Our study explores situated learning between parents and therapists within early years community physiotherapy for infants and young children with disability. Early physiotherapy supports parents with treatment planning and translation of therapeutic principles into family routines, to optimise child development during a critical period. Family-centred care principles are central to this practice context yet observing how learning is socially organised has rarely been undertaken and new understandings of these interactions could enhance praxis. We used novel methodology for this setting. Video case studies involving the triadic relationship of parent, child and physiotherapist were analysed using multimodal conversation analysis. Interview data supplemented analysis. We observed a recurring interactional structure. Shared observations of the child's sensorimotor behaviour elicit reflective responses from the other adult, which are built upon to provide summative feedback. Interactions vary according to relational and interactional dynamics in sessions. Our synthesis connects these findings with dialogue-based education theory and Goodwin's understanding of cooperative organisation in knowledge construction. The study highlights how shared observations, if reciprocated, play a key role in collaborative learning by bridging differential knowledge, supporting therapeutic interventions, and recognising the parent's role in treatment direction-key principles of family-centred care.

ABSTRACT Introduction This study explores the ‘peripandemic’ implementation of synchronous videoconference calls during COVID‐19 for delivering physiotherapy early intervention services to families of infants with childhood‐onset disability. The interactional experience of conducting early intervention through videoconference calls is under researched. We aimed to understand parents' and therapists' experiences of communication and learning within early intervention sessions for infants with cerebral palsy conducted via video conference calls. Methods Data were collected through interviews, video case studies and focus groups involving 15 parents and 16 therapists. We used qualitative analytical methods inspired by grounded theory and multimodality. Results Undertaking early intervention sessions via synchronous videoconference calls creates complexities and disrupts communication norms between parent, therapist and infant. These audio‐visual constraints have implications for developing shared understanding and learning. Resolving these challenges necessitated increased interactive work within the parent–therapist partnership. The onus placed on parents to have additional logistical roles in some circumstances created strain, which diverted attention from optimal learning. Conclusion The post‐pandemic healthcare landscape pushes for digital innovation challenging traditional therapy models. Our contribution outlines that while videoconference calls may improve efficiency, they also add cognitive load and interaction challenges, which require modification to routine in‐person session designs. We provide recommendations for adaptive implementation strategies for videoconference calls that will benefit from further iterative codesign cycles. Public and Patient Contribution We partnered with parents through public and patient involvement. Parents (n = 9) who were previous NHS early intervention service users formed the Parent Advisory Group (PAG). These parent partners came from a variety of backgrounds and provided their unique perspectives to directly contribute and guide decision‐making throughout the project. Their contribution influenced approach to recruitment and consent; the participant information and consent form development; topic guide development; considerations of the use of video in the project design and sense checking of analytical interpretations.

This article explores the multimodal assessment practices of teachers in a vocationally oriented filmmaking course, specifically identifying the principles guiding the assessment of students' post-production work. The study addresses the question, according to what principles do teachers assess students' film post-production choices and expressions? Although there is previous research into assessment of multimodal text across different subjects, it is yet not fully understood how multimodal assessment plays out in practice in vocationally oriented media education, where media artefacts (or 'products') become the ultimate expression of competence. Utilising a multimodal social semiotic framework, the qualitative analysis of teacher interviews, documents, and artefacts identifies four assessment principles: composition of text, text-making process, alignment with institution, and alignment with profession. Tensions emerge between the syllabus, emphasising practical/technical skills, and teachers' assessments, which also take into account aesthetic dimensions of filmmaking.

This chapter provides a rationale for a multimodal perspective on meaning, communication and discourse. It draws attention to the range of different modes that people use beyond speech and writing and explores the theoretical and methodological implications of multimodality. The chapter addresses two key questions. First, what is multimodality? Why and how is it relevant to linguistics? Second, how has multimodality been taken up? What questions are addressed, what materials are collected, and what methods are used to analyze these materials? Taking one approach – Social Semiotics – and one area of research – online text making – as an example, the chapter defines and illustrates key concepts and steps in multimodal inquiry. It concludes with consideration of future directions.

Children who use augmentative and alternative communication (AAC) are multimodal communicators. However, in classroom interactions involving children and staff, achieving mutual understanding and accomplishing task-oriented goals by attending to the child's unaided AAC can be challenging. This study draws on excerpts of video recordings of interactions in a classroom for 6-9-year-old children who used AAC to explore how three child participants used the range of multimodal resources available to them - vocal, movement-based, and gestural, technological, temporal - to shape (and to some degree, co-control) classroom interactions. Our research was concerned with examining achievements and problems in establishing a sense of common ground and the realization of child agency. Through detailed multimodal analysis, this paper renders visible different types of practices rejecting a request for clarification, drawing new parties into a conversation, disrupting whole-class teacher talk-through which the children in the study voiced themselves in persuasive ways. It concludes by suggesting that multimodal accounts paint a more nuanced picture of children's resourcefulness and conversational asymmetry that highlights children's agency amidst material, semiotic, and institutional constraints.

This paper presents a conceptual analysis and critical review of the notion of 'affordance' and its uptake, transformation and application in the work of Gunther Kress. It traces its origins and explores how Kress, co-founder of social semiotics, (re)conceptualised affordance and incorporated it in his social semiotic theory of sign making, defining affordance in terms of the "potentials and limitations of specific modes". The paper discusses how his take on the term was received, and develops a radical critique questioning the analytical merits of affordance. It concludes with a call for a return to Kress's original question of exactly what it is about a form (signifier) that makes it suitable, in the eyes of the sign maker, for what they want to express (signified), and to consider materiality and social convention alongside the sign maker's lifeworld, audience, situation, and conditions of sign making.

This chapter outlines a theoretical framework to account for practices of meaning making in health care and sets out an agenda for clinical educational research. It shows how meaning making pervades all aspects of clinical work and how it can be explored and made explicit within a framework derived from social semiotics. The chapter illustrates how the framework produces accounts of the ways in which clinicians make sense of and interact with the world, in situations where they give, review, and imagine care. It explores how clinicians interpret, and communicate through, human bodies, tools, and technologies, giving meaning to, and expressing meaning through, distinct material forms. In so doing, the chapter begins to render visible the semiotic skills that clinicians develop to prepare for, provide, and evaluate clinical care.

BackgroundEarly intervention occupational and physiotherapy aims to capitalise upon innate infant neuroplasticity to ameliorate the functional impact of early brain lesions causing cerebral palsy. Contemporary early intervention has encouraged increased parental engagement. However, parents’ perspectives on their engagement in early intervention are lacking. The‘Optimise EI Study’ research project explores parental perspectives of engagement and aims to inform early intervention approaches. One category of data will be presented relating to parental perceptions of the neuroplasticity discourse and its impact on their engagement and self-concept.MethodsQualitative grounded theory methodology informs the data collection and analysis. Twenty parents participated in 28 in-depth interviews, lasting 1-3 hours.ResultsParents transition from framing their engagement through uncertainty into a more focused ‘pursuit’ frame following the shock of an early predictive diagnosis of cerebral palsy. At this time, parents invest themselves intensively in early intervention while feeling a sense of accountability pressure. In particular, parental interaction with the neuroplasticity evidence discourse becomes formative in their transition and engagement. Neuroplasticity provides significant hope and motivation for parents, which drives an intensive pursuit to improve their child’s outcomes through their engagement in EI. However, parents also expressed feeling pressure, ‘like a sand timer, you feel time is running out’. This phenomenon creates tension for parents where their intensive engagement in ‘doing’ more early intervention physical therapy can begin to influence their well-being and shapes their parental identity development.ConclusionThe tension parents experience between hope in early intervention neuroplasticity evidence discourse against the sense of time pressure and intensive investment of themselves in ‘doing’, can negatively influence their parental identity development and well-being. Greater professional awareness of this phenomenon is required to offer holistic support to parents while avoiding additional pressure and stress

IntroductionA workplace-based assessment (WBA) is a learning recording device that is widely used in medical education globally. Although entrenched in medical curricula, and despite a substantial body of literature exploring them, it is not yet fully understood how WBAs play out in practice. Adopting a constructivist standpoint, we examine these assessments, in the workplace, using principles based upon naturalist inquiry, drawing from a theoretical framework based on Goffman's dramaturgical analogy for the presentation of self, and using qualitative research methods to articulate what is happening as learners complete them. MethodsLearners were voluntarily recruited to participate in the study from a single teaching hospital. Data were generated, in-situ, through observations with field notes and audiovisual recording of WBAs, along with accompanying interviews with learners. ResultsData from six learners was analysed to reveal a set of general principles-the WBA playbook. These four principles were tacit, unwritten, unofficial and learners applied them to complete their WBA proformas: (1) maintain the impression of progression, (2) manage the authenticity of the individual proforma, (3) avoid losing face with the assessor and (4) complete the proforma in an effort-efficient way. By adhering to these principles, learners expressed their understanding of their social position in their world at that time the documents were created. DiscussionThis paper recognises the value of the WBA as a lived experience, and of the WBA document as a social space, where learners engage in a social performance before the readers of the proforma. Such an interpretation better represents what happens as learners undergo and record WBAs in the real-world, recognising WBAs as learner-centred, learner-driven, meaning-making phenomena. In this way, as a record of interpretation and meanings, the subjective nature of the WBA process is a strength to be harnessed, rather than a weakness to be glossed over.

The history of discourse analysis is beset by a vagueness around the homonym ‘discourse’. The term names a large territory, located somewhere between two ‘markers’, which might, generally speaking, be something like ‘providing accounts of connected stretches of language in use’ and ‘uncovering salient social, political, psychological features in text-like entities’. In sociolinguistics, by and large, the major emphasis has been on understanding the link between (environments of) language use and (features of) the language used (Hymes, 1964; Labov, 1966, 1972; Bernstein, 1984). In such work, ‘the social’ and its meanings and effects are foregrounded: who speaks, to whom, when, with what purposes, in what ways. These factors and the purposes leave traces – whether the details of pronunciation in Labov’s early work or the regularity of use of a certain range of linguistic resources, leading to the development of the notion of ‘codes’ in Bernstein’s theory.

Background The adoption of video calls during the pandemic is seen as an innovation opportunity in early intervention occupational and physiotherapy delivery for infants with cerebral palsy. The aim of this work is to explore parent and therapist perspectives of communication and learning in early intervention via video calls, and co-produce knowledge for guidance of telehealth service delivery. Methods Data were taken from the larger ‘Optimise EI’ study. Data collection commenced prior to the pandemic. The flexibility of grounded theory methods enabled the exploration of parent and therapist engagement via video calls as it occurred naturalistically. Data are drawn from interviews (n=30) and focus groups (n=2) involving 14 parents and 15 therapists, and including two video cases, where multimodal interaction analysis was also undertaken. Results Parents reported increased engagement challenges relating to communication and learning due to interaction complexities via video calls. Video calls removed certain communication modes meaning that other modes were amplified to compensate. For example, parents were required to perform supplementary commentary while enacting therapeutic play with their child for the observing therapist. Visual information on video calls is critical for effective communication and learning because accurate interpretation is needed to undertake embodied actions. The simultaneous responsibility on parents to direct the camera while conducting the therapeutic activities created a particular challenge for visual interpretation. Camera positioning required constant parent awareness and decision making to accommodate the therapist’s visual perspective to ensure ongoing shared understanding of events. Traditional therapist-parent roles were disrupted by video calls. Positively, parents were more actively involved. Yet, parents reflected that the higher logistical requirements, in enhanced performative roles as ‘Actor-Directors’, detracted from their learning. Conclusion This research outlines the challenges that parents and therapists face to collaborative learning via video calls, which needs further consideration to optimise the potential of this format.