Consideration of Child and Family Information in Clinical Decision Making

With persistent challenges in determining the 'right' therapy or support for autistic children, there is a growing need for clinicians to integrate the preferences and priorities of clients and their families in their clinical decision making.

The purpose of the current study was to investigate speech-language pathologists' perspective of client factors that clinicians consider when planning supports and therapies for young children with social communication delays.

A sample of 264 United States-based SLPs completed a survey that collected information about SLP professional training (e.g., amount and type of training) and clinical decision making (e.g., the types of information considered when making decisions regarding supports).

The SLPs rated the importance of several internal sources they consider when planning support and therapies for young children with social communication delays. More participants rated family/child preferences as highly important to planning than any other client source. Participant engagement in autism-specific continuing education was related to clinicians' likelihood to rate a child's diagnosis as very important to clinical decision making, whereas continuing education related to early intervention was not related to the importance of child diagnosis.

Findings suggest that SLPs give importance to internal sources within an evidence-based practice framework as they make clinical decisions. These findings support the need for professional development programs that emphasize client-centered care and equip clinicians to integrate family preferences into early intervention planning.

What is already known on this subject Clinical decision making when selecting therapies and supports for autistic children is complex and often guided by the evidence-based practice (EBP) model, which includes research evidence, clinical expertise, and client values. However, research has disproportionately emphasized research evidence, while the use of client-specific sources - such as family preferences and contextual information - has been under-examined. Speech-language pathologists (SLPs) are crucial in supporting communication development in young autistic children, yet their training in autism and early intervention can be inconsistent, and how they consider different internal sources of information is not well understood. What this study adds to existing knowledge This study provides novel insights into how U.S.-based SLPs rate the importance of child and family sources of information sources when planning interventions for young children with social communication delays. Family and child preferences emerged as the most valued internal source, more so than diagnosis or procedural details. This study also highlighted that continuing education was positively associated with greater emphasis child and family preferences, familiarity with the child, and the child and family schedule. These findings suggest continuing professional development plays a critical role in promoting evidence-based, family-centered care. What are the clinical implications of this study? These findings underscore the importance of promoting continuing education opportunities that emphasize client and family-centered care, especially in autism and early intervention contexts. Clinical decision-making that prioritizes family preferences and individual child contexts is aligned with evidence-based best practice and shared decision-making models. Service providers and professional bodies should ensure that clinicians are equipped to integrate these child and family sources of information into therapy planning. Embedding structured training in these areas can enhance clinical outcomes and family satisfaction in early autism services.