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Expert Consensus on the Role of Speech-Language Pathologists in Working With Deaf Children Who Use American Sign Language in the United States: A Classical e-Delphi Study

Am J Speech Lang Pathol. 2025 Apr 4:1-37. doi: 10.1044/2025_AJSLP-24-00298. Online ahead of print.

ABSTRACT

PURPOSE: Although approximately 40% of school-based speech-language pathologists (SLPs) regularly serve Deaf and hard of hearing (DHH) students, at present, there are no agreed-upon standards specifying the minimum qualifications and best practices for working with this population, especially those who use signed language. The goal of the present study is to establish expert consensus on recommended clinical training and practice for SLPs working with signing DHH children.

METHOD: Experts in fields related to speech-language pathology and deaf education (N = 30, 16 DHH) participated in three rounds of a classical e-Delphi study. In Round 1, experts responded to open-ended questions about the role of SLPs working with DHH children who sign. In Rounds 2 and 3, experts rated their agreement with statements generated by fellow experts in Round 1.

RESULTS: A mixed-method design included qualitative content analysis (Round 1) and quantitative descriptive statistics (Rounds 2 and 3). Experts rated a total of 185 items in Round 2 and 186 items in Round 3. Consensus (at least 70% agreement) was met for 158 statements, with recommendations for SLPs’ knowledge, attitudes, and practices. Consensus was not achieved for 28 items, including the level of American Sign Language proficiency required for SLPs.

CONCLUSIONS: This study is the first to elicit input from a panel of experts seeking to establish professional standards for SLPs who work with signing DHH children. These findings contribute to the movement toward more inclusive and culturally responsive clinical practice and can inform educational standards and policy for SLPs. Future research is needed to determine whether practicing SLPs meet these recommended standards and how clinical training can support growth for standards that are not currently being met.

SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.28665218.

PMID:40184609 | DOI:10.1044/2025_AJSLP-24-00298

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