Exploring concepts of understanding in the working practice of speech and language therapists in the UK: a preliminary survey

Bunning, K. ORCID: https://orcid.org/0000-0002-7396-9205, Buell, S., Flannery, L. ORCID: https://orcid.org/0009-0009-1235-8177, Manzi, E. ORCID: https://orcid.org/0009-0003-4158-8971 and Grove, N. (2026) Exploring concepts of understanding in the working practice of speech and language therapists in the UK: a preliminary survey. International Journal of Language and Communication Disorders, 61 (5). ISSN 1368-2822

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Abstract

Background: All communication involves both the expression and the reception of information, both of which are considered by speech and language therapists (SLTs) when assessing and planning intervention for language difficulties. Comprehension, or understanding, has to be inferred, whereas expressive behaviours are directly observable. Possibly because of the level of inference, views and assessments of a person’s understanding often vary: between different practitioners, professionals, family members and carers. The aim of the research was to examine how and why such different perspectives occur and how they are managed. There were 3 research questions: 1. How is understanding conceptualised and addressed from the perspectives of: a) SLT practitioners and b) SLT educators? 2. Are discrepant views on a person’s understanding recognised and encountered in SLT practice? and 3. if so, how are such differences explained and navigated in practice? Methods: The research design used a survey methodology involving two bespoke online questionnaires aimed at: (i) SLT practitioners; and (ii) SLT educators. Purposive convenience samples were recruited via UK-based pre-registration programmes in Speech & Language Therapy and the Clinical Excellence Networks (CENs) of the Royal College of Speech & Language Therapists (RCSLT). The online questionnaires included demographic information followed by a mixture of closed and free-field questions exploring conceptualisation and assessment of understanding. Descriptive statistics were applied to closed question responses, and summative content analysis to the free-field responses. Results: A total of 80 completed questionnaires were returned: (i) SLT practioners = 77; (ii) SLT educators = 3. Understanding was defined in different ways. Approaches to assessment focused on vocabulary and semantics, language processing, and responses to different communicative modalities. Differing views on a person’s understanding were recognised to be a common issue encountered by SLTs, which were mainly associated with parents, partners and family members rather than fellow professionals. Conclusions: SLTs seem to vary in the ways they conceptualise and address the question of understanding in their practice, and the findings confirm anecdotal suggestions that differences of opinion with other professionals, family members and carers are relatively common. Receptive communication, therefore, emerges as a contested field, which has implications for how successfully and thoroughly SLTs are able to plan and deliver effective interventions. Further clarification is needed regarding the relevant information and guidance provided in pre-registration training. Implementation science may provide some useful guidance as to the marrying of theory and research evidence.

Item Type:	Article
Additional Information:	Data Availability Statement: The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
Uncontrolled Keywords:	conceptualisation,speech and language therapy,survey,practice,theory,understanding
Faculty \ School:	Faculty of Medicine and Health Sciences > School of Health Sciences Faculty of Social Sciences > School of Education and Lifelong Learning
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Groups > Rehabilitation Faculty of Medicine and Health Sciences > Research Centres > Mental Health and Social Care (fka Lifespan Health)
Depositing User:	LivePure Connector
Date Deposited:	07 Aug 2026 15:48
Last Modified:	09 Aug 2026 05:29
URI:	https://ueaeprints.uea.ac.uk/id/eprint/104056
DOI:

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