Perspectives of Speech-Language Pathologists and Parents on Implementing Communication Approaches for Preterm Infants: A Focus Group Study in Pakistan

Preterm infants are at an increased risk of language delays but still standardised approaches supporting early communication development remain limited. Speech language pathologists and parents play an important role in supporting early communication development, yet their roles are unexplored. This study focusses on investigating the perspective of both SLPs and parents on the implementation of communication guidelines for the language development in preterm infants. This is a qualitative study that was conducted using focus group discussions (FGDs) including 14 SLPs and 16 parents of premature infants ranging from the age of 6-36 months. Reflexive Thematic analysis was used to analyse the data. In the result section, 5 major themes were identified: (1) From medical stability to fostering early communication- early communication was often hindered due to medical concerns; (2) Developing parents’ confidence with the help of coaching- parents encouraged simple, hands-on techniques, yet SLPs faced difficulties due to caseloads and time limitation; (3) Socio-cultural and environmental barriers— socioeconomic constraints and family influences affects feasibility; (4) Building coordinated support systems—both categories of participants emphasized the need for structured follow-up and culturally relevant resources; and (5) Lack of a structured framework for communication support — Both SLP's and parents reported inconsistency and ambiguity due to the absence of standardized guidelines. Participants recognize the value of early communication approaches for preterm infants at the same time they face systematic, cultural and environmental challenges. Findings of this study in lights the dire need for culturally appropriate standardized framework that integrate communication development in neonatal care units.