背景:增强型Milieu教学(EMT)是针对发育障碍儿童的基于证据的自然主义发展行为干预(NDBI)。关于EMT的适合性或在资源受限的环境中可能需要哪些调整来提高其适用性知之甚少。
目的:探讨利益相关者对在资源有限的环境中发育障碍幼儿EMT的情境适合性的看法,并确定适应性以改善EMT的情境适合性。
方法:我们使用半结构化访谈和焦点小组进行了描述性定性研究。参与者包括5名言语和语言治疗师以及11名发育障碍儿童的照顾者,他们会说英语和南非荷兰语或isiXhosa。使用主题分析,数据被编码为10个子主题,并根据Adaptome框架组件进行分组。
结果:总体而言,利益相关者认为EMT是南非背景下的适当干预措施。他们指出,某些干预组件可能需要修改。具体来说,临床医生可能需要调整干预材料和活动,以对家庭可用资源敏感,首选活动例程和优先级。从这些数据来看,我们提供指导方针,以提高EMT在南非的适合性。
结论:增强Milieu教学是南非背景下的适当干预措施,尽管一些适应可以增强其适应性。贡献:本文强调了与利益相关者接触以确定NDBI的适合性的重要性,比如EMT,因为它们在新的环境中实现。基于这些见解,提供了利益相关者知情的适应指南,以改善资源受限环境中EMT的上下文适合性。
BACKGROUND: Enhanced Milieu Teaching (EMT) is an evidence-based naturalistic developmental behavioural intervention (NDBI) for children with developmental disabilities. Little is known about the EMT\'s fit or what adaptations might be needed to improve its applicability within a resource-constrained setting.
OBJECTIVE: To explore stakeholders\' perceptions of the contextual fit of EMT for young children with developmental disabilities in a resource-constrained context and to identify adaptations to improve EMT\'s contextual fit.
METHODS: We conducted a descriptive qualitative study using semi-structured interviews and focus groups. Participants included 5 speech and language therapists and 11 caregivers of children with developmental disabilities who speak English and Afrikaans or isiXhosa. Using thematic analysis, data were coded into 10 subthemes and grouped according to the Adaptome framework components.
RESULTS: Overall, stakeholders view EMT as an appropriate intervention in the South African context. They indicated that certain intervention components may need to be modified. Specifically, clinicians may need to adapt intervention materials and activities to be sensitive to families\' available resources, preferred activity routines and priorities. From these data, we provide
guidelines to improve the fit of EMT in South Africa.
CONCLUSIONS: Enhanced Milieu Teaching is an appropriate intervention in the South African context, although some adaptations can enhance its fit.Contribution: This article highlights the importance of engaging with stakeholders to determine the fit of NDBIs, like EMT, as they are implemented in new contexts. Based on these insights, stakeholder-informed adaptation
guidelines are provided for improving the contextual fit of EMT in resource-constrained settings.