Caregiver beliefs and practices about communication disorders in early childhood development centres from Durban: A qualitative study

Introduction: Children with communication difficulties from impoverished families may face barriers to accessing rehabilitation services, shaped by caregiver health-seeking behaviour as one of the factors informing poor follow-up for intervention. These factors warrant closer examination, particularly for children aged birth to 5 years, to enable early intervention and improved prognosis. This study aimed to explore the beliefs of a group of caregivers, namely parents or legal guardians, early childhood development centre practitioners (teachers and support staff) and parents of adults who are Deaf, regarding the causes and practices of communication disorders. Materials and methods: The study employed a qualitative, exploratory, cross-sectional phenomenological design, with data collected through focus groups and semi-structured interviews. The 30 participants included 19 early childhood development practitioners and 11 caregivers. Seven of whom were parents of children who underwent developmental communication screening and four were parents of adults who are Deaf. The parents and early childhood development practitioners were randomly selected from early childhood development centres that had screening conducted. Additionally, purposive sampling was used to recruit parents of people who are Deaf. All participants were from the eThekwini Municipality (Durban) in KwaZulu-Natal Province, South Africa. Results: Two key themes emerged: the intersectionality of beliefs about the causes of communication disorders and complex practices for their management. Participants attributed communication disorders to social and spiritual factors, and these beliefs influenced their complex decision-making about treatment and help-seeking. Conclusion: Health professionals seeking to establish community-based rehabilitation services for communication disorders must first understand caregivers' beliefs and practices, as these shape behaviours regarding service use and influence intervention programme acceptance and follow-up.