Development of the Caregiver-Child Auditory Skills Tracking (CAST) scale: A Pilot Study on Caregiver Implementation via International Telepractice

Parent engagement is a key component during early language development for all children, but particularly for a child with hearing loss. Through the application of technology-based models of service delivery such as telehealth, researchers have found an increase in parent-child engagement during auditory-verbal therapy (AVT) sessions due to the physical absence of the provider and parents becoming the primary language facilitators. However, current measures of parent-child interactions do not have a coding system to monitor facilitation of auditory skills. This present study will discuss the development of the Caregiver-Child Auditory Skills Tracking (CAST) Scale to track progress of caregiver implementation of the auditory skill hierarchy. Initial development included using the CAST scale for a pilot case study of parent interaction during 2 sessions (6 months) of auditory-based sessions via international telehealth. The participants were Spanish-speaking parents of a 2-year-old child with bilateral cochlear implants who reside in Mexico and received intervention from an Arkansas-based clinician. Parent interactions were qualitatively coded by graduate student clinicians using the CAST scale to rate implementation of auditory skill hierarchy stages. Data was coded twice (approximately 4 weeks apart) for both sessions on the auditory skills strategies data sheet developed by the researchers. The statistical analysis performed on the data collection was a repeated measures ANOVA. The results of the analysis found that there is a significant effect of time on both session conditions (rating one and rating two). Specifically, the rater’s auditory skills training had a statistically significant effect on auditory skills strategies data. Additionally, telehealth was observed to increase parent engagement in both sessions. These findings provide a guideline towards continued progression of the CAST scale and adds to research that supports telehealth as a viable option of speech-language pathology service delivery. Acknowledgements Things happen for a reason. This is one of the most important lessons I have learned so far in my graduate school journey. Although the road to get to where I am has not been easy, none of it would be possible without the support of the inspiring people in my life. I want to thank my family who have always encouraged me to believe in myself and been proud of all my accomplishments no matter how small. In the moments that I doubted my ability to achieve my dreams, my sisters were there to reassure me that I was capable doing that and so much more. To my beautiful nieces and nephews, thank you for always putting a smile on my face. To Mario and Eliza, you inspire me to make the world a better place. Good friends are necessary to help every step of the way on this journey. Jennifer Araujo, my best friend for 12 years, thank you for everything. From answering all my grad school questions to being my SLP supervisor this past summer, you are relentless and it shows with how much your clients appreciate everything you do for them. To my cohort especially to the 5 of us who message each other words of support when things seem impossible, thank you. I want to thank Erika Rodriguez for being such an amazing work partner. Without her, I would not have been able to get this far on my thesis or have published my first international blog post on hearing loss. To my committee members, Tracy, Elizabeth, and Dr. Holyfield, thank you for your guidance and motivation. You are all essential to this amazing field and your endless, remarkable contributions are proof of that. Last but not least, I want to thank my mentor, Dr. Rachel Glade. I will forever be thankful for your guidance and expertise throughout this process. I could not have done this without you. You trusted and believed in me to accomplish this goal before I did. You motivate me to be the best person and SLP that I can be. To the rest of my extended family, friends, and colleagues, I appreciate all your words of encouragement and support. Dedication To my parents. Everything I have done is for you. You both left your families and all that you knew to come to this country with hopes and dreams of a better life. I am so proud to be your daughter and it will take me more than a lifetime to thank you for everything you have done for me. Gracias. Table of