Parents of children with Autism Spectrum Disorder are responsible for deciding which interventions to implement with their child. There is limited research examining parental decision-making with regards to intervention approaches. A constructivist grounded theory methodology was implemented in this study. Semi-structured interviews were undertaken with 14 participants from 12 family units. Data collection and analysis occurred concurrently, allowing a grounded theory to be constructed. Parental decision-making was influenced by many factors, arranged into seven core categories (values, experience, information, motivation, understanding, needs and logistics). Decision-making evolved over time, as parents transformed from 'parent' to 'expert'. The results of this study provide an insight into parental decision-making, which has implications for the support provided to parents by health professionals.

The results demonstrate that these ECEs use the relationship with the children in their care as a tool for provision of optimal learning experiences across multiple developmental domains.

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Background Maintaining a health professional workforce in rural and remote areas poses a significant challenge internationally. A range of recruitment and retention strategies have had varying success and these are  generally developed from the collective experience of all health professions, rather than targeted to professional groups with differing educational and support contexts. This review explores, compares and synthesises the evidence examining the experience of early career rural and remote allied health professionals and doctors to better understand both the profession specific, and common factors that influence their experience. Methods Qualitative studies that include early career allied health professionals’ or doctors’ experiences of working in rural or remote areas and the personal and professional factors that impact on this experience were considered. A systematic search was completed across five databases and three grey literature repositories to identify published and unpublished studies. Studies published since 2000 in English were considered. Studies were screened for inclusion and critically appraised by two independent reviewers. Data was extracted and assigned a level of credibility. Data synthesis adhered to the JBI meta-aggregative approach. Results Of the 1408 identified articles, 30 papers were eligible for inclusion, with one rated as low in quality and all others moderate or high quality. A total of 23 categories, 334 findings and illustrations were aggregated into three synthesised findings for both professional groups including: making a difference through professional and organisational factors, working in rural areas can offer unique and rewarding opportunities for early career allied health professionals and doctors, and personal and community influences make a difference. A rich dataset was obtained and findings illustrate similarities including the need to consider personal factors, and differences, including discipline specific supervision for allied health professionals and local supervision for doctors. Conclusions Strategies to enhance the experience of both allied health professionals and doctors in rural and remote areas include enabling career paths through structured training programs, hands on learning opportunities, quality supervision and community immersion. Systematic review registration number PROSPERO CRD42021223187.

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Background Internationally, health and social services are undergoing creative and extensive redesign to meet population demands with rationed budgets. This has critical implications for the health workforces that serve such populations. Within the workforce literature, few approaches are described that enable workforce development for health professions in the service contexts that emerge from large scale service redesign in times of industry shift. We contribute an innovative and robust methodology for workforce development that was co-designed by stakeholders in allied health during the personalisation of disability funding in Australia (the introduction of the National Disability Insurance Scheme). Methods In the context of a broad action research project, we used program logic modelling to identify and enact opportunities for sustainable allied health education and workforce integration amidst the changed service provision context. We engaged with 49 industry stakeholders across 92 research engagements that included interviews (n = 43), a workshop explicitly for model development (n = 8) and a Project Advisory Group (n = 15). Data from these activities were inductively coded, analysed, and triangulated against each other. During the program logic modelling workshop, we worked with involved stakeholders to develop a conceptual model which could be used to guide trial and evaluation of allied health education which was fit-for-purpose to emerging workforce requirements. Results Stakeholder interviews showed that drivers of workforce design during industry shift were that (1) service provision was happening in turbulent times; (2) new concerns around skills and professional engagement were unfolding for AHP in the NDIS; and (3) impacts to AHP education were being experienced. The conceptual model we co-designed directly accounted for these contextual features by highlighting five underpinning principles that should inform methodologies for workforce development and AHP education in the transforming landscape: being (1) pedagogically sound; (2) person- or family-centred; (3) NDIS compliant; (4) informed by evidence and (5) having quality for all. We use a case study to illustrate how the co-designed conceptual model stimulated agility and flexibility in workforce and service redesign. Conclusions Proactive and situated education of the emerging workforce during policy shift is essential to realise future health workforces that can appropriately and effectively service populations under a variety of changing service and funding structures – as well as their transitions. We argue that collaborative program logic modelling in partnership with key stakeholders including existing workforce can be useful for broad purposes of workforce (re)design in diverse contexts.

Professional development can provide opportunities to develop new skills and knowledge, and to apply them to practice in a sustainable way. However, delivery of professional development needs to consider the philosophies and pedagogies of training recipients, and activities should be tailored to meet their needs. This article reports on an exploratory study of an embedded, service-based model of professional development for early childhood educators (educators), targeting children's speech, language, and communication skill development. This innovative model, conducted by speech and language therapy (SLT) students and a SLT professional practice educator, utilized co-teaching strategies to facilitate the professional learning of educators and SLTs in this context. A qualitative research design was employed and data gathered through focus group interviews with educators and individual semi-structured interviews with centre directors. The data were triangulated with some observational data of educators' practices with young children several months post program completion to explore their application of skills and knowledge that had been covered in the professional development program. The data contained four main themes: Communication, relationships, environment, and translating knowledge into practice. Observational data lent further depth and validation to the results by confirming the presence or absence of expressed practice values and experiences in the educators' everyday interactions with children. The observational data supported the themes relationships and translating knowledge into practice. The results contribute to our understanding of educators' and childcare centre directors' perspectives on their knowledge, skills, and practice in response to this embedded professional development program. This model of professional development may be appropriate to facilitate knowledge and skill development about children's speech, language, and communication skills for educators working with young children in a childcare setting. Benefits

Standardised language assessments such as the Clinical Evaluation of Language FundamentalsPreschool 2 United Kingdom (CELF Preschool 2 UK) (Wigg, Secord & Semel, 2006) are often used in speech-language pathology clinics to determine if a child is at risk of language difficulties. Many of these assessments are designed and standardised for use with monolingual Standard English speaking children. It is thus recommended that these assessments should only be used with the populations they were designed for; if not test bias might result. However, such tests are still selected and used in the clinics of many multicultural and multilinguistic communities (e.g. Singapore). This research aimed to explore the performance of Singaporean English-Mandarin preschool children on the Expressive Vocabulary (EV) subtest of the CELF Preschool 2 UK and to determine if their performance on the EV subtest accurately reflected their language abilities by comparing their performance on a local screening language assessment tool, the Singapore English Action Picture Test (SEAPT) (Brebner, 2002). Results showed that local children performed poorly as compared to their UK counterparts. Two plausible reasons for the findings are: 1) the subtest elicited only a single measure in English which ignored the language abilities of these bilingual children in their second language; 2) the presence of culturally and linguistically biased test items.