Current practices, supports, and challenges in speech-language pathology service provision for autistic preschoolers

Binns, A.V., Cunningham, B. J., Andres, A., & Oram Cardy, J. (2022). Current practices, supports, and challenges in speech-language pathology service provision for autistic preschoolers. Autism & Developmental Language Impairments, 7, 23969415221120768–23969415221120768. https://doi.org/10.1177/23969415221120768

    Speech-language pathology services are one of the most frequently accessed services for autistic preschoolers. In Ontario, this service is mostly accessed through the Preschool Speech and Language Program. Capturing current speech-language pathology practices used with autistic preschoolers as well as supports and challenges is needed to inform research and clinical decisions about the program.

    In this study, 258 clinicians including speech-language pathologists (SLPs) and communication disorders assistants (CDAs) were surveyed on their experiences of delivering services to autistic preschool children and their family. Results were as follows:

• Assessment – SLPs used a variety of assessment tools (3-4 per assessment) to primarily evaluate four skills: prelinguistic skills (e.g., joint attention, nonverbal skills), language, play, and pragmatics (social use of language)
• Intervention – Clinicians provided services to about 23 children per month, with 39% of their caseload being children with suspected or diagnosed autism. Therapy goals aligned with the four areas assessed. Although therapy tended to be caregiver training, up to 26 unique therapy programs were reported. In addition, there was no difference in reported practice for children with suspected or diagnosed autism
• Facilitators – At the individual level, having professional development in e.g., caregiver training, ADOS training, and learning about regulation and sensory processing facilitated practice. At the program level, being able to collaborate with other professionals and access to supports (e.g., CDAs) were ranked highly
• Barriers – At the individual level, challenges included access to professional development and counseling families. At the program level, managing caseload (number of clients for whom therapy is provided) and workload (other activities such as documentation and meetings) and community messaging (undervaluing speech-language pathology services in favour of ABA) were ranked as challenges

    Overall, the findings revealed variability in speech-language pathology practices used with autistic preschoolers, highlighting a need to establish and promote equity in services. Our lab aims to initiate a similar line of research by capturing current practices in school-board speech-language pathology services.

Blogger: Theresa Pham is a Postdoctoral Associate working with Drs. Lisa Archibald and Janis Cardy.