 4 were very satisfied and 11 were satisfied. Cancellation policies While no parents indicated any level of dissatisfaction with cancellation policies, 4 parents did not respond to this section of the survey. Fewer parents expressed high levels of satisfaction compared with other sections of the survey, i.e., 11 parents were extremely satisfied and 9 parents were very satisfied. Prior to this project, parents were usually though not routinely asked to give reasonable notice if they were unable to attend. Overall satisfaction Results indicated most mothers (23) were extremely satisfied with the service they received. Eight mothers were very satisfied and 2 expressed satisfaction. No parents expressed any level of dissatisfaction. Open–ended statements Twenty- five mothers completed this section of the survey. Analysis of qualitative responses supported the current approach being used with regard to listening to parent opinion, as 9 parents wrote they liked that the therapist “listened to my input”. Parents also wrote they liked the “positive approach”, that their “skills had improved” and that their child “had fun while learning”. The qualitative comments also supported the need for parent–teacher consultation. For example, mothers indicated they would like the SP to develop “more integration with schools”, and to provide a “brief report to school”. expressed any dissatisfaction. Teacher consultation

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ACQ Volume 12, Number 3 2010

ACQ uiring knowledge in speech, language and hearing