Therapeutic Relationship between Primary Caregivers of School-Aged Children with Autism Spectrum Disorder and Speech-Language Pathologists

Abstract

The purpose of the current investigation was to determine facilitators and barriers that contribute to the therapeutic relationship between primary caregivers of school-aged children with ASD and their child’s speech-language pathologist (SLP). Because the stress levels that caregivers of children with ASD may experience could impact/be impacted by their working alliance with their child’s SLP, an additional research aim was to investigate the relationship between the therapeutic alliance and parental stress levels. To do so, primary caregivers of children with ASD, between the school grades of Kindergarten and fifth grade, were recruited to take a 59-item, web-based, nationally-distributed survey. Ninety primary caregivers completed the survey. Results indicated that caregivers value every aspect of their child’s speech therapy goals, tasks, and bond with therapist—however, they place the most importance on the “tasks” their child’s SLP uses in therapy. Although, no relationship was found between parental stress levels and their view of the therapeutic relationship, caregivers were noted to use various forms of social support, with sources of informal support being used by significantly more caregivers than formal sources. Additionally, the setting in which the child receives speech therapy is a potential barrier in establishing a positive bond, with caregivers of children receiving services from a school-based SLP reporting a significantly poorer working alliance. Despite barriers created by treatment setting, it is important that SLPs strive to maintain communication and keep parents informed partners in each step of the child’s care. Implications for school-based SLPs will be discussed.