Language Sample Analysis in Clinical Practice: Speech-Language Pathologists' Barriers, Facilitators, and Needs.

Inge S Klatte,Vera Van Heugten,Rob Zwitserlood,Ellen Gerrits

doi:10.1044/2021_lshss-21-00026

Abstract

Most speech-language pathologists (SLPs) working with children with developmental language disorder (DLD) do not perform language sample analysis (LSA) on a regular basis, although they do regard LSA as highly informative for goal setting and evaluating grammatical therapy. The primary aim of this study was to identify facilitators, barriers, and needs related to performing LSA by Dutch SLPs working with children with DLD. The secondary aim was to investigate whether a training would change the actual performance of LSA. A focus group with 11 SLPs working in Dutch speech-language pathology practices was conducted. Barriers, facilitators, and needs were identified using thematic analysis and categorized using the theoretical domain framework. To address the barriers, a training was developed using software program CLAN. Changes in barriers and use of LSA were evaluated with a survey sent to participants before, directly after, and 3 months posttraining. The barriers reported in the focus group were SLPs' lack of knowledge and skills, time investment, negative beliefs about their capabilities, differences in beliefs about their professional role, and no reimbursement from health insurance companies. Posttraining survey results revealed that LSA was not performed more often in daily practice. Using CLAN was not the solution according to participating SLPs. Time investment remained a huge barrier. A training in performing LSA did not resolve the time investment barrier experienced by SLPs. User-friendly software, developed in codesign with SLPs might provide a solution. For the short-term, shorter samples, preferably from narrative tasks, should be considered.

Highlights

Most speech-language pathologists (SLPs) working with children with developmental language disorder (DLD) do not perform language sample analysis (LSA) on a regular basis, they do regard LSA as highly informative for goal setting and evaluating grammatical therapy
The LSA training was evaluated with an online survey before, directly after, and 3 months posttraining
Step 1: Identify What Needs to Change SLPs shared information about facilitators referring to six domains and barriers referring to seven of the 14 domains of the theoretical domain framework (TDF)

Summary

Introduction

Most speech-language pathologists (SLPs) working with children with developmental language disorder (DLD) do not perform language sample analysis (LSA) on a regular basis, they do regard LSA as highly informative for goal setting and evaluating grammatical therapy. Standardized language tests mostly tap into separate domains and were never designed to set Disclosure: The authors have declared that no competing financial or nonfinancial interests existed at the time of publication Because of all these advantages, LSA is considered best practice (Heilmann, Miller, et al, 2010; Price et al, 2010) or even the gold standard to identify gaps in children’s use of grammar for setting therapy goals and to evaluate grammatical therapy (Heilmann, 2010; Overton & Wren, 2014). The question arises why SLPs do not use LSA regularly (Heilmann, 2010; Kemp & Klee, 1997; Overton & Wren, 2014; Pavelko et al, 2016) they recognize its many advantages

Objectives

Methods

Results

Conclusion