Exploring voice and participatory processes for children who communicate in unconventional ways

Abstract

The participatory rights of children in consenting to receive services, and for including children in feedback processes on the services that they receive, are well established in international standards and laws. However, children with disability often experience barriers to participating in these processes. Tools and strategies have been developed to facilitate accessible processes, however these approaches typically assume that the person is able to provide direct and unambiguous responses. Drawing on qualitative interview methodologies, with insights from intellectual disability literature and the authors’ experiences as speech-language pathologists, a combined methodological approach to conducting a single interview with two children with intellectual disability was explored to capture the children's feedback on a speech-language pathology service. Using situated discourse analysis, the results demonstrate the dynamic and responsive journey towards shared co-construction of meaning and voice between each child, their parent and the interviewer. Further, a continuum of ambiguity was evident in the children's messages, and communication partners were observed to use a range of strategies to explore this ambiguity and co-construct meaning. This study has implications for the realisation of children's participatory and health-related rights, qualitative interview methodologies, and speech-language pathology practice with children and adults with intellectual disability or communication differences.