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Administering the Communication and Symbolic Behavior Scales in Collaboration With Caregivers in a Virtual
Jessica H Franco1, Jerrica M Butler2, Annabel Garza2
1Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin.
American Journal of Speech-Language Pathology
|February 26, 2026
Summary
Telepractice assessments using the Communication and Symbolic Behavior Scales (CSBS) are feasible and reliable for evaluating social communication in toddlers. This virtual coaching method enhances accessibility for families facing logistical challenges.
Area of Science:
- Speech and Hearing Science
- Developmental Psychology
- Telehealth Research
Background:
- Telepractice for social communication interventions is established, but telepractice-based assessments, especially for toddlers, are under-researched.
- Telepractice offers enhanced accessibility for families with geographic or scheduling barriers.
- Limited research exists on the efficacy and reliability of telepractice for early childhood communication assessments.
Purpose of the Study:
- To explore the telepractice-based administration of the Communication and Symbolic Behavior Scales (CSBS) by caregivers with virtual coaching.
- To examine the fidelity of caregiver administration and assessor coaching during virtual assessments.
- To evaluate scoring reliability and caregiver perceptions of the telepractice assessment process for toddlers.
Main Methods:
- Thirty toddlers (younger siblings of autistic children) and their caregivers participated in virtual CSBS assessments over 6 months.
- Caregivers administered the CSBS at home, guided by assessors via telepractice; assessment kits were mailed.
- Fidelity was assessed via video recordings; scoring reliability was determined through interrater comparisons; caregiver feedback was collected via surveys.
Main Results:
- High caregiver administration fidelity (95.61%) and strong assessor coaching fidelity (91.14%) were observed.
- Robust scoring reliability was achieved (intraclass correlation coefficient = .85).
- Caregivers reported positive experiences but noted challenges with child engagement and adapting to the assessment structure.
Conclusions:
- Virtual administration of the CSBS is a feasible and reliable method for assessing toddler social communication.
- This telepractice approach can improve access to services for families facing barriers.
- Further research is recommended to refine protocols and incorporate caregiver feedback for optimal implementation.
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