Participation Matters: Improving Outcomes in School-Age Children with Communication Disorders through Implementation Science

PROJECT SUMMARY/ABSTRACT Nearly 20% of school-age children have a communication disorder that limits their ability to participate in daily life, such as classroom discussions or conversations with peers at school. Speech-Language Pathologists are essential for improving the communication of children with communication disorders in schools. Intervening during the school-age developmental period (ages 5-12) is key to leveraging the cognitive, social, and linguistic growth that occurs during this time. Targeting communicative participation (i.e., the child’s ability to communicate while taking part in everyday life) has been documented as an effective approach to support children’s communication and well-being. Directly supporting communicative participation is critical to prioritizing meaningful life participation as a key focus of speech/language intervention. However, less than 1/5 of Speech- Language Pathologists focus their intervention on supporting communicative participation. The research-to- practice gap is clear: researchers have developed a guide that describes how to target communicative participation as an intervention outcome (Baylor & Darling-White, 2020), but this guide is not being used with school-age children with communication disorders. This proposal aims to address this gap by examining the barriers and facilitators influencing Speech-Language Pathologists’ use of communicative participation intervention outcomes (Aim 1) and analyzing Speech-Language Pathologists’ proposed adaptations to the communicative participation intervention guide (Aim 2). By using an implementation science approach, this project directly aligns with the NIDCD Notice of Special Interest in Implementation Science in Communication Disorders (NOT-DC-24-024) and Theme 4 of the NIDCD Strategic Plan (Translate and implement scientific advances into standard clinical care). We will use a convergent mixed methods approach that combines the findings of an online survey (quantitative; Aim 1) and focus groups (qualitative; Aim 2). By partnering with school- based Speech-Language Pathologists, we aim to understand the barriers and facilitators to using these intervention outcomes in schools and adapt the intervention guide based on their direct input. This research will lay the groundwork for future studies focused on reducing the barriers, elevating the facilitators, and implementing the communicative participation intervention guide in school settings with children with communication disorders. Focusing on the Speech-Language Pathologists’ critical role in supporting communicative participation will ultimately benefit the many school-age children currently struggling to express their ideas and communicate in everyday situations at school.