Bringing the Computer-Based instrument for Low motor Language Testing to Canada: A survey of caregiver and clinician perspectives

Abstract Background: Accurate assessment of language comprehension is crucial to positive outcomes for children with cerebral palsy (CP) and limited functional speech (LFS). This study describes Canadian caregivers’ and clinicians’ language comprehension assessment experiences and needs when working with these children prior to soliciting feedback on the Computer-Based instrument for Low motor Language Testing (C-BiLLT-CAN), a new validated standardized assessment tool, to support its implementation in Canada. Materials and Methods: We conducted an environmental scan using surveys codesigned by the research team, including rehabilitation professionals, and families with lived experiences. Surveys collected quantitative and qualitative data from 22 caregivers of and 39 clinicians who provided services to children with CP and LFS. Results: Most caregivers (n = 17; 77%) and clinicians (n= 26; 72%) had experienced language comprehension assessment. Experienced caregivers and clinicians highlighted the importance of accurate language comprehension assessment but had limited confidence in current practices that typically rely on informal tools (i.e., clinical observation, caregiver interview, informal questions) (n= 25-26; 96 – 100 %). Qualitative comments identified a need for population specific test/testing procedures and/or associated normative data. Participants identified that the C-BiLLT-CAN would have a significant impact on children with CP and LFS, with most clinicians (n = 15; 71%) anticipating at least a moderate effect on practice. Perceived benefits of the C-BiLLT-CAN included improved interaction with, participation for, and understanding of the abilities of these children; improved services including better language comprehension assessment procedures and results; and improved interventions and outcomes for these children and their families. Participants indicated that currently available response methods could be improved by including joystick, contact access, orofacial access, brain-computer interface, and vocalization and/or humming based access and by supporting visual and auditory access modifications to promote customization to the needs of individual children. Conclusions: The C-BiLLT-CAN could fill a critical gap in services available to Canadian children with CP and LFS. Caregivers and clinicians recognized the importance and potential benefits of a reliable standardized language comprehension assessment for this population but indicated the need for additional response methods and features to support access and implementation in Canada.