Calibrating expertise: Situated learning in family-centred early intervention for childhood-onset disability

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.