Discharge of children with developmental language disorder by Croatian speech-language pathologists: A qualitative...

Discharge decisions pose a challenge in speech-language pathology practice. Although professional guidance exists, there is little research on what factors influence discharge decisions in practice. This study aimed to explore the discharge decisions of speech-language pathologists in the context of children with Developmental Language Disorder, in particular to identify influential factors.

This is a qualitative knowledge-elicitation study using individual interviews and a focus group to explore the knowledge of 19 Croatian speech-language pathologists with more than two years experience of working with children with Developmental Language Disorder.

Speech-language pathologists described a complex process that was influenced by four overarching case-related factors: A child reaching a plateau, the child's achievements, support, and motivation. Much of this knowledge was challenging for clinicians to define and measure. Speech-language pathologists also reported the influence of resource pressures.

The process described by speech-language pathologists broadly follows published professional guidance. Clinicians descriptions of the interpretation of those factors to child, family, and situational contexts showed the individualisation and weighing up of the relative importance of factors. These detailed judgements were challenging. Therefore, support and monitoring particularly for novice speech-language pathologists is recommended. Discussion between clinicians will also support the emergence of consensus and build confidence in discharge decision-making. Further explication of the influential factors and development of ways to measure and evaluate levels of support and children's functional performance is needed.