Perceptions of Saudi Parents Towards Collaboration With Professionals

Discussion

This study aimed to investigate parents of young children with disabilities perceptions toward collaboration with professionals, knowledge levels, and their stratifications toward services in Saudi Arabia. Potential barriers and promote factors of collaboration between parents and professionals in Saudi Arabia were also examined. Six parents of young children were also interviewed to explore their perceptions, promotors, hinders, and cultural effects. In particular, this study sought to investigate factors affecting collaboration between parents and professionals (i.e., knowledge of practices, communication, commitment, equality, trust, and respect).

Previous western studies have demonstrated that collaboration between parents and professionals lead to improve the young children outcomes (Bruder, 1998; Friend & Cook, 2003; Harry, 2008; Idol, Nevin, & Paolucci-Whitcomb, 2000; McKenzie, 2009; Simpson & Envy, 2015). Most past studies have focused on investigating teachers’ perceptions regarding several forms of collaboration with little focus on family perceptions (Guise, Habib, Thiessen, & Robbins, 2017; Hang & Rabren, 2009).

This chapter will provide a discussion of the results as related to previous research addressing the parents’ perception and attitude toward the early intervention. The collected qualitative and quantitative data should reveal whether the early intervention and parents’ social, economic, and personal peculiarities have some intersections and correlations in understanding and collaboration with clinicians and medical personnel. The further discussion and explanation of findings can be utilized for guidelines and recommendations creation to ensure that both parents and clinicians effectively participate in the early clinical intervention and treatment of children’s disabilities. Such collaboration requires quality outcomes and full commitment from both parties. The long-term effects of medical intervention should benefit children and their parents, as the life-long outcome.

Collaboration with Professionals

The collaboration between parents and professionals is based on the communication aspects and perceptions of intervention models and methodologies. The core idea of collaboration strengthening is the increase of communicative variables reliability and positive responses from parents regarding their understanding and commitment during the treatment process. In this instance, the conducted survey depicts how parents evaluate clinicians’ behavior, activities, and efforts in explaining, delivering, and integrating proposals and recommendations from parents and evidence-based practices.

Knowledge of Practices

Parents’ knowledge of practices is an integral part of the medical intervention, as they are primary stakeholders in children’s disabilities treatment. According to the conducted survey and qualitative analysis, 40.8% of all parents reported they have sufficient knowledge of collaboration by selecting “Strongly Agree.” Most of the respondents (53.7%) reported “Strongly Agree” regarding understanding the multiple purposes of collaboration. Most parents also indicated that their knowledge of collaboration practices is valuable for quality outcomes. 51.1% of them indicated “Strongly Agree;” 43.7% reported knowing various essential components of effective collaboration practices; and, 65.1% indicated they understand that collaboration involves more than merely attending meetings. Finally, 51.8% chose “Strongly Agree” in response to the statement regarding the benefits of cooperation in early childhood special education; and, 61% of respondents also selected “Strongly Agree” regarding the comment on collaboration being beneficial to their child with disabilities and their families.

The collected results indicate that parents’ knowledge and awareness is high regarding collaboration practices, their peculiarities, and essential milestones. Such a discovery can be explained through the importance of parents’ direct involvement, as they should participate in the intervention, treatment plan construction, and any medical nuances discussion. Moreover, the literature suggests that the close parental collaboration with clinicians stimulates quality outcomes so that both medical personnel and parents understand how to assist children, support them, and offer them the most suitable and appropriate care services (Blackmore, Aylward, & Grace, 2016). As a result, the study confirms that parents tend to participate in the early intervention due to their sense and feeling of importance of the treatment and recovery process. In return, the obtained data may confirm that intensive collaboration between parents and doctors increases chances for efficient, qualified, and accurate treatment program selection.

Communication

The communication variable delivers controversial data on collaboration and agreement between clinicians and parents. Overall clinicians’ communication skills are graded as occasional by: (a) 37.9% of respondents regarding whether clinicians answer questions sufficiently; (b) by 36.0% regarding their perception of professionals’ honesty during collaboration; (c) by 36.8% on the statement about professionals being open and good listeners in discussions; and, (d) by 32.4% about professionals communicating positively during meetings. Such findings provide several concerns about the quality and efficiency of the communication, as it is evident that parents struggle to obtain essential information accurately and straightforwardly. As a result, the quality decline can occur, making the early intervention less efficient or precise.

Nonetheless, the cultural and ethical aspects of communication deliver the opposite image of the situation. Parents favorably graded clinicians’ skills and traits regarding culture and family values. The highest grade for understanding the family values gave almost 34% of all responders. In this case, the communication between parents and clinicians is built around core social and cultural values, which support the synergy between both parties.

On the contrary, the clear problem is detected: both parents and clinicians lack basic communication tools and resources to respond and ask appropriately. Parents lack skills in asking questions and searching for more information to expand their knowledge (Turnbull, Turnbull, Erwin, Soodak, & Shogren, 2015). Clinicians tend to use complicated notions and structures to explain some intervention peculiarities so that parents may lose concentration and main idea about further actions and treatment intervention.

Commitment

Another aspect of the high-quality communication between parents and clinicians is commitment. The average percentage of all responders indicated that medical personnel occasionally share details, clear explanations, and advice. The provided results in Table 1.3 show that the average rate of satisfied parents is between 28%-34%, meaning that clinicians should be more aligned to the parents’ and children’s needs. In this instance, it can be noted that clinicians do not frequently provide pieces of training or consultancies, as 34% of all surveyed parents revealed that they get assistance occasionally rather than often or always. While the difference between reasonable satisfaction and complete satisfaction is floating between 2%-5%, such a difference can be crucial for parents to understand whether the early intervention will have an effect and provide qualified care services to their children.

Equality

The presented results in Table 1.4 reveal how parents perceive equity regarding clinicians’ actions and early health interventions. The survey delivers positive results on the conflict resolution techniques between parents and clinicians, as 31,6% responders stated that all disputes were resolved smoothly. What is more, clinicians show high sensitivity to the parents’ needs and expectations, as almost 22% of responders positively graded doctors’ ability to listen to problems, and 31,6 indicated that clinicians respect and recognize parents’ efforts and contributions.

Such findings show that clinicians tend to understand and fulfill parental concerns regarding early intervention. The use of appropriate conflict-resolution skills and mediation tools indicates that medical personnel is willing to assist and deliver high-quality care services, consultations, and guidelines (Schultz, Sreckovic, Able, & White, 2016). In return, the high percentage of positive responses from parents regarding clinicians and their perception of parents’ role supports the idea that satisfied and confident parents are more likely to support intervention strategies and treatment programs.

Trust and Respect

The last aspect of the communication variable reveals the level of trust between parents and clinicians. The surveyed parents mostly stated that clinicians occasionally listen to proposals, value these proposals, and integrate them into the final decision. The average percentage among all questions is 32%-33%, which are distributed among “occasional” and “frequently” ratings. Such a situation has a bilateral effect on both parents and clinicians. From one perspective, parents are interested in decision-making process participation. As a result, they demand that their ideas and suggestions are incorporated into medical decisions and treatment program selection (Vélez-Agosto, Soto-Crespo, Vizcarrondo-Oppenheimer, Vega-Molina, & Coll, 2017). Nonetheless, clinicians have education and field experience so that they tend to rely on evidence-based practices rather than parents’ concerns and demands (Simpson & Envy, 2015). In this instance, the survey results show the communication gap, where parents are overwhelming clinicians with their natural fear and anxiety about children’s health, while clinicians do not have effective communicative means to explain all nuances and peculiarities of their decisions and selection criteria of one program over the others.

Promotors of Collaboration with Professionals

The conducted interview with parents and the combined findings from surveys indicate that the primary driving force for the highly efficient collaboration between parents and professionals is shared values and intentions. In the interview, parents suggested that the opportunity to discuss concerns, problems, and prior experience played a pivotal role in communication and cooperation establishment. Besides, parents indicated that such a beginning of the early intervention procedures allowed them to understand all processes better, ask precise questions, and obtain explanations. Further, the high percentage of positive evaluation regarding clinicians’ communication skills and approaches is based on parents’ comments during the interview. They stated that some clinicians put all efforts to stay in contact with the parents, provide them with any changes and relevant information, and deliver detailed guidelines about the intervention process.

Another aspect of high-quality collaboration between parents and medical personnel can be found in conflict management techniques. Most responders revealed that clinicians effectively resolve disputes and facilitate any disagreements during the medical intervention (Viviani, 2016). As a result, it can be predicted that clinicians’ skills and traits have an impact on how parents are perceiving and understanding the intervention practices and their outcomes. In this case, the vital aspect is the results of conflict-resolution activities. The interview with parents confirms more positive feedbacks about clinicians if they can mitigate and avoid the conflict. Nonetheless, the concerning issue is the differentiation between interview results and qualitative data from the survey (Vuorinen, 2018). In some instances, parents agree that clinicians understand them and share values if the medical personnel accept parents’ position or integrate it into the final decision. On the contrary, the negative comments toward the practices and clinicians’ behavior are based on the reject or negligence of parental recommendations (Young, 2018). Such deviations indicate the subjective nature of the parents’ responses, as they are aligned with communication and relationships between clinicians and parents.

Hinders of Collaboration with Professionals

The main hinder for effective collaboration between parents and professionals is opinion-based behavior from both parties. It is understandable that parents are concerned about their children’s health and demands more information, details, and attention to their problems. Nonetheless, parents are focused on their positions and do not recognize the importance of standards and evidence-based practices, which are proved to be efficient (Etikan, Musa, & Alkassim, 2016). In this case, the clinicians tend to pursue their point of view and use tested and approved methods to treat children even if parents have some doubts. Such inconsistency in communication disjoints parents from clinicians and makes collaboration less efficient and qualified.

Another issue is that clinicians are limited in resources and time so that they cannot devote all efforts to provide detailed feedback and explanations per parents’ demand. In this case, the survey reveals that more than 21% of all responders feel abandoned and disjointed from the process. Moreover, they admit that clinicians are less available and sensitive to their children’s issues (Hadidi & Alkhateeb, 2020). From this perspective, the review of interview and survey results indicates that the collaboration hinders are based on differentiation in opinions and lack of resources, which cause breaches in understanding and perception of practices from parents’ side and lack of flexibility from clinicians’ side.

Differences Between Groups

Differences Based on Respondents’ Gender

The conducted statistical test on the gender difference in intervention practices reveals that male and female parents identically react and respond to the clinicians and their approaches. The mean score for all participants was 3.60 (SD =.74), which is higher than p (p<.05). In this instance, it can be admitted that both genders are subjects of similar behavioral and communicational patterns regarding collaboration with professionals. Assuming this fact, medical personnel should tend to use unified communicative means to guide parents and rely on the situational changes rather than gender peculiarities.

As a result, the survey results and the conducted interview show that parents are driven by their needs and concerns. In return, they define the behavior, positions, and intentions during the collaboration (Sabol, Sommer, Sanchez, & Busby, 2018). Such a situation suggests that clinicians should pay attention to the specific medical case and disease history so that a more qualified and efficient treatment program can be selected.

On the contrary, the obtained results on dissatisfactory responses regarding professionals’ suggestions and intervention reveal that parents can be subjects of stereotypes. In this case, the lack of collaboration or reduced communication rates can be explained via medical personnel actions (Zhang, 2017). If clinicians pay less attention to proposals, recommendations, and concerns of one of the genders, it is expected that such a high percentage of parents stated low quality and engagement among the professionals. While the interview and survey review parents’ perspectives on the early intervention, the reliability of the test should be strengthened with the clinicians’ views on the parents’ gender.

Differences Based on Respondents’ Educational Level

The one-way ANOVA test between parents’ educational level and their understanding of practices depicts statistically low dependence between these two variables. The obtained results suggest that parents’ educational background does not affect how they collaborate with clinicians. The difference in educational level between groups and within groups showed low significance for parents to understand practices, details, and evaluate communication patterns (Singh & Zhang, 2018). As a result, the test confirms that parents’ educational background should not be a leading variable for clinicians in building their relationships with parents.

On the contrary, awareness in practices showed statistical significance in understanding and collaboration with clinicians. While parents’ educational background has little impact on cooperation, the ability to search and learn information about different methodologies and interventions affects the way how parents cooperate with professionals. From this perspective, the research offers some suggestions on how to increase collaboration between parents and clinicians during the early intervention.

The essential idea is that there is a dependence between how clinicians explain and deliver details on the intervention, and how parents decide and participate in this intervention. According to the nursing theory, the increase in patients’ education triggers the growth of quality outcomes, collaboration efficiency, and patients’ satisfaction rates. Applying these theoretical ideas on the survey results, the ongoing improvement in collaboration should be based on clinicians’ efforts to deliver the information and parents’ desire to search and learn about the early intervention (Lohman, Hathcote, & Hogan, 2018). As a result, the percentage of those who believe that clinicians are less sensitive or communicative can be reduced so that both parties can find common ground for the intervention discussion, share values definition, and establish the joint decision-making process.

Differences Related to Respondents’ Income

One-way ANOVA was used to determine differences, if any, related to parents’ monthly income and knowledge of practices, communication, commitment, equality, and trust and respect. The responses were: less than 5000 SAR; 5001-10000 SAR; 10001-15000 SAR; and, more than 15000 SAR. The statistical test confirms that there are no significant relations between parents’ income and their communication attitude toward the understanding of early intervention practices. What is more, there are no statistical confirmations that income affects collaboration with healthcare professionals, as all aspects related to the trust, respect, and commitment have p>.05.

The results show that clinicians should not rely on the parents’ income statements in their approaches and communication techniques to explain or select the early intervention models. Moreover, the parents’ decision on treatment methodology does not depend on their financial situation. In this instance, the statistical findings suggest that the collaboration between parents and professionals rely on other parameters different from income.

The literature review confirms that parents tend to adjust their behavior according to the situation rather than their perceptions. As a result, they rely on the descriptions and details provided by professionals, which define how they understand and participate in the final decision-making process regarding the early intervention program. The collaboration between parents and clinicians depend on trust, respect, commitment, and communication; however, these variables are affected by parents’ efforts to understand the early intervention, their children’s needs, and outcomes that can be obtained during the treatment (Guise et al., 2017). From this perspective, the use of income statement in analysis and definition of collaboration quality and efficiency will not offer reliable criteria so that medical personnel should disregard them and follow more personalized approaches to cooperate and engage parents in the process participation.

Differences Related to Degree of Severity of Child’s Disability

One-way ANOVA was used to determine differences, if any, among these three groups related to knowledge of practices, communication, commitment, equality, and trust and respect. The statistical findings do not confirm that the disability severity has a connection with parents’ ability to make decisions and collaborate with clinicians. It is suggested that disability severity also does not affect the level of awareness and degree of participation. As a result, parents are driven by the importance of treatment and intervention rather than disability characteristics or types of disability.

Nonetheless, it can be admitted that the trust and respect variable indicates the lowest significance p=.122. In this instance, there is a possibility that the disability severity may have an impact on the perception of information and decisions during the early intervention (Hakyemez, 2015). While the statistical test confirms the absence of significant correlations and dependencies, it can be proposed that the disability severity impact parents’ behavior and perception of the situation.

Parents may seek more information and details if the disease is more severe than it is expected. In this case, they may search and demand more information, features, and explanations from the professionals if parents do not find any assistance or active engagement from the medical personnel to convince them and guide regarding the early intervention (Biersteker & Kvalsvik, 2019). As a result, the levels of trust and respect can be distorted, and parents will search for alternatives to fulfill their demands or find more appropriate intervention programs. Nonetheless, a more in-depth analysis is needed to test whether the trust and respect regarding disability severity can affect parents’ behavior and their decision-making approach toward the early intervention programs, medical facilities, and professionals.

Differences Related to Type of Early Intervention Center

One-way ANOVA was conducted to identify the differences between the three situations, which were: government-run early intervention center, private early intervention center, and no intervention center. The variables were: knowledge of practices, communication, commitment, equality, and trust and respect. The obtained results indicate the absence of significant dependencies between intervention center type and parents’ collaboration with professionals. What is more, the statistical test reveals that the most impact has practices and techniques used by the healthcare facilities rather than their belongingness to governmental, private, or non-intervention center’s type (Majoko, 2017). In this case, the focus should be done on how the medical personnel communicates with parents, build relations, and represent competencies and qualifications to convince parents in the quality and efficiency of the proposed early intervention programs.

The theory of quality management proposes to study quality in the system of medical care according to 8 characteristics: professional competence, accessibility, cost-effectiveness, personal relationships, efficiency, continuity and consistency, safety, convenience:

1. Professional competence is determined by the level of skills and competencies that are realized in the process of activity of people who provide medical services in the activities of management and support staff.
2. The availability of medical care shall be assessed to the extent that medical care can be provided without interruption, regardless of geographical, economic, social, cultural, organizational, or linguistic factors.
3. Effectiveness is the extent to which the patient’s treatment contributes to the improvement of his condition or the desired result.
4. Personal relationships are about the quality of the interaction between service providers and consumers, management and care providers, health care providers, and residents.
5. Cost-effectiveness is determined by the ratio between the need for service and existing resources to assist. Efficiency is achieved by providing the optimum amount of health care to the population, which is the highest quality assistance that can be made with the resources available.
6. Continuity and consistency reflect the extent to which the patient receives the care he or she requires without interruption, interruption, or unnecessary repetition of examinations or treatment.
7. Safety is determined by the extent to which the health care system reduces the risk of injury, infection, adverse events, or other losses in the care delivery process.
8. Convenience is a characteristic of health care that does not directly relate to clinical efficacy but may have a positive effect on the patient’s level of satisfaction with the quality of care. Comfort is determined by the appearance and cleanliness of the premises used, equipment, and staff, as well as comfort and convenience measures.

Health care quality assurance activities may address one or more of the characteristics in this list that help identify the framework within which expert teams work in analyzing quality issues and assessing the degree of compliance. The eight components above selected based on literature analysis and synthesis of ideas from quality assurance experts (Mereoiu, Abercrombie, & Murray, 2016). Each of these characteristics should be considered the specific program and the local context. They all relate to both the clinical and organizational aspects of care delivery and support services.

Professional competence involves the appropriate skills and knowledge and direct day-to-day work of health care professionals and support staff. That is, to ensure the quality of occupational health care, POP staff must first and foremost have a high-quality, up-to-date education and an appropriate level of practical experience that enables them to perform specific tasks consistently and accurately. Professional competence reflects how well the health care provider adheres to clinical protocols and standards

Reliability, neatness, and consistency include clinical skills in the diagnosis, treatment, and prevention of diseases, as well as medical knowledge, the art of establishing the right diagnosis, healing the patient. For example, the professional skills of a specialist include the following professional traits: violations that deserve further attention; collect focused patient analysis, discussing in detail situations and episodes directly relevant to occupational and differential diagnoses; make effective use of interview time; when surveying systems, focus on those symptoms that may provide information about risk factors and guide diagnostic testing; to adapt the examination methodology to the circumstances, the patient’s condition and the time available, paying particular attention to the abnormalities evidenced by the disease; During the examination, to act methodically correctly and effectively, to be able to relax the patient and to establish with him informative contact, showing attention to the human dignity, age, physical and psycho-emotional state, cultural and religious characteristics of patients, avoiding pain or other unpleasant feelings during manipulation; and also to wash hands before and after inspection. Particular attention should be paid to the correct interpretation of the data and physical examination, considering the clinical features of the patient when making a list of his or her health-related problems, formulating the most likely and differential diagnoses (Barrett, Flynn, & Welch, 2018). The competence of a manager is first and foremost about the ability to make optimal decisions about urgent issues and to manage effectively. Lack of expertise can lead to a variety of consequences: from minor deviations from the standard to severe errors that reduce the effectiveness of treatment or even endanger the health and life of the patient.

Limitations of the Study

There were several limitations in this study, both in the quantitative and qualitative results, that should be mentioned.

Quantitative limitations

The participants of this study were not randomly selected and participation in the online survey was voluntary. In addition, the participation in this study was limited to parents of young children with disabilities in Saudi Arabia. Surveys were completed by (n=272) individuals (out of 900). 72.1% of the respondents were females with total of 196 respondents and 27.9% of the respondents were male with a total of 76 respondents. Female participation was higher, perhaps due the motherhood as several cultural stereotypes suggest that mothers take care of children more than fathers. Also, male frequency was lower, perhaps due to their duties outside of home. Also, regarding to the participation it took six weeks to reach the minimum of sample size that determined according to the power analysis. It was worth to reaching the smallest sample size because it is important to detect the effect of a given test at the anticipated level of significance.

As any survey, the findings of this study might be subject to certain response biases. Respondents may have preferred to overreport their knowledge of practices if they believed this was a socially desirable way of responding. To reduce social desirability bias, the researcher ensured all participants that their responses were anonymous and reported. The results would not harm the respondents. The respondents reported a fairly high rate of knowledge of practices, it seems unlikely that social desirability bias was a significant problem in the findings. However, it is not possible to eliminate the possibility if it is exciting or not.

Another limitation was the survey delivery method. The survey was administered via Qualtrics (online survey management). Generalizability is also limited because of the delivery method. The participants of this study were limited to who had an internet connection. Conclusions drawn from this study may not be applied to other settings or other samples of parents. Also, the survey was translated from English to Arabic. It is possible that respondents may have misinterpreted some items due to language differences or unfamiliarity with some of the terms that used in the survey.

Finally, in terms that used in survey, the study used new terms and concepts (e.g., parents of young children perception about collaboration), which may have been misinterpreted to respondents. Respondents might have faced some difficulty to understand the definition of collaboration. In addition, this study was focused on specific aspects of collaboration and the results may not be broadly applicable to all elements that are related to collaboration in early childhood special education in Saudi Arabia.

Qualitative limitations

The researcher interviewed six parents of young children with disabilities who voluntarily participated in the survey as well. The interviews were done using FaceTime and Google voice, iPhone Apps. One of the most important limitations of the qualitative phase was the distance between interviewer and interviewees. Long-distance interview include difficulty in communicating with parents (e.g., time difference), and the expense (few of the parents had FaceTime). Face to face interview has many advantages specially to understand interviewees expressions and that lead to better interaction and more accurate screening. Also, an important limitation of the qualitative phase was the small sample size. The interview results cannot represent all parents of young children with disabilities in Saudi Arabia. Sometimes, respondents misinterpreted the guided questions that used in the interview. Finally, the questions may not have been appropriate to the educational level of all the parents.

Implications for Practice

This study investigated the perceptions of parents of young children with disabilities in Saudi Arabia. In addition, the interview was conducted with six parents to elaborate and examined perceptions of Saudi parents regarding collaboration including cultural affects, promotors, and hinders that the parents face when they collaborate with professionals provide early childhood special education services.

The results indicated that at the level of individual parents reported their perceptions about collaboration with professionals in early childhood special education centers in Saudi Arabia. Furthermore, respondents identified that commitment, trust and respect skills that professionals’ practice are the lowest variables in collaboration. It appears that professionals are, on the whole, not receiving additional training on how to collaborate with families. This is a significant issue that centers, and institutions will need to address in order to ensure that professionals are receiving the highest possible quality training services to raise the skills of commitment and be a source of trust for the families. This study found in the qualitative phase, parents want the professionals to be more trained in how they deal with families. One of the recommended practices in this study is to raise the professionals’ knowledge on how to collaborate with families by showing good commitment skills and get families’ trust and respect.

Finally, parents in the interview mentioned that the families’ role about collaboration is not clear enough. Respondents felt unprepared enough to practice collaboration effectively. The quantitative and qualitative results yielded some contradiction regarding knowledge of practices. In the survey, the parents reported their knowledge of practice perception as the highest variable in the survey mean [4.31, (SD=.65)]. However, there were several issues that reported in the interview regarding parents’ knowledge of practices of collaboration. Parents should receive more sessions to rise their awareness about disabilities in general and how to collaborate with professionals to help the children with disabilities. It is suggested that the Saudi Ministry of Education, centers of early childhood special education, policy makers, and professionals to prepare the families for long life with children with disabilities. The parents need support in the early stages that help families to improve the abilities of children by collaborating with professionals to provide better services.

Recommendations for Future Research

Several directions for future research have been indicated as a result of the findings of this study. Most importantly, researchers should keep investigating more about families of young children with disabilities in Saudi Arabia. Research have shown that how families’ role in early childhood special education result in positive outcomes for students with disabilities. To date, few researches had been implemented on the nature of existing in Saudi Arabia. There are not a lot of studies supporting the practices for children and families of early childhood special education programs. In addition, more researches are needed to be conducted in Saudi Arabia to elaborate, explain, and confirm the finding of this study regarding the families’ perceptions.

Additionally, this study aimed to investigate the families’ perceptions toward collaboration. Investigating the perception with a few carefully selected survey items and then conducting interviews (explanatory sequential design mixed method) with families. The interviews’ limitations are based on the quantitative findings. Direction for future research should explore families’ perceptions with more detail and no boundaries using qualitative research designs directly with no survey. The benefit of qualitative design would expose detailed information from parents regarding collaboration in early childhood special education in Saudi Arabia. Investigating deeper and understanding of what recommendations for families are, hinders might lead to improving the services that provided to their children with disabilities.

Finally, the targeted population of this study were parents of children with disabilities in Saudi Arabia. There are several researches implemented in Saudi Arabia and professionals were the participants in those studies. However, there is no research to date has been found that aimed to investigate professionals’ perceptions regarding collaboration with parents of young children with disabilities. Therefore, more research is needed to connect professionals and parents’ expectations to better practices in early childhood special education in Saudi Arabia. Professionals are essential in general and to even to confirm the findings of this study by understanding both sides perceptions toward collaboration.

Conclusion

Thus, parents’ communication and collaboration characteristics impose specific requirements on the collaboration process and perception of the early intervention program, but at the same, time “temper” them in discussion with professionals. These problems require considerable knowledge in the field of psychology in dealing with parents and their intentions to control and intervene in the treatment processes. As a result, clinicians should evaluate the communication situation, identify their mistakes, and look at possible issues. In other words, a professional can already transform theoretical knowledge of communication problems into practical skills and be prepared for various disputes and debates about details and peculiarities of the proposed intervention strategies. Another direction of such work might assist clinicians in resolving the most common conflict episodes that require a doctor’s active position to address it.

Adequate training on the basics of parents-professionals communication should exist and be mandatory for the medical personnel in the early intervention centers. However, for specialists in the field of early intervention, training programs are only possible in non-compulsory subject improvement courses. Therefore, the ability to communicate with parents should be considered a necessary professional competence of the intervention centers’ personnel. The professionalism of the doctor is assessed not only by the amount of specialized knowledge and skills but also by the personal qualities of the ethics-deontological plan. Difficulties in the relationship between parents and professionals, the presence of conflict situations due to the communicative illiteracy of both parties make it necessary to adjust intervention programs and collaboration expertise requirements.

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