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Implementing the language comprehension test C-BiLLT: a qualitative description study using the COM-B model of

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|November 29, 2022
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Summary

Implementing the Computer Based instrument for Low motor Language Testing (C-BiLLT) presented unique challenges for clinicians assessing children with severe impairments. Understanding clinician capability, opportunity, and motivation is key to improving assessment tool adoption.

Keywords:
AssessmentCOM-B modelCerebral palsyClinician behaviorCommunication

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Area of Science:

  • Speech-language pathology
  • Clinical assessment tools
  • Child development

Background:

  • Assessing language comprehension in children with severe motor and speech impairments is challenging with traditional tools.
  • The Computer Based instrument for Low motor Language Testing (C-BiLLT) enables assessment via non-traditional methods like eye gaze.
  • This study investigates factors influencing C-BiLLT implementation by clinicians in the Netherlands and Norway.

Purpose of the Study:

  • To understand clinician-reported barriers and facilitators to C-BiLLT implementation.
  • To explore the influence of clinician capability, opportunity, and motivation on C-BiLLT use.
  • To inform strategies for improving the adoption of novel assessment tools.

Main Methods:

  • Qualitative study using semi-structured interviews with 15 clinicians.
  • Data analyzed deductively using a COM-B model codebook.
  • Thematic analysis applied abductively to identify patterns within COM-B components.

Main Results:

  • Clinicians used C-BiLLT with both its target population and other clients.
  • More complex barriers were experienced when using C-BiLLT with the intended population.
  • Barriers and facilitators were identified across clinician capability, opportunity, and motivation.

Conclusions:

  • Insights into capability, opportunity, and motivation factors are crucial for sustained assessment behavior change.
  • Tailored interventions can improve the implementation of novel assessment tools.
  • Findings support enhanced service delivery for children with complex communication needs.