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Barriers and Facilitators to School Speech-Language Pathologists’ Identification of Developmental Language Disorders in Kindergarten Children
Sultani, Mollee
Sultani, Mollee
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Abstract
Purpose. Few children with developmental language disorder (DLD) are identified by speech-language pathologists (SLPs) in kindergarten (Tomblin et al., 1997a). Currently, no studies have examined SLPs’ practice in this area. Implementation science frameworks like the Theoretical Domains Framework (TDF, Cane et al., 2012) may help identify potential strategies for changing practice. The purpose of this study was to examine and explain school SLPs’ practices for identifying children with DLD in kindergarten and to identify strategies and research priorities to increase early identification of DLD. Method. An explanatory sequential mixed methods design with two phases was used. In the first phase, quantitative data from a survey on SLPs’ language identification practices and ratings of TDF domains (i.e., barriers and facilitators) was collected. In the second phase, quantitative results were used to select participants for qualitative semi-structured interviews on SLPs’ current practice and the barriers and facilitators they face when identifying children with DLD. Results. The quantitative results from the survey showed that SLPs most often learn about students’ language weaknesses through teacher report and least often through universal language screenings. Potential facilitators to screening for DLD identified by the survey included SLPs’ skills and knowledge related to language screening and their belief that identifying language concerns would benefit students’ educational progress (TDF areas of skills, knowledge, and beliefs about consequences). Potential barriers included SLPs’ intentions to screen for DLD, perceived difficulty of screening, and available resources and administrative support for screening (TDF areas of intentions, beliefs about capabilities, and environmental context and resources). The qualitative results from the interviews generally aligned with the survey results. In addition, interviewed SLPs described their preferences for improving existing screening methods through improving teacher referral, accounting for the effect of school experience on language screening, and using more naturalistic screening tasks. The results suggested that external barriers related to available screening methods and workplace pressures make it difficult for SLPs to complete thorough screening for DLD in kindergarten children. Conclusion. Additional research that focuses on modifying or combining existing screening methods is needed to lay a stronger foundation for implementing early identification of DLD. Broad policy changes related to school SLPs’ workload and practice context are needed to support SLPs in early identification of DLD.
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Date
2022-08-31
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University of Kansas
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Keywords
Speech therapy, developmental language disorder, implementation science, language, mixed methods, screening, speech-language pathology