Clinician perspectives on implementing the C-BiLLT-CAN for non-speaking children with cerebral palsy: a focus group study

Currently available methods may not reliably assess language comprehension in children with significant speech and motor limitations. The Computer-Based instrument for Low motor Language Testing (C-BiLLT) is a standardized assessment designed for children with cerebral palsy that allows them to participate using various alternative response methods. This study aimed to understand speech-language pathologists’ and occupational therapists’ perceived facilitators and barriers to implementing the Canadian C-BiLLT (C-BiLLT-CAN).
Six focus groups were conducted with 30 clinicians. Transcripts were analyzed using a semi-deductive thematic analysis. The Consolidated Framework for Implementation Research was used to guide the identification of clinicians’ perceived facilitators and barriers.
Clinicians unanimously reported interest in implementing the C-BiLLT-CAN. Facilitators and barriers were classified into five primary themes. Key facilitators related to the test’s evidence-based design, standardized nature, and potential flexibility. Key barriers related to Internet connectivity, the need to expand customization and response options to meet a greater breadth of needs, privacy policies, lack of resources, and perceived costs associated with equipment, training, and time.
Many perceived barriers aligned with previous European and Canadian C-BiLLT implementation research. However, findings elucidated unique considerations that will inform adaptations to the C-BiLLT-CAN and development of training/educational materials.

Clinicians unanimously expressed interest in implementing the C-BiLLT-CAN in their clinical practice with children with limited functional speech and motor skills
Facilitators to implementing the C-BiLLT-CAN related to its evidence-based design, standardized nature, and potential flexibility
Key barriers related to Internet connectivity, the need to expand customization and response options to meet a greater breadth of needs, privacy policies, lack of resources, and potential costs
Findings will inform an adapted C-BiLLT-CAN to facilitate clinical implementation, as well as training and educational materials to support implementation

Clinicians unanimously expressed interest in implementing the C-BiLLT-CAN in their clinical practice with children with limited functional speech and motor skills
Facilitators to implementing the C-BiLLT-CAN related to its evidence-based design, standardized nature, and potential flexibility
Key barriers related to Internet connectivity, the need to expand customization and response options to meet a greater breadth of needs, privacy policies, lack of resources, and potential costs
Findings will inform an adapted C-BiLLT-CAN to facilitate clinical implementation, as well as training and educational materials to support implementation