Acceptability of a word encoding intervention for children with Developmental Language Disorder: A qualitative exploration through the theoretical framework of acceptability

Intervention studies for children with developmental language disorder (DLD) often focus on effectiveness without considering the impact on the target population. When acceptability is addressed, parents’ perspectives are prioritized due to methodological challenges in interviewing children. This study investigates the acceptability of a word-encoding intervention, previously evaluated using a single-case experimental design (SCED), by integrating views of children, parents, and teachers. Five children, four parents, and one teacher who participated in the SCED study completed semi-structured interviews. Acceptability was assessed using the domains of the Theoretical Framework of Acceptability. Parents’ and the teacher's responses were analysed using qualitative framework analysis. Multi-modal responses from the children were synthesised and described. Overall, participants viewed the intervention positively. All participants considered the intervention ethical. Parents reported a range of benefits, including gains in untargeted domains, while children had limited awareness of their progress or the intervention's purpose. For parents, perceived burden and cost were influenced by the setting (school vs. clinic). Children found sessions enjoyable but those in school caused some disruption. Parents’ understanding of the intervention was influenced by whether they attended sessions; similarly, the teacher, who did not attend, had limited understanding. Insights from multiple stakeholders highlighted key considerations for researchers designing and clinicians selecting interventions. Dosage should be sustainable for children; school-based delivery may improve accessibility and reduce parental costs but can disrupt participation. Clear communication between researchers and stakeholders is essential to ensure shared understanding of goals and outcomes.