JCPSLP July 2014_Vol16_no2

Responses were collated and frequencies for each item are presented in the following section. Results Tables 1, 2 and 3 show the results obtained for questions about treating (C)APD contained in the survey. The Appendix shows the results for questions not reported in these tables. The questions and response options have been presented in a shortened form to save space. The full questionnaire and its results are available from the authors on request. Discussion This study provides preliminary data on how SLPs in Queensland, Australia, are treating CAPD. Nearly half of all SLPs in this study reported their treatment does not change if a child receives a diagnosis of (C)APD. This could have been influenced by at least two other findings. First, only 15% of clinicians who treat children with (C)APD reported seeing children without language and literacy difficulties. High rates of (C)APD coexisting with other disorders has previously been reported (Sharma et al., 2009). Second, while just over half of the clinicians favoured a combined approach to treating these children, 79% reported their most used approach was to treat language/literacy in these children. This approach is supported by recent evidence- based reviews which have found that although some direct auditory treatments may have positive outcomes on specific measures of auditory processing, these types of treatments do not lead to enhanced outcomes for either language or literacy (Fey et al., 2011; Wilson & Arnott, 2012). Overall, the present study’s results confirm that Queensland SLPs who work with children with (C)APD generally use a combination of direct treatment, compensatory strategies, and environmental modifications, an approach advocated by ASHA (2005) and Ferre (2006). With respect to direct treatments, consistent with recent recommendations in the literature (Fey et al., 2011; Kamhi, 2011; Wallach, 2011), SLPs overwhelmingly favour language and literacy treatments over auditory treatments with this client group. The most popular language interventions, employed by at least 90% of respondents, were individualised language- based treatments and phonological awareness training. Further, clinicians’ ratings indicated they felt that both of these treatment approaches were effective in remediating auditory processing, language, literacy, and academic skills. The least popular language treatments were prosody training and commercially available auditory/linguistics computer software programs, being used by just 12% and 32% of respondents, respectively. Interestingly, while only nine clinicians indicated that they used computer software programs, all nine chose to use the Earobics program (Cognitive Concepts, 1997). Emanuel et al. (2011) reported that Earobics was recommended for (C)APD by 70% of their sampled audiologists in the United States, while recent reviews into the effectiveness of a range of interventions for (C)APD have proposed that there is only some weak evidence that Earobics improves auditory processing and phonological awareness skills in school-age children with (C)APD, with or without spoken language, reading, or learning difficulties (Wilson & Arnott, 2012). With respect to the direct auditory treatments examined, simple speech auditory training (e.g., phoneme discrimination) was the most popular, being employed by 65% of respondents with more clinicians indicating that it was effective than not effective in improving all skill areas: auditory processing, language, literacy, and academic skills. Phoneme training has been recommended for (C)APD by more than 50% of sampled audiologists in the United

an email inviting those working with school-aged children with (C)APD to participate in an online survey. The email contained a link to an information sheet and a request for consent to participate in the study and access the survey. Seventy-one SLPs consented to participate in the study. Eleven of these participants either did not answer any of the survey questions or only responded to items requesting demographic information and so, their data were removed from analysis. Of the remaining 60 participants (4% of all SLPs registered in Queensland), 45 (75%) completed the survey, and the remainder omitted responses to some items. As a result, many questions had a response rate lower than 60. A decision was made to include the responses of participants who did not complete the entire survey as their responses offered useful information. The limitation of having only a small number of responses for some questions is, however, acknowledged. Of the SLPs in Queensland who completed parts or all of the survey, the majority (40/60, 67%) indicated they held a Bachelors qualification in speech pathology, had practised as an SLP for >10 years (32/60), work in private practice or schools (53/58, 91%), work in Brisbane (33/56, 60%), work >30 hours per week (39/60, 65%), and have between 1% and 20% of their caseload in (C)APD (48/58, 83%). Just over half of the participants felt their university training in (C)APD did not adequately prepare them for managing cases of (C)APD (31/60, 52%), and a third (20/60, 33%) had been practising SLPs for more than 20 years. The majority of participants favoured a definition of (C)APD that emphasised difficulties processing basic acoustic information (i.e., sound) with potential flow-on effects to phonological and linguistic processing (36/58, 62%). Finally, the majority of participants reported adequate or better knowledge of what (C)APD is (50/58, 86%) and of the diagnostic tests used to assess for (C)APD (38/58, 66%). Knowledge of evidence-based treatments for (C)APD was lower (32/59, 54%). The raw data describing the participants is contained in the appendix of the first article (Arnott, Henning & Wilson, 2014) in this two article series. Procedure The questionnaire was based on Emanuel et al. (2011) and included 72 items involving single and multiple responses, ratings scales, and open-response questions. SurveyMonkey™ online survey software (http://www. surveymonkey.com) was used to deliver the questionnaire which remained “live” for four weeks during which time respondents were able to complete the survey only once. A reminder email was sent two weeks after the initial email had been sent. The questionnaire had been piloted with three SLPs serving as clinical educators within the home school of the researchers. Each of these educators had at least one year’s experience working with children with (C)APD in that school’s speech pathology clinics. As a result of the pilot, minor changes were made to the content, formatting and timing of the questionnaire, and Fey et al.’s (2011) descriptions of direct auditory treatments and direct language and literacy treatments (as described in the introduction) were added to the relevant parts of the survey. On completing the final questionnaire, not all participants were asked every question, as some items were skipped depending on how the participant responded to a previous question. There were 47 items designed to gather information about respondents’ approaches to treating (C)APD. These are the focus of the current paper. The remaining 25 items pertained to respondents’ demographics, understanding of (C)APD, and screening and assessment procedures and are reported elsewhere (Arnott, Henning & Wilson, 2014).

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JCPSLP Volume 16, Number 2 2014

Journal of Clinical Practice in Speech-Language Pathology