JCPSLP
Volume 16, Number 2 2014
67
(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.
In 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 25 items designed to
gather information about respondents’ demographics,
understanding of (C)APD, and screening and assessment
procedures. These are the focus of the current paper.
The remaining 47 items pertained to specific treatment
approaches and are reported elsewhere (Arnott, Henning &
Wilson, 2014).
Results
The results obtained for questions about the respondents’
demographics, understanding of (C)APD, and screening
and assessment procedures in the survey are displayed in
Table 1 while the results for questions not reported in this
table are provided in the Appendix. In this and the second
paper in this series, the questions and response options
have been presented in a shortened form, however, the full
questionnaire and its results are available from the authors
on request.
Discussion
More SLPs (61.4%) identified with a bottom-up model of
(C)APD in which lower order auditory deficits underlie higher
order listening, language, and learning problems than with a
top-down model that holds that (C)APD and language/
literacy problems can coexist but are not causally related
(26.3%). This finding is somewhat consistent with ASHA
(2005) adopting a predominantly bottom-up approach to
(C)APD but stating it can coexist with top-down deficits in
cognition and language. It contrasts somewhat against
other approaches such as the British Society of Audiology
(2011), however, which claim there is no evidence to
support the assertion that (C)APD results primarily from
impaired bottom-up processing in the auditory system.
Nearly two-thirds of the SLPs (60%) routinely referred
a child suspected of having a (C)APD to an audiologist.
The main clinical indicators used for referral were parent
or teacher reports of classroom listening difficulties. The
use of such functional indicators is supported by ASHA
(2005), although ASHA warns that such indicators are not
diagnostic for (C)APD. In contrast, Moore, Rosen, Bamiou,
Campbell, and Sirimanna (2012) advocate the development
of a standardised questionnaire similar to the Children’s
Communication Checklist (Bishop, 2003) as a sensitive way
for screening for auditory processing difficulties in children.
Interestingly, of the 40% of clinicians who indicated that
they do not usually refer a child for a (C)APD assessment,
most of these (84%) stated the reason as being financial.
In particular, these clinicians felt that the prohibitive cost
to the parent was not justified as the diagnosis and report
do not usually provide information that adequately informs
their treatment planning. Some SLPs also cited school-
related influences on their decision not to refer a child for
a CAP assessment, including schools not prioritising this
type of assessment, the education system not recognising
(C)APD as a verifiable disability, and that the assessment
results could jeopardise a diagnosis of speech-language
impairment and associated funding in the Queensland state
school system.
Most SLPs indicated that they have never been
contacted (72%) or are only occasionally contacted (24%)
In light of the potential for confusion as to the role of
the SLP in screening and assessing for (C)APD, the major
objective of the present study was to conduct a survey
to determine how SLPs in Queensland currently manage
these aspects of (C)APD and to compare the results with
published recommendations (ASHA, 2005). This study is
the first of two articles arising from the survey, the second
article considers how the surveyed SLPs treat (C)APD.
Methods
Participants
Speech-language pathologists (SLPs, n = 1536) registered
with the Speech Pathologists Board of Queensland were
sent 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 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 questions.
As a result, many questions had a lower response rate than
60. A decision was made to include 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 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, 53%), 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 being
(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%)
although 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, which,
in turn, could cause language and literacy impairments
(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%), but not of evidence-based treatments for
(C)APD (32/59, 54%). The raw data describing the
participants is contained in the Appendix.
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 (
.
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
