A Pathway to Research-Reliable Dynamic Temporal and Tactile Cueing for Children With Childhood Apraxia of Speech: A Multiphase Process for Training Community Clinicians.

Abstract

Purpose: Mounting research supports the use of motor-based intervention (e.g., Dynamic Temporal and Tactile Cueing [DTTC]) for children with childhood apraxia of speech (CAS), but large randomized controlled trials (RCTs) are needed to better understand optimal treatment conditions. Partnering with community clinicians may help support recruitment and data collection for large groups of participants with CAS. However, to achieve this, rigorous training is needed to ensure high-fidelity treatment and adherence to research protocols. This work presents a multiphase process for training community clinicians to implement high-fidelity DTTC. We then examined whether clinician factors predicted their performance on assessment tasks used to determine eligibility to be hired as research clinicians and DTTC treatment fidelity.

Method: Community clinicians underwent a multiphase process of application, training, and assessment tasks to determine their eligibility as research clinicians for an RCT on DTTC dose frequency. Throughout the RCT, DTTC treatment fidelity was monitored across 20% of all treatment sessions. Linear regressions were performed to determine if clinician factors predicted performance on (a) eligibility assessment tasks and (b) DTTC fidelity with the first RCT participant.

Results: DTTC fidelity during the eligibility assessment phase was predicted by clinicians' prior DTTC experience, but not years of overall clinician experience or CAS-specific experience. No clinician factors predicted DTTC fidelity within the RCT.

Conclusions: Results suggest that this multiphase process was successful in preparing community clinicians to provide research-reliable DTTC treatment, even when prior clinical experience varied. We posit that multiple and varied learning opportunities, combined with individualized feedback, mentorship, and self-reflection, contributed to these results.