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JCPSLP
Volume 16, Number 2 2014
Journal of Clinical Practice in Speech-Language Pathology
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 (
.
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).
