Speak Out August 2020 DIGITAL EDITION

Member research

Active waiting for paediatric speech pathology services

Nicole McGill was awarded the Nadia Verrall Memorial Research Grant in 2018 for the project titled: Use of a website to facilitate active waiting for speech pathology. The project was undertaken as a part of her doctoral studies at Charles Sturt University, in collaboration with colleagues from Charles Sturt University and Western NSW Local Health District. The study involved a randomised controlled trial (RCT) to evaluate whether access to an evidence-based, purpose-built website (active waiting group) compared with a control group (passive waiting) improved (a) children’s speech, intelligibility, language, and early literacy outcomes, and (b) caregivers’ levels of empowerment and satisfaction. This research aimed to inform the provision of home-based interim care and best practice management of children and families on waiting lists. Ninety-seven children aged 3 to 6 years were referred to a community health speech pathology service in Victoria between January and October 2018. Following eligibility screening (n = 71) and comprehensive baseline assessment (n = 46) of children’s speech, language and early literacy and caregivers’ satisfaction and empowerment, 42 children were randomly allocated to one of two groups: active waiting (received the website while waiting; n = 20) or passive waiting (control group who waited without support (usual practice at the service); n = 22). The purpose-built website contained evidence- based information, strategies, and resources for facilitating children’s speech, language, and early literacy development while on the waiting list. Follow-up assessments were completed (n = 36) after approximately 6 months on the waiting list to measure child and caregiver outcomes for each group. The following instruments were used to measure outcomes during baseline and follow-up assessments: Children’s speech: Diagnostic Evaluation of Articulation and Phonology (DEAP) – phonology subtest, Percentage Consonants Correct (PCC). Children’s intelligibility: Intelligibility in Context Scale (ICS). Children’s language: Clinical Evaluation of Language Fundamentals Preschool – 2nd ed., Australian Standardised Edition (CELF-P2), core language subtests. Children’s early literacy: Preschool Word and Print

Nicole McGill

Awareness (PWPA) measure. Caregivers’ empowerment: Family Empowerment Scale (FES) – subset of 18 questions. Caregivers’ satisfaction: Patient Enablement and Satisfaction Survey (PESS) – adapted. Intention to treat (n = 36) and per protocol (n = 30) analyses were completed using ANCOVA analyses (controlling for baseline scores). There was no statistically significant change between groups for any of the child or caregiver outcomes, which indicated that the intervention (website) was not effective in this study. A small amount of clinically significant change in language skills (CELF-P2 scores) was noted for children in both groups when considering unadjusted mean scores, which may be attributed to maturational change. However, gains were smaller than could be anticipated if children received direct speech pathology intervention. Minimal to no change in children’s speech, intelligibility, or early literacy outcomes was observed for either group. In particular, there was no improvement in children’s speech (PCC scores) in either

24

Speak Out | August 2020