Administering the Communication and Symbolic Behavior Scales in Collaboration With Caregivers in a Virtual Environment: Reliability, Fidelity, and Lessons Learned.
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| Title: | Administering the Communication and Symbolic Behavior Scales in Collaboration With Caregivers in a Virtual Environment: Reliability, Fidelity, and Lessons Learned. |
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| Authors: | Franco, Jessica H.1, Butler, Jerrica M.2, Garz, Annabel1,2, Glickman, Alana3, Lidov, Elizabeth, Hobson, Amanda3, Schmitgen, Elizabeth M.2, Hampton, Lauren H.2 lauren.hampton@austin.utexas.edu |
| Source: | American Journal of Speech-Language Pathology. May2026, Vol. 35 Issue 3, p969-982. 14p. |
| Subject Terms: | *Interprofessional relations, *Human services programs, *Autism, *Communication, *Asperger's syndrome, *Child behavior, *Caregiver attitudes, Research funding, Signs & symbols, Research evaluation, Descriptive statistics, Telemedicine, Surveys, Social skills, Medical needs assessment, Confidence intervals, Video recording, Customer satisfaction |
| Geographic Terms: | Texas |
| Abstract: | Purpose: While telepractice interventions for social communication have been more widely studied, research on telepractice-based assessments, particularly for toddlers, remains limited. Telepractice assessments offer a range of potential benefits, including improved accessibility for families facing logistical challenges such as geographic distance or scheduling conflicts. This study explored the use of the Communication and Symbolic Behavior Scales (CSBS) in a telepractice context, administered by caregivers with virtual coaching. Key research questions examined fidelity of administration, scoring reliability, and caregiver perceptions of the assessment process. Method: Thirty infant/toddler younger siblings of autistic children and their caregivers were recruited from an ongoing clinical trial. Participants completed virtual CSBS assessments at three intervals over a 6-month period. Assessment materials were provided through kits mailed to participants' homes. Caregivers, guided by trained assessors via telepractice, administered the assessments with their children. Video recordings of the sessions were analyzed to evaluate caregiver implementation fidelity and assessor coaching fidelity using standardized criteria. Scoring reliability was examined through interrater comparisons, with a subset of assessments independently rated to ensure agreement. Caregiver feedback on the telepractice process was collected through surveys, capturing both satisfaction and reported challenges. Results: Caregivers administered the CSBS with a high level of fidelity (M = 95.61%), and assessors demonstrated strong fidelity in their coaching and support during the assessments (M = 91.14%). Scoring reliability between raters was robust (intraclass correlation coefficient = .85). While caregivers generally reported positive experiences with the telepractice format, some noted difficulties in maintaining their child's engagement and adjusting to the structured nature of the assessment process. Conclusions: The findings suggest that virtual administration of the CSBS is a feasible and reliable method for assessing social communication in young children. This approach has potential to increase accessibility for families facing barriers to in-person services, though further research is needed to refine protocols and address caregiver feedback. [ABSTRACT FROM AUTHOR] |
| Copyright of American Journal of Speech-Language Pathology is the property of American Speech-Language-Hearing Association and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Education Research Complete |
| FullText | Links: – Type: pdflink Text: Availability: 0 |
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| Header | DbId: ehh DbLabel: Education Research Complete An: 193560205 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Administering the Communication and Symbolic Behavior Scales in Collaboration With Caregivers in a Virtual Environment: Reliability, Fidelity, and Lessons Learned. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Franco%2C+Jessica+H%2E%22">Franco, Jessica H.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Butler%2C+Jerrica+M%2E%22">Butler, Jerrica M.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Garz%2C+Annabel%22">Garz, Annabel</searchLink><relatesTo>1,2</relatesTo><br /><searchLink fieldCode="AR" term="%22Glickman%2C+Alana%22">Glickman, Alana</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Lidov%2C+Elizabeth%22">Lidov, Elizabeth</searchLink><br /><searchLink fieldCode="AR" term="%22Hobson%2C+Amanda%22">Hobson, Amanda</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Schmitgen%2C+Elizabeth+M%2E%22">Schmitgen, Elizabeth M.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Hampton%2C+Lauren+H%2E%22">Hampton, Lauren H.</searchLink><relatesTo>2</relatesTo><i> lauren.hampton@austin.utexas.edu</i> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22American+Journal+of+Speech-Language+Pathology%22">American Journal of Speech-Language Pathology</searchLink>. May2026, Vol. 35 Issue 3, p969-982. 14p. – Name: Subject Label: Subject Terms Group: Su Data: *<searchLink fieldCode="DE" term="%22Interprofessional+relations%22">Interprofessional relations</searchLink><br />*<searchLink fieldCode="DE" term="%22Human+services+programs%22">Human services programs</searchLink><br />*<searchLink fieldCode="DE" term="%22Autism%22">Autism</searchLink><br />*<searchLink fieldCode="DE" term="%22Communication%22">Communication</searchLink><br />*<searchLink fieldCode="DE" term="%22Asperger's+syndrome%22">Asperger's syndrome</searchLink><br />*<searchLink fieldCode="DE" term="%22Child+behavior%22">Child behavior</searchLink><br />*<searchLink fieldCode="DE" term="%22Caregiver+attitudes%22">Caregiver attitudes</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22Signs+%26+symbols%22">Signs & symbols</searchLink><br /><searchLink fieldCode="DE" term="%22Research+evaluation%22">Research evaluation</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Telemedicine%22">Telemedicine</searchLink><br /><searchLink fieldCode="DE" term="%22Surveys%22">Surveys</searchLink><br /><searchLink fieldCode="DE" term="%22Social+skills%22">Social skills</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+needs+assessment%22">Medical needs assessment</searchLink><br /><searchLink fieldCode="DE" term="%22Confidence+intervals%22">Confidence intervals</searchLink><br /><searchLink fieldCode="DE" term="%22Video+recording%22">Video recording</searchLink><br /><searchLink fieldCode="DE" term="%22Customer+satisfaction%22">Customer satisfaction</searchLink> – Name: SubjectGeographic Label: Geographic Terms Group: Su Data: <searchLink fieldCode="DE" term="%22Texas%22">Texas</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Purpose: While telepractice interventions for social communication have been more widely studied, research on telepractice-based assessments, particularly for toddlers, remains limited. Telepractice assessments offer a range of potential benefits, including improved accessibility for families facing logistical challenges such as geographic distance or scheduling conflicts. This study explored the use of the Communication and Symbolic Behavior Scales (CSBS) in a telepractice context, administered by caregivers with virtual coaching. Key research questions examined fidelity of administration, scoring reliability, and caregiver perceptions of the assessment process. Method: Thirty infant/toddler younger siblings of autistic children and their caregivers were recruited from an ongoing clinical trial. Participants completed virtual CSBS assessments at three intervals over a 6-month period. Assessment materials were provided through kits mailed to participants' homes. Caregivers, guided by trained assessors via telepractice, administered the assessments with their children. Video recordings of the sessions were analyzed to evaluate caregiver implementation fidelity and assessor coaching fidelity using standardized criteria. Scoring reliability was examined through interrater comparisons, with a subset of assessments independently rated to ensure agreement. Caregiver feedback on the telepractice process was collected through surveys, capturing both satisfaction and reported challenges. Results: Caregivers administered the CSBS with a high level of fidelity (M = 95.61%), and assessors demonstrated strong fidelity in their coaching and support during the assessments (M = 91.14%). Scoring reliability between raters was robust (intraclass correlation coefficient = .85). While caregivers generally reported positive experiences with the telepractice format, some noted difficulties in maintaining their child's engagement and adjusting to the structured nature of the assessment process. Conclusions: The findings suggest that virtual administration of the CSBS is a feasible and reliable method for assessing social communication in young children. This approach has potential to increase accessibility for families facing barriers to in-person services, though further research is needed to refine protocols and address caregiver feedback. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of American Journal of Speech-Language Pathology is the property of American Speech-Language-Hearing Association and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1044/2025_AJSLP-25-00160 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 14 StartPage: 969 Subjects: – SubjectFull: Interprofessional relations Type: general – SubjectFull: Human services programs Type: general – SubjectFull: Autism Type: general – SubjectFull: Communication Type: general – SubjectFull: Asperger's syndrome Type: general – SubjectFull: Child behavior Type: general – SubjectFull: Caregiver attitudes Type: general – SubjectFull: Research funding Type: general – SubjectFull: Signs & symbols Type: general – SubjectFull: Research evaluation Type: general – SubjectFull: Descriptive statistics Type: general – SubjectFull: Telemedicine Type: general – SubjectFull: Surveys Type: general – SubjectFull: Social skills Type: general – SubjectFull: Medical needs assessment Type: general – SubjectFull: Confidence intervals Type: general – SubjectFull: Video recording Type: general – SubjectFull: Customer satisfaction Type: general – SubjectFull: Texas Type: general Titles: – TitleFull: Administering the Communication and Symbolic Behavior Scales in Collaboration With Caregivers in a Virtual Environment: Reliability, Fidelity, and Lessons Learned. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Franco, Jessica H. – PersonEntity: Name: NameFull: Butler, Jerrica M. – PersonEntity: Name: NameFull: Garz, Annabel – PersonEntity: Name: NameFull: Glickman, Alana – PersonEntity: Name: NameFull: Lidov, Elizabeth – PersonEntity: Name: NameFull: Hobson, Amanda – PersonEntity: Name: NameFull: Schmitgen, Elizabeth M. – PersonEntity: Name: NameFull: Hampton, Lauren H. IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 05 Text: May2026 Type: published Y: 2026 Identifiers: – Type: issn-print Value: 10580360 Numbering: – Type: volume Value: 35 – Type: issue Value: 3 Titles: – TitleFull: American Journal of Speech-Language Pathology Type: main |
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