Background: For children to receive the full benefit from any treatment, it needs to be delivered with high levels of adherence to the treatment protocol (i.e., high fidelity). However, when treating Childhood Apraxia of Speech (CAS), speech pathologists typically combine elements of different treatments in an eclectic approach. The reasons for this practice are not well understood. There is limited information about the perceived barriers to the implementation of high-fidelity CAS treatment from the perspective of caregivers and speech pathologists. This study arises from a unique opportunity within the research-to-practice continuum for Dynamic Temporal and Tactile Cueing (DTTC) treatment where community clinicians were trained to deliver 24 sessions of (DTTC), an evidence-based treatment for CAS, to children for a treatment study. This enabled us to use qualitative methods to examine the experiences of speech pathologists and caregivers with high-fidelity DTTC.

Methods: Seven participants (4 speech pathologists; 3 caregivers) participated in semi-structured interviews, via Zoom, four weeks after the conclusion of the DTTC treatment study. Questions explored perceptions of DTTC treatment and experiences of participating in a research study. Data was analysed using inductive thematic analysis using an iterative and reflective process.

Results: Analysis of participant data led to the construction of two themes: “Research DTTC was more challenging than regular therapy for speech pathologists and families but surprisingly effective”, and “Researchers don’t understand what it’s like for clinicians to deliver high-fidelity DTTC treatment in a research study”.

Discussion: These results revealed that despite improvement in the children’s speech, aspects of DTTC were uncomfortable for speech pathologists and families, and speech pathologists perceived a schism between researchers and clinicians. Overcoming these barriers is essential in facilitating implementation of high-fidelity DTTC treatment in community contexts.

At the conclusion of this presentation, participants will:
1: List 3 components of DTTC treatment that were challenging for clinicians and caregivers
2. Describe the relative preference given to external evidence and practice-based evidence by researchers and clinicians
3. Identify one way that they can overcome the research to practice gap