Thoughts From the Front Lines: Canadian Perspectives in Adopting and Implementing Recommended Clinical Labels in Preschool Speech-Language Pathology
Bibliographic record
Abstract
PURPOSE: Previous literature has proposed barriers to speech-language pathologists (SLPs) using standard clinical labels; however, the perspectives of SLPs have been studied to a lesser extent. This quality improvement project reports on SLPs' perceived barriers and facilitators to using currently recommended clinical labels for preschool communication disorders and identifies next steps to support implementation in one preschool communicative health system. METHOD: This project aimed to establish the consistent use of clinical labels in one large Canadian preschool speech and language program. After completing a web-based training and a 3-month trial period, 387 SLPs completed an exit survey to share their perceived barriers and facilitators to label use. Qualitative survey data were analyzed using a hybrid codebook inductive/deductive thematic analysis approach. RESULTS: Six themes were identified, which aligned with the diffusion of innovations theory. SLPs identified several facilitators and barriers to using the recommended clinical labels within each theme. Major facilitators included improved communication, better caregiver understanding of children's communication, positive feedback from caregivers, SLPs' increased confidence in sharing labels, and improved access to services for children. Major barriers related to additional time required to share labels, SLPs' perceptions of caregivers' values, SLPs' views surrounding the recommended labels, lack of comfort using some labels, and limited opportunity to practice label use or observe successful label use by others. CONCLUSIONS: Contextual barriers continue to impact SLPs' use of the recommended clinical labels. Ongoing collaboration with SLPs and caregivers will be critical for supporting implementation. Further research examining SLPs' perspectives across other clinical settings and geographic areas is needed. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.27296970.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".