Research Article

Preparedness, Training, and Support for

Augmentative and Alternative Communication
Telepractice During the COVID-19 Pandemic
Elizabeth E. Biggs,a Elizabeth Burnett Rossi,a Sarah N. Douglas,b Michelle C. S. Therrien,c
and Melinda R. Snodgrassd
a
Department of Special Education, Vanderbilt University, Nashville, TN b Human Development and Family Studies, Michigan State University,
East Lansing c School of Communication Science and Disorders, Florida State University, Tallahassee d Department of Special Education, Illinois
State University, Normal

ARTICLE INFO ABSTRACT

Article History: Purpose: The global COVID-19 pandemic brought about widespread use of tele-
Received October 20, 2021 practice to provide services to children with communication disorders, including
Revision received December 17, 2021 students who use aided augmentative and alternative communication (AAC)
Accepted December 28, 2021 such as speech-generating devices. This descriptive quantitative study utilized
network analysis to investigate the nature of speech-language pathologists’
Editor-in-Chief: Holly L. Storkel (SLPs’) professional resource networks during the pandemic, including what
Editor: Elizabeth D. Peña aspects of their professional networks were associated with their confidence to
use telepractice to serve students who use aided AAC and whether there were
https://doi.org/10.1044/2021_LSHSS-21-00159 differences for school-based compared to nonschool-based SLPs.
Method: Participants were 283 SLPs who responded to an online survey that
consisted of closed- and open-ended survey items. A resource generator
approach was used to gather data about SLPs’ professional resource networks
for AAC telepractice.
Results: SLPs varied widely in their confidence for AAC telepractice. School-
based SLPs and SLPs who had 3 years or fewer of AAC experience reported
lower confidence, whereas SLPs who spent more work time each week using
telepractice and who accessed a greater number of different types of training
reported higher confidence. The number of people in different roles providing per-
sonal support and the number of different electronic/print resources accessed
were not significant predictors of SLPs’ confidence. The majority of SLPs wanted
additional training, support, or resources related to AAC telepractice.
Conclusion: The findings from this research suggest the importance of SLPs’
access to quality training and support in the areas of AAC and telepractice, par-
ticularly for school-based SLPs.

The global pandemic caused by the spread of the
novel coronavirus (COVID-19) instigated a dramatic
change in service delivery for students with communica-
tion disorders, including students with complex communi-
cation needs who use aided augmentative and alternative
communication (AAC) such as speech-generating devices.
Correspondence to Elizabeth E. Biggs: elizabeth.e.biggs@vanderbilt.
edu. Publisher Note: This article is part of the Forum: Can You See
My Screen? Virtual Assessment in Speech and Language. Disclosure:
The authors have declared that no competing financial or nonfinancial
interests existed at the time of publication.
As schools and other facilities stopped in-person service
delivery to reduce the spread of the virus, speech-language
pathologists (SLPs) in the United States and around the
world adapted to provide services via telepractice at a
level never before experienced (Caffery, 2020; Fong et al.,
2021; Kuvač Kraljević et al., 2020). Although telepractice
has long been recognized as a promising means for provid-
ing services from a distance to children with disabilities and
their families, SLPs’ use of telepractice was actually quite
limited prior to the COVID-19 pandemic, particularly
within the school system (Tucker, 2012a, 2012b). There-
fore, along with their students and students’ families, most

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 SLPs experienced telepractice for the first time during
COVID-19 lockdowns and needed to rapidly develop new
skills to ensure services could continue during this global
crisis.
Understanding SLPs’ confidence in their knowledge
and abilities related to AAC telepractice during this time,
along with how they accessed training and support, could
provide important insight, particularly since evaluating
SLPs’ confidence is a useful way to measure the construct
of self-efficacy (Sanders et al., 2021). Such research could
also illuminate future telepractice-related training and sup-
port needs for service providers such as SLPs who serve
students learning to use aided AAC.
Issues Surrounding AAC Telepractice
Although telepractice is often equated with web-
based videoconferencing, it is defined more broadly as the
use of technology for the delivery of professional services
from a distance (American Speech-Language-Hearing
Association [ASHA], 2021; Camden et al., 2020). There-
fore, telepractice can involve a variety of technologies and
methods, including asynchronous methods (e.g., recorded
videos, online modules, e-mails, and text messages) and
synchronous methods (e.g., videoconferencing and phone
calls; Casale et al., 2017). Available evidence suggests that
the use of videoconferencing may be useful but not
required for effective telepractice. In a review of random-
ized controlled trials involving remote technologies to pro-
vide services to children with disabilities, Camden et al.
(2020) found that telepractice interventions involving a
variety of different modalities (e.g., videoconferencing,
phone, e-mail, and online modules) were effective to pro-
duce desired outcomes and viewed as acceptable means
for providing services. Furthermore, the findings of their
review suggested that neither the technology mode nor the
number of modes used influenced efficacy.
A further point of variation in telepractice service
delivery is that telepractice can be used both to (a) provide
direct services to students with disabilities and (b) indi-
rectly serve children through coaching, collaboration, and
consultation with parents or other communication part-
ners (Camden et al., 2020; Casale et al., 2017). For chil-
dren and youth with developmental disabilities who have
complex communication needs, telepractice appears to be
especially promising when it involves a strong coaching
component, such as with parents (Akemoglu et al., 2020;
Biggs, Therrien, Douglas, & Snodgrass, 2022; Camden
et al., 2020). Whether used for coaching or direct services,
cited benefits for telepractice—both generally and specifi-
cally for AAC services—include reduced wait time for ser-
vices, fewer scheduling challenges, less travel time for families
and providers, increased service access in underserved areas,
stronger family–provider partnerships, and improvement to
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students’ communication skills within their natural environ-
ments (Akemoglu et al., 2020; Anderson et al., 2012, 2015;
Biggs, Therrien, Snodgrass, & Douglas, 2022; Casale et al.,
2017). All these benefits may be particularly helpful for serv-
ing students who are learning to use AAC given the need for
strong collaboration with and support of family members to
ensure consistent communication supports across environ-
ments (Biggs & Hacker, 2021) and the current reality of short-
ages of service providers with AAC experience and training
(Anderson et al., 2012).
Despite these potential benefits, telepractice also
comes with challenges for service providers and families
alike. Documented challenges include having the needed
technological devices and Internet service, lacking physi-
cal contact with students, needing someone to support
the student’s engagement and navigation of the technol-
ogy, and learning demands for providers such as SLPs
(Casale et al., 2017; Curtis, 2014; Snodgrass et al., 2017;
Tucker, 2012b). Many of these challenges may be experi-
enced even more by SLPs using telepractice to serve students
who are learning to use aided AAC. When using telepractice,
SLPs cannot use hands-on strategies that they may otherwise
regularly use in person for AAC services, such as ensuring
proper positioning, providing physical or gestural prompts,
providing behavior supports, and physically modeling the
use of an AAC device during ongoing interactions with the
student. Furthermore, the cognitive, motor, and social
demands of interacting with an SLP through a computer
may be especially difficult for many students who are learn-
ing to use AAC if they have intellectual or developmental
disabilities (Curtis, 2014; Snodgrass et al., 2017).
Another significant challenge is that few SLPs have
had quality training and experience using telepractice
prior to the pandemic, particularly in school settings. For
example, in a survey prior to the pandemic of directors of
graduate speech-language pathology programs, Grogan-
Johnson et al. (2015) found that only 24% of university
clinics provided any services through telepractice, and
most of these reported that few of their students actually
had any direct clinical training with telepractice. Results
of the survey also indicated that 66% of program directors
reported that their students received no preparation in tele-
practice, even within other coursework. In a separate sur-
vey of 170 school-based SLPs, only three participants
reported experience using telepractice (Tucker, 2012a). In
this study, even the SLPs who had some experience with
telepractice reported that they did not have specialized or
in-depth training and that their inadequate training posed a
significant barrier (Tucker, 2012b). These SLPs described
their training experiences as “baptism by fire” and “trial
and error” (p. 51), indicating their learning was typically
self-initiated and self-guided (e.g., pursuing resources and
support through online communities or chat boards). Fur-
ther training gaps for SLPs beginning to use telepractice
 during the pandemic may relate to partnering with fami-
lies. Although evidence for parent coaching is well estab-
lished in AAC research literature, prior research indicates
that school-based SLPs especially lack confidence in their
ability to provide effective family-centered services and
parent coaching for students with complex communication
needs (Mandak & Light, 2018).
Telepractice and AAC Telepractice During
the COVID-19 Pandemic
Although the pandemic has brought new challenges
and benefits to using telepractice to serve students with
disabilities, relatively little is known about the experiences
of SLPs during this time, including their training and per-
ceptions of confidence. Broader literature signals that pro-
viders working in hospital and clinic settings during the
COVID-19 pandemic have expressed high levels of satis-
faction with telepractice and interest in continuing to use
telepractice after the pandemic (Andrews et al., 2020;
Tanner et al., 2020). These generally positive views of tele-
practice, however, do not suggest that providers have not
experienced challenges. For example, in a national survey
of pediatric physical therapists working across school-
based and nonschool-based settings, Hall et al. (2021)
found that physical therapists reported the effectiveness of
telepractice during the pandemic was highly dependent on
three intersecting factors: caregiver engagement, technol-
ogy equity and access, and pandemic-related resilience for
therapists and caregivers alike.
Our research team conducted a nationwide survey to
address the need for understanding the telepractice experi-
ences of SLPs in the United States working with students
learning to use aided AAC during the pandemic. We
included SLPs working with children and youth aged 3–
21 years in both school and nonschool settings so we
could understand how their views and experiences aligned
or varied. Earlier findings from this research indicated
that the challenges SLPs experienced during the shift to
telepractice were compounded not only because they also
had little training or comfort with AAC (Biggs, Therrien,
Douglas, & Snodgrass, 2022) but also because SLPs who
received training on AAC telepractice viewed it as a more
useful service delivery mode than those who had not
received training (Biggs et al., in press). These prior find-
ings signal that training is important, but they leave
many questions unanswered about SLPs’ preparedness
for AAC telepractice, including their perceptions of their
own confidence, the nature of their training and support,
and what resources actually make a difference in improv-
ing SLPs’ feelings of confidence.
Furthermore, our prior analyses suggested that the
experiences of school-based SLPs during the shift to tele-
practice may have been different from those of their
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colleagues working in outpatient, private practice, or other
out-of-school settings. Specifically, school-based SLPs
rated their efforts using telepractice to serve students who
used aided AAC as being significantly less effective than
those of nonschool-based SLPs, and they were also signifi-
cantly less likely to plan to continue utilizing telepractice
after the pandemic (Biggs, Therrien, Douglas, & Snodgrass,
2022). These findings raise questions as to whether the train-
ing and support that school-based SLPs received might have
also been different from those received by SLPs working in
nonschool settings.
Examining SLPs’ Training and Support
Through Network Analysis
Network analysis offers a valuable tool for investi-
gating the nature of SLPs’ training and support in a partic-
ular area, such as their professional resource networks for
AAC telepractice. Egocentric network analysis focuses on
mapping connections with resources from the perspective of
a single person (i.e., an “ego”; Perry et al., 2018). Although
“social” network analysis focuses on people’s social ties
with other people, egocentric network analysis can be
extended to examine a person’s broader professional
resource network that would include both their social net-
work and other types of nonpeople resources (e.g., trainings
and electronic resources such as information on websites).
With this in mind, an SLP’s professional resource
network related to AAC telepractice can be thought of as
all of the people, trainings, and other print or electronic
resources (e.g., web-based resources and articles) they
access that relate to telepractice generally or for serving
students who use aided AAC. For example, when an SLP
was first experiencing the shift to telepractice because of
COVID-19 lockdowns, they may have attended a live
web-based presentation about telepractice. Later, they
might have talked with a colleague about the challenges
they experienced, and over the course of a few months,
they may have searched for research articles related to tele-
practice for their students who use AAC. Together, these
resources (i.e., web training, colleagues, and research arti-
cles) comprise that individual SLP’s professional resource
network. Research examining the professional resource net-
works of SLPs during the pandemic could be instrumental
in revealing the nature and composition of these networks
and determining whether aspects of professional resource
networks contribute to differences in SLPs’ confidence in
their knowledge and skills to serve students effectively
through telepractice. Social resource theory (Lin, 1999) sug-
gests that a larger and more diverse resource network
would be beneficial for SLPs and could help them feel
more confident because it would provide access to an
increased number and greater diversity of resources, infor-
mation, and supports.
Biggs et al.: Preparedness and Support for AAC Telepractice 3
 Study Purpose
The purpose of this research was to investigate the
nature and composition of SLPs’ professional resource
networks related to AAC telepractice, seeking to under-
stand how SLPs’ networks are associated with their confi-
dence in their knowledge and skills in this important area.
For this study, we defined SLPs’ professional resource net-
works as consisting of different types of training (e.g., live
or recorded web-based presentations), people in different
roles who provided personal support (e.g., other SLPs
who were familiar colleagues, supervisors, or administra-
tors), and other electronic/print resources (e.g., social
media or research articles). Based on social resource the-
ory (Lin, 1999), we were particularly interested in whether
the size of SLPs’ resource networks—measured as the
number of different types of resources or sources of
support—was associated with their confidence to use tele-
practice to serve students who used aided AAC. We were
also interested in whether self-confidence and resource net-
works were different for school-based SLPs compared to
nonschool-based SLPs. The following research questions
were addressed:
1. How do SLPs rate their confidence for AAC tele-
practice, and are there differences between school-
based SLPs and nonschool-based SLPs?
2. How do SLPs describe their professional resource
networks related to AAC telepractice, and are there
differences between school-based and nonschool-
based SLPs?
3. What SLP characteristics and aspects of professional
resource networks predict increased ratings of confi-
dence for AAC telepractice?
4. What additional training and support do SLPs want
related to using telepractice with students who use
aided AAC?
Based on earlier findings from our research (Biggs,
Therrien, Douglas, & Snodgrass, 2022), we anticipated
that school-based SLPs would rate their confidence for
AAC telepractice lower than SLPs working in out-of-
school settings. Similarly, our hypothesis was that school-
based SLPs would have smaller resource networks than
their colleagues in nonschool settings, particularly related
to training and personal support (although possibly not
electronic/print resources). Although we did not have
empirical rationale, we used clinical judgment to hypothe-
size that, in addition to being school-based, SLPs would
rate their confidence for AAC telepractice lower if they
were (a) new to using telepractice, (b) new to working
with students who used aided AAC, (c) older, and (d)
spending less of their time providing telepractice services at
the time of the survey. Based on social resource theory (Lin,
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1999), we also predicted that—controlling for these other
factors—the number of different types of trainings and peo-
ple providing personal support (but not necessarily other
electronic/print resources) would significantly predict higher
confidence ratings. We did not make specific hypotheses
regarding the descriptive research questions (such as the
nature of SLPs’ professional resource networks or the addi-
tional training and support they desire).
Method
Participants
To participate in the larger survey project, partici-
pants had to be a practicing SLP in the United States who
provided services to students 3–21 years old who used any
form of aided AAC. SLPs could participate in the larger
study regardless of whether they were using telepractice at
the time of the survey; however, for this study, we limited
inclusion only to SLPs who (a) reported actively using tele-
practice to provide services to at least one student who
used aided AAC and (b) did not exit the survey before
providing data on their professional resource networks
and/or their confidence for AAC telepractice. Out of the
full sample of SLPs who accessed and began the survey
(n = 394), 329 reported using telepractice to provide ser-
vices to at least one student who used aided AAC. How-
ever, we needed to exclude an additional 65 potential par-
ticipants who exited the survey before completing the sec-
tion on resource networks. Therefore, 283 SLPs met all
inclusion criteria and participated in this study. Using chi-
square tests, we compared the characteristics of SLPs who
were excluded (because of missing data) to those of the
included participants to determine if the two groups dif-
fered on any variables. Only three differences were signifi-
cant: Included participants were (a) less likely to identify
as being Native American, American Indian, or Alaska
Native (i.e., 0.7% of included participants vs. 4.6% of
excluded, χ2 = 5.70, p = .02) and (b) less likely to work
with students who had autism (i.e., 82.7% of included par-
ticipants vs. 93.4% of excluded, χ2 = 5.10, p = .02).
The majority of the 283 participants were female
(94.3%). Using nonmutually exclusive categories, 88.3%
identified as White, 5.3% as Hispanic or Latino, 4.2% as
Asian or Asian American, 3.5% as Black or African
American, and 1.0% from other ethnic or racial back-
grounds. Participants ranged from 24 to 73 years of age,
with an average of 40.1 years (SD = 11.2). The majority
of participants were school-based SLPs (n = 183, 64.7%),
but 51 participants (18%) reported working exclusively
outside school settings (e.g., clinics and private practice),
and 49 (17.3%) reported working across both school-based
and nonschool-based settings. Overall, only 8.5% of
 participating SLPs had used telepractice with students
aged 3–21 years prior to the COVID-19 pandemic (n =
24), which included 7.7% of school-based SLPs, 5.9% of
nonschool-based SLPs, and 14.3% of SLPs who worked
across multiple settings. Participating SLPs reported case-
load size ranging from one to 150 students (Mdn = 35),
which included a range of one to 150 students who used
aided AAC (Mdn = 6). As a proportion, SLPs reported
between 2% and 100% of their caseload were students who
used aided AAC (Mdn = 20%). SLP participants represented
much of the United States, specifically 41 of the 50 states,
excluding Alaska, Delaware, Hawaii, Mississippi, Montana,
Nevada, South Dakota, Vermont, and West Virginia.
Table 1 reports additional information about the
characteristics of participants and the students they served.
Based on chi-square analyses, SLPs who worked exclu-
sively in school-based settings were less likely than others
in the sample to report working in small urban communi-
ties (p < .001); working with preschool-age (p < .001),
secondary-age (p < .05), or transition-age (p < .05) stu-
dents who used aided AAC; and working with students
using aided AAC who had primary or secondary special
education eligibility labels of speech or language impair-
ment (p < .01) or traumatic brain injury (p < .05), who
were proficient AAC users (p < .001), or who accessed
their AAC devices through eye gaze (p < .05) or switch
access (p < .01).
Procedure
Our interdisciplinary research team used the princi-
ples of “tailored design” for survey research (Dillman
et al., 2014). Tailored design aims to minimize survey
error by having researchers tailor their survey designs to
their particular goals and situations. Therefore, our team
developed the survey by considering the research ques-
tions, using established methods for collecting network
data, reviewing prior research literature about AAC tele-
practice (e.g., Anderson et al., 2012; Tucker, 2012a,
2012b), and considering the best ways to gather informa-
tion from the target population (i.e., SLPs using teleprac-
tice to serve students who used aided AAC). To ensure
data protection, the survey was built and managed on
REDCap, a secure platform for data collection and data
management (Harris et al., 2009). Based on guidelines for
rigorous survey design methods (Eysenbach, 2004), our
team piloted the survey with five practicing SLPs and two
master’s-level graduate students, using this testing of the
survey to (a) elicit feedback on the wording and nature of
the questions and (b) evaluate the usability and technical
functionality of the way the survey was formatted. Based
on their feedback, only minor edits needed to be made to
the wording of a few survey items; no concerns about
functionality or usability were raised.
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After the study was approved by the institutional
review board, the online survey was active for a 6-week
window from May to June 2020. Participants were
recruited in multiple ways with the aim of obtaining a
diverse, national sample that reflected variations in our tar-
get population in terms of geographical diversity and prac-
tice characteristics (e.g., caseload, role, and students
served). Thus, we partnered with a variety of people and
organizations to distribute e-mails and electronic flyers,
including state-level professional associations for SLPs in
the United States (n = 19), state departments of education
(n = 8), University Centers for Excellence in Developmental
Disabilities (n = 4), an AAC device company representative
(n = 1), and a statewide practitioner-led AAC organization
(n = 1). Information about the study was also posted on
social media (i.e., Twitter and Facebook) and online discus-
sion boards (n = 16 different locations for online posts).
We used this multipronged approach to attempt to reach
different pockets or subgroups of our target population.
Recruitment materials directed potential participants to go
to the survey through a QR code or weblink. A description
of the study was on the first page, which explained to
potential participants that completion of the survey indi-
cated informed consent to participate in the research study.
SLPs then had to complete screening questions to deter-
mine eligibility before continuing to the survey. The survey
could only be completed electronically and took approxi-
mately 20–30 min to complete. A lottery system was used
to encourage survey completion, in which five randomly
selected participants received a $75 gift card.
Measures
The Appendix includes a list of the exact wording of
the survey items and response options used for analysis in
this article.
Dependent Variable: SLP Self-Confidence for AAC
Telepractice
Ten survey items related to SLPs’ perceptions of
confidence. The items were created for this study based on
a review of literature related to AAC telepractice (e.g.,
Anderson et al., 2012; Tucker, 2012a, 2012b). Items were
arranged in a matrix that asked SLPs: “How confident do
you feel in your knowledge and skills within each of these
specific areas related to using telepractice with students
who use aided AAC?” Responses were provided on a 5-
point scale, ranging from 1 = not at all confident to 5 =
very confident, and specific items included different aspects
related to utilizing telepractice, such as selecting appropriate
technologies, conducting direct or consultative/coaching ses-
sions, and evaluating progress when using telepractice. As
our dependent variable, we created a sum confidence score
as the simple sum of all 10 items. Possible values ranged
Biggs et al.: Preparedness and Support for AAC Telepractice 5
 Table 1. Percentage of participating speech-language pathologists (SLPs) with various characteristics by role.

% School-based % Nonschool % Mixed settings

Variable (n = 183) (n = 51) (n = 49)
a
Community type
Rural 29.5 9.8 32.7
Suburban 40.4 33.3 44.9
Small urban (50,000–250,000) 19.1 51.0 30.6
Large urban (< 250,000) 15.8 27.5 18.4
Years of experience as an SLP
1–5 21.9 41.2 22.4
6–10 16.4 17.6 28.6
11–20 32.2 19.6 26.6
> 20 29.5 21.6 22.4
Years of experience with AAC
1–5 36.6 39.2 34.7
6–10 23.0 25.5 26.5
11–20 27.8 25.5 20.4
> 20 12.6 9.8 18.4
Student age rangeb
Preschool (3–5 years) 42.1 74.5 53.1
Early elementary (5–8 years) 65.6 74.5 77.6
Middle grades (9–12 years) 61.2 52.9 61.2
Secondary (13–17 years) 32.8 43.1 49.0
Transition (18–21 years) 15.3 25.5 24.5
Student IDEA disability categoriesb
Autism 83.1 80.4 83.7
Intellectual disability 55.7 56.9 67.3
Multiple disabilities 56.3 58.8 65.3
Developmental delay 48.6 52.9 61.2
Speech or language impairment 41.5 58.8 57.1
Other health impairment 33.9 27.5 44.9
Visual impairment (including blindness) 15.8 27.5 14.3
Orthopedic impairment 14.8 21.6 24.5
Hearing impairment 10.4 17.6 10.2
Specific learning disability 4.4 7.8 10.2
Traumatic brain injury 3.8 15.7 6.1
Deaf-blindness 4.4 9.8 4.1
Emotional disturbance 3.8 3.9 8.2
Deafness 4.4 2.0 6.1
Student communication levelsb
Preintentional 44.3 60.8 46.9
Intentional, prelinguistic 66.7 70.6 73.5
Emerging symbolic 81.4 82.4 87.8
Early linguistic 69.4 66.7 69.4
Proficient AAC 11.5 29.4 24.5
Student AACb
Low tech 86.9 82.4 91.8
High tech 90.2 86.3 93.9
Student AAC accessb
Touch with finger or part of the hand 98.9 96.1 95.9
Eye gaze 25.7 39.2 34.7
Partner-assisted scanning 16.4 21.6 22.4
Touch with other body part 9.8 11.8 12.2
Switch scanning 7.7 21.6 14.3
Other 1.0 0.0 0.0

Note. AAC = augmentative and alternative communication; IDEA = Individuals with Disabilities Education Act
(SLPs reported on both primary and secondary IDEA categories of their students who used aided AAC).
a
Percentages do not add to 100% because many SLPs worked across different communities. bPercentages reflect
the percentage of SLPs who worked with students who used AAC with each characteristic; percentages do not
add to 100% because SLPs reported on each of the students on their caseload who used aided AAC.

from 10 to 50, with higher values indicating greater self- Independent Variables
confidence for the use of telepractice to serve students SLP characteristics. Participants answered demographic
who used aided AAC. Cronbach’s alpha was .92 for the questions and questions about professional characteristics
10 items, indicating strong internal reliability. that were used to characterize the sample (see Table 1).

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 Five variables from these questions were of interest as
potential predictors of confidence for AAC telepractice:
age, prior telepractice experience (1 = experience with
telepractice before the pandemic, 0 = no prior experience),
school-based (1 = exclusively school-based, 0 = nonschool-
based or across school and nonschool settings), new to AAC
(1 = 3 years or less working with students who use aided
AAC, 0 = more than 3 years), and percentage of work time
spent on telepractice (1 = less than 25%, 2 = 25%–49%, 3 =
50%–74%, 4 = 75%–100%).
Professional resource networks. The survey used a
resource generator to collect professional network data
related to training and personal support. A resource
generator is an established means of collecting network
data that involves a fixed roster of specific resources
across domains (Van Der Gaag & Snijders, 2005). In the
case of this study, the two domains were (a) training types
and (b) people in different roles who provided personal
support (e.g., individually focused advice or help). For
training types, survey respondents were asked if they had
participated in six different types of training related to
using telepractice for students who use aided AAC: formal
coursework, group training or workshop, on-the-job or
individual training, in-person conference presentation, live
web presentation, or recorded web presentation. For
personal support, respondents were asked if they had
received personal support (such as advice, help, individual
training, or other personal support) from any of the
following people: a familiar colleague (e.g., another SLP),
an unfamiliar colleague, a supervisor or an administrator,
a consultant or trainer, a representative from an AAC
device company, or a university instructor or professor.
Using checkboxes arranged in a matrix, SLP respondents
signaled whether they had participated in each type of
training or received support from each person “never,”
“in the last 3 months” (which roughly corresponded to the
beginning of lockdowns from the COVID-19 pandemic),
“in the last 4–12 months,” “more than a year ago,” or
“more than 5 years ago.” Because we were not certain
that we could create a comprehensive fixed roster for
other electronic/print resources, we used a name generator
approach (Perry et al., 2018) instead of a resource generator
approach to collect network data on electronic/print
resources. Whereas a resource generator has respondents
report information about their professional network using a
fixed roster of items that is set by the researcher, a name
generator is an open-ended approach and has respondents
list all specific resources that come to mind in response to a
particular question. Thus, in a yes/no survey item, we asked
participants: “In the last 3 months, have you accessed any
other information electronically or in print related to using
telepractice for students who use aided AAC (e.g., getting
information from a website, reading posts on social
network sites, reading research articles, and listening to a
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podcast)?” If respondents indicated “yes,” the survey then
prompted them to list each individual resource on separate
lines.
Data Analysis
The first research question was addressed using
descriptive statistics (percentages, means, and standard
deviations) to summarize each individual survey item
addressing confidence for AAC telepractice, as well as the
sum confidence score. We used nonparametric two-tailed
Mann–Whitney U tests to test for differences between
school-based SLPs and nonschool-based SLPs because
they are robust to nonnormality and appropriate for
Likert-type data (Allen & Seaman, 2007). We opted to
exclude SLPs who worked across both school and non-
school settings from this comparative analysis because we
did not have data regarding the extent to which they spent
their work hours in different settings or roles. Separate
Mann–Whitney U tests were run for each individual sur-
vey item and the sum score. We used an α level of .05 for
all statistical tests, which has been suggested for use in
exploratory research when multiple significance tests are
used for descriptive purposes (Bender & Lange, 2001).
For the second research question, we calculated
descriptive statistics to summarize the percentages of SLPs
who accessed each different type of training and personal
support across roles (i.e., school based or nonschool
based) and for the full sample. Because survey items about
electronic/print resources were open-ended, we conducted
inductive content analysis to identify categories of differ-
ent types of electronic/print resources (e.g., social media,
blogs, and commercial websites with for-pay continuing
education units [CEUs]) and then coded the open-ended
responses from participants into specific categories. For
example, the response “Facebook groups” was coded into
social media, and the response “PRC-Saltillo” was coded
into device company websites or materials. Data on
electronic/print resources were missing for 23 participants
who indicated that they did access other resources but did
not specify which ones. A chi-square analysis indicated
that these missing data were balanced across the groups of
school-based and nonschool-based SLPs.
To examine the size of SLPs’ professional resource
networks during the pandemic, we created three separate
variables, for the total number of different (a) types of
training, (b) roles/people providing personal support, and
(c) types of electronic/print resources accessed in the last
3 months. We calculated the total professional network
size as the sum of all of these (i.e., the number of different
types of training, the number of different roles/people pro-
viding support, and the number of different types of
electronic/print resources). We then tested the differences
between school-based and nonschool-based SLPs by running
Biggs et al.: Preparedness and Support for AAC Telepractice 7
 separate Mann–Whitney U tests to compare the total net-
work size, the number of different training types, the num-
ber of different people providing support, and the number
of different types of electronic/print resources. As with com-
parative analysis for the first research question, we excluded
SLPs who worked across school and nonschool settings.
Finally, we used ordinary least squares (OLS)
regression to investigate whether hypothesized factors pre-
dicted SLPs’ confidence for AAC telepractice (as the sum
score of the 10 survey items). Although a Shapiro–Wilk’s
test (p = .007; Shapiro & Wilk, 1965) and a visual inspec-
tion of histograms, normal Q–Q plot, and box plot
showed that the sum scores for confidence were nonnor-
mally distributed, with a skewness of −0.144 (SE = 0.145)
and a kurtosis of −0.487 (SE = 0.289), we found that the
residuals for the fitted model were normally distributed
and homoscedastic. Therefore, OLS regression was appro-
priate because the data met this and other assumptions.
Prior to fitting the model, we examined bivariate Pear-
son’s correlations among all variables to ensure there was no
indication of multicollinearity. To interpret the linear regres-
sion, we examined the unstandardized and standardized
Figure 1. Speech-language pathologists’ (SLPs’) ratings of confidence for different aspects of providing augmentative and alternative com-
munication telepractice services.
8 Language, Speech, and Hearing Services in Schools • 1–25
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regression coefficients, semipartial correlation coefficients,
and statistical significance of each predictor to isolate the
predictive value and weight of each variable, holding other
variables in the model constant. Semipartial correlations
are a measure of relative importance or explanatory value
of each predictor through the amount of variance explained
uniquely by that variable.
Results
Ratings of Confidence for AAC Telepractice
Figure 1 displays data about SLPs’ confidence rat-
ings for different aspects of providing AAC telepractice
services. Overall, confidence levels about AAC telepractice
were varied, both across items and across SLPs. SLPs
rated their confidence highest in the area of protecting con-
fidentiality and following the code of ethics (M = 4.0,
SD = 1.1) and lowest in the area of evaluating progress
when delivering services through telepractice (M = 2.6,
SD = 1.1). The distribution of confidence ratings for the
 other eight items was fairly similar and more centrally dis-
tributed (see Figure 1). Variability could also be seen in the
sum score for confidence, which ranged from 13 to 50 out
of a possible range from 10 to 50 (M = 33.7, SD = 8.2).
As hypothesized, the results of the Mann–Whitney
U test showed that there were significant differences in the
summed confidence scores between school-based and
nonschool-based SLPs, with higher scores for SLPs working
in nonschool settings (n = 51; Mdn = 40, range: 18–49)
than for those who were school-based (n = 183; Mdn = 33,
range: 14–50), U = 2,667.0, p < .001, r = −.31. As shown
in Table 2, the results of separate Mann–Whitney U tests
also showed significant differences between the two groups
on each item, with school-based SLPs, as a group, rating
their confidence approximately 1 point lower on the 5-point
scale for each survey item.
Professional Resource Networks for AAC
Telepractice
Table 3 reports information about the different types
of training, sources of personal support, and electronic/
print resources that SLPs reported accessing. When con-
sidering the number of different types of trainings and
sources of personal support, the average professional net-
work size was 3.6 (SD = 2.4), ranging widely from 0 to 11
out of the maximum of 12 from the fixed roster. Adding
in different types of electronic/print resources, the average
network size increased to 5.0 (range: 0–14, SD = 3.1). On
average, SLPs reported that they accessed approximately
two different types of trainings (M = 1.9, range: 0–6,
SD = 1.5), had one to two people in different roles who
provided personal support (M = 1.6, range: 0–6, SD =
1.4), and accessed one to two different types of electronic/
print resources (M = 1.5, range: 0–6, SD = 1.4).
Of the 283 participating SLPs, 91.5% reported acces-
sing some type of training, personal support, and/or
electronic/print resources in the prior 3 months, leaving
8.5% (n = 24) who reported that they had not accessed
any of these resources since the start of the pandemic.
More specifically, 77.7% of all participants reported acces-
sing some type of training, 70.7% reported receiving per-
sonal support from someone, and 67.1% reported acces-
sing other electronic/print resources. The most frequently
accessed resources included recorded web-based presenta-
tions, live web-based presentations, support from familiar
and unfamiliar colleagues (e.g., other SLPs), and social
media.
Contrary to our hypothesis, results of Mann–
Whitney U tests did not find differences in professional
resource network size between school-based and nonschool-
based SLPs, nor for the number of different types of train-
ing or electronic/print resources (see Table 4). However,
there were small differences related to the number of
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different sources of personal support, with nonschool-based
SLPs receiving support from a slightly greater number of
people in different roles than school-based SLPs (see
Table 4). In a follow-up chi-square test, results similarly
showed that there were no differences in the likelihood of
accessing any training or electronic/print resources across
the two groups (i.e., school-based vs. nonschool-based).
However, school-based SLPs were significantly less likely
to report receiving personal support (from anyone) than
their colleagues working in nonschool settings (i.e., 84.3%
of nonschool-based SLPs reported receiving personal sup-
port as compared to 66.7% of school-based SLPs; χ2 =
5.97, p = .02)
Factors Associated With Confidence for
Telepractice
As shown in Table 5, there were significant positive
bivariate correlates between SLPs’ confidence for AAC
telepractice and the percentage of work time spent on tele-
practice, the number of different training types, and the
number of different people providing support. Addition-
ally, being school-based and being newer to AAC (i.e.,
3 years or fewer of experiences with students who use
AAC) were significantly negatively correlated with confi-
dence. Each aspect of SLPs’ professional resource net-
works was weakly correlated with the others (i.e., training,
support, and electronic/print resources; see Table 5).
Results from the linear regression model predicting
confidence for AAC telepractice are displayed in Table 6.
The overall model was significant, F(8, 250) = 7.84, p <
.001, explaining 20.1% of the variance (R2). Being new to
AAC, being a school-based SLP, and age were all signifi-
cant negative predictors of confidence, whereas having
prior telepractice experience and the amount of time spent
on telepractice at the time of the survey were significant
positive predictors. Looking more specifically at factors
related to SLPs’ professional resource network, the num-
ber of different types of trainings also significantly and
positively predicted confidence; however, the number of
people in different roles providing personal support and
the number of different electronic/print resources accessed
were not significant in the model. The variables that
explained the greatest unique amount of variance (in order
from greatest to least based on semipartial correlation
coefficients) were being new to AAC, being a school-
based SLP, the number of different training types, and
time spent on telepractice (see Table 6).
Desired Training and Support
The majority of SLPs (86.6%) indicated that they
wanted additional training, support, or resources related
to using telepractice to provide services to students who
Biggs et al.: Preparedness and Support for AAC Telepractice 9
 10
Language, Speech, and Hearing Services in Schools • 1–25

Table 2. Differences in confidence in knowledge and skills within each area related to augmentative and alternative communication telepractice for school-based and nonschool-
based speech-language pathologists (SLPs).

Descriptive statistics
School-based SLPs Nonschool-based SLPs Significance tests
(n = 183) (n = 51) Mann–Whitney
Survey item 1 2 3 4 5 Mdn 1 2 3 4 5 Mdn U Z p

Confidentiality and ethics 3.8% 8.7% 22.4% 32.8% 32.2% 4.0 2.0% 0.0% 9.8% 31.4% 56.9% 5.0 3,156.5 −3.714 < .01
Conducting consultation/coaching 1.6% 18.0% 32.2% 36.1% 12.0% 3.0 0.0% 7.8% 19.6% 43.1% 29.4% 4.0 3,204.0 −3.580 < .01
sessions
Working with families and 2.2% 16.9% 36.6% 31.1% 13.1% 3.0 0.0% 3.9% 21.6% 41.2% 33.3% 3.0 2,893.0 −4.330 < .01
caregivers
Planning for consultation/coaching 2.2% 18.6% 36.1% 31.1% 12.0% 3.0 0.0% 7.8% 25.5% 31.4% 35.3% 4.0 3,110.0 −3.792 < .01
Conducting direct telepractice 6.6% 20.2% 34.4% 27.9% 10.9% 3.0 5.9% 3.9% 23.5% 27.5% 39.2% 4.0 2,903.0 −4.264 < .01
sessions
Using videoconferencing features 9.3% 19.7% 31.1% 29.5% 10.4% 3.0 2.0% 7.8% 33.3% 23.5% 33.3% 4.0 3,205.5 −3.531 < .01
Determining best approach for 8.7% 17.5% 33.9% 29.5% 10.4% 3.0 2.0% 5.9% 35.3% 23.5% 33.3% 4.0 3,213.5 −3.524 < .01
students (e.g., direct, coaching,
hybrid)
Selecting appropriate technologies 6.0% 16.4% 41.5% 27.9% 8.2% 3.0 3.9% 9.8% 23.5% 43.1% 19.6% 4.0 3,354.0 −3.215 < .01
or modalities
Planning for direct telepractice 9.8% 19.7% 34.4% 25.7% 10.4% 3.0 3.9% 9.8% 37.3% 17.6% 31.4% 3.0 3,470.0 −2.896 < .01
sessions
Evaluating progress 23.0% 29.5% 32.2% 9.8% 5.5% 2.0 11.8% 11.8% 49.0% 13.7% 13.7% 3.0 3,261.5 −3.414 < .01

Note. 1 = not at all confident; 2 = a little confident; 3 = somewhat confident; 4 = quite confident; 5 = very confident.

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 Table 3. Percentage of speech-language pathologists (SLPs) who accessed the different types of training, sources of personal support, and electronic/print resources.

All SLPs School-based SLPs Nonschool-based SLPs

(N = 283) (n = 183) (n = 51)
Not 3 4–12 1–5 >5 Not 3 4–12 1–5 >5 Not 3 4–12 1–5 >5
Variable accesseda months months years years accesseda months months years years accesseda months months years years

Training on AAC telepractice

Recorded web 22.6 63.3 10.6 6.4 1.1 21.9 61.7 10.9 7.7 1.1 29.4 58.8 11.8 3.9 0.0
presentation
Live web 34.4 53.7 8.5 4.9 2.8 37.2 49.2 9.3 5.5 3.3 37.3 52.9 5.9 5.9 2.0
presentation
Group training 44.2 32.5 12.0 9.9 3.5 40.4 33.3 13.7 10.4 4.9 47.1 27.5 11.8 11.8 2.0
or workshop
On-the-job, 45.2 31.1 14.1 6.4 3.9 48.1 29.0 13.1 6.0 4.4 37.3 35.3 17.6 7.8 2.0
individual
training
In-person 64.3 10.2 12.0 11.3 3.9 61.7 12.6 9.8 12.6 5.5 70.6 3.9 19.6 7.8 0.0
conference
Biggs et al.: Preparedness and Support for AAC Telepractice

presentation
Formal university 66.1 2.8 1.4 14.5 15.5 68.9 2.7 1.1 9.8 18.0 54.9 2.0 3.9 31.4 7.8
coursework
Personal support
Familiar 28.6 57.2 9.2 6.0 1.4 30.6 53.6 10.4 4.4 2.2 25.5 66.7 5.9 9.8 0.0
colleague
Unfamiliar 46.6 39.2 7.4 4.9 2.8 45.4 38.8 8.2 4.9 3.8 49.0 41.2 3.9 3.9 2.0
colleague
Supervisor or 68.2 22.6 6.4 1.4 2.1 69.4 21.3 6.0 1.1 2.2 66.7 25.5 9.8 0.0 2.0
administrator
AAC device 59.4 21.9 9.5 8.8 3.2 61.2 18.6 9.3 9.3 3.8 49.0 37.3 11.8 7.8 2.0
representative
Consultant 64.7 19.8 8.8 4.9 3.5 63.9 19.1 8.2 6.0 3.8 58.8 27.5 11.8 3.9 2.0
University 77.4 2.8 2.5 8.8 9.2 78.1 1.6 2.2 6.6 12.0 68.6 7.8 3.9 19.6 2.0
instructor

(table continues)
11

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 12
Language, Speech, and Hearing Services in Schools • 1–25

Table 3. (Continued).

All SLPs School-based SLPs Nonschool-based SLPs

(N = 283) (n = 183) (n = 51)
Not 3 4–12 1–5 >5 Not 3 4–12 1–5 >5 Not 3 4–12 1–5 >5
Variable accesseda months months years years accesseda months months years years accesseda months months years years
Electronic/print resourcesa
Social media 70.4 29.6 — — — 72.8 27.2 — — — 65.9 34.1 — — —
Blogs 80.4 19.6 — — — 79.3 20.7 — — — 84.1 15.9 — — —
ASHA 83.1 16.9 — — — 83.4 16.6 — — — 72.5 13.7 — — —
Other 84.2 15.8 — — — 84.6 15.4 — — — 84.1 15.9 — — —
noncommercial
websites
Commercial 86.5 13.5 — — — 86.4 13.6 — — — 86.4 13.6 — — —
websites with
PD or CEUs
Device company 86.5 13.5 — — — 88.2 11.8 — — — 84.1 15.9 — — —
websites or
materials
YouTube or vlogs 91.2 8.8 — — — 92.3 7.7 — — — 86.4 13.6 — — —
Podcasts 91.9 8.1 — — — 92.3 7.7 — — — 97.7 2.3 — — —
Commercial 93.5 6.5 — — — 92.3 7.7 — — — 82.4 3.9 — — —
websites with
lessons or
materials
Journal articles 93.5 6.5 — — — 94.1 5.9 — — — 95.5 4.5 — — —
Employer 96.2 3.8 — — — 95.9 4.1 — — — 93.2 6.8 — — —
resources
University- 98.1 1.9 — — — 97.1 2.9 — — — 100 0.0 — — —
sponsored
resources
AT center 99.2 0.8 — — — 99.4 0.6 — — — 97.7 2.3 — — —
resources
Textbooks 99.6 0.4 — — — 99.4 0.6 — — — 100 0.0 — — —

Note. AAC = augmentative and alternative communication; ASHA = American Speech-Language-Hearing Association; PD = professional development; CEUs = continuing educa-
tion units; AT = assistive technology.
a
For print/electronic resources, this column represents the participants who did not access in the last 3 months. We only asked speech-language pathologists about the electronic/
print resources they accessed in the last 3 months; thus, the — marks instances where data were not collected.

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 Table 4. Examining differences in professional resource networks for augmentative and alternative communication telepractice of school-
based and nonschool-based speech-language pathologists (SLPs).

Descriptive statistics
School-based SLPs Nonschool-based SLPs
(n = 183) (n = 51) Significance tests
Percentiles Percentiles Mann–Whitney
Variable 10% 50% 90% M Mdn 10% 50% 90% M Mdn U Z p

Total professional resource 0.0 5.0 9.0 4.9 5.0 1.0 5.0 9.5 5.3 5.0 3,388.5 −0.91 .36
network sizea
No. of different types of training 0.0 2.0 4.0 1.9 2.0 0.0 2.0 3.8 1.8 2.0 4,594.5 −0.17 .86
No. of different roles of people 0.0 1.0 4.0 1.5 1.0 0.0 2.0 4.0 1.5 2.0 3,682.5 −2.36 .02
providing support
No. of different types of 0.0 1.0 3.0 1.4 1.0 0.0 1.0 3.5 1.5 1.0 3,688.0 −0.09 .93
electronic/print resourcesa
a
Total professional resource network size as the sum of the number of different types of training, the number of different roles of people pro-
viding personal support, and the number of different types of other electronic/print resources. Data on electronic/print resources were miss-
ing for 14 school-based and seven nonschool-based SLPs who indicated that they accessed electronic/print resources but did not specify
which ones. Thus, these participants are not represented in the data related to network size and electronic/print resources.

use aided AAC. Several topics were raised by participating
SLPs, including (a) planning and implementing direct tele-
practice sessions or activities with children (42.0% of the
188 SLPs who listed any topics); (b) using various modali-
ties, equipment, and videoconferencing features for tele-
practice (28.7%); (c) collaborating with and coaching par-
ents or other family members (24.5%); (d) supporting
AAC implementation more effectively, including during
telepractice but also more general knowledge and skills
related to AAC (22.3%); (e) data collection, assessment,
and evaluating progress through telepractice (18.6%); and
(f) knowing how to support children or youth with specific
characteristics (e.g., prelinguistic communicators, children
with autism, children with challenging behaviors, children
with multiple disabilities, and younger children; 10.1%). A
few other topics were also mentioned by small numbers of
SLPs, including collaborating with teachers and parapro-
fessionals (n = 7, 3.7%), privacy and confidentiality-
related issues and laws (n = 4, 2.1%), literacy (n = 2,
1.1%), and time management and organization when using
telepractice (n = 2, 1.1%). Additionally, 32 SLPs (17.0%
of those who listed any topics) simply responded with gen-
eral statements about wanting more training and support
(e.g., “pretty much any and everything,” “all the things,”
and “literally everything”).
SLPs were asked to select up to three most preferred
formats for receiving additional training or support for
AAC telepractice. The most preferred formats were
recorded web-based presentations (68.2% of SLPs who
wanted additional training, support, or resources); live
web-based presentations (53.7%); websites or other elec-
tronic resources (39.9%); personal support from a col-
league, whether familiar or unfamiliar (22.6%); and in-
person workshops, trainings, or conference presentations
(20.8%). Fewer SLPs indicated a preferred format would
be through any of the following: social media websites
(10.6%), podcasts (7.1%), research articles (7.1%), printed
articles or other printed materials (4.6%), personal support

Table 5. Bivariate Pearson’s correlations for study variables (N = 283).

Variable 1 2 3 4 5 6 7 8 9

1. Confidence —
2. Age −.15 —
3. Prior telepractice experience .10 .19 —
4. School based −.27** .11 −.04 —
5. New to AAC −.16** −.48** −.05 −.11 —
6. Time spent on telepractice .20** .11 .04 −.08 .02 —
7. No. of training types .24** −.01 −.05 −.05 < .01 .08 —
8. No. of people providing support .13* −.06 −.11 −1.00 .06 .06 .40** —
9. No. of electronic/print resources .06 .03 −.18** −.03 .03 .03 .24** .18** —

Note. AAC = augmentative and alternative communication.

*p < .05. **p < .01.

Biggs et al.: Preparedness and Support for AAC Telepractice 13

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 Table 6. Results of the regression predicting confidence for augmentative and alternative communication (AAC) telepractice.
Unstandardized
coefficients
Independent variable β SE
Age −0.10
Prior telepractice experience 4.08
School based −4.09
New to AAC −5.07
Time spent on telepractice 1.44
No. of training types 1.20
No. of people providing personal support −0.03
No. of electronic/print resources 0.18
from a supervisor (2.5%), or textbooks or book chapters
(1.1%).
Discussion
The findings from this survey study revealed that
SLPs who were using telepractice to serve students who use
aided AAC during the early months of the pandemic (May
to June 2020) varied widely in their confidence in their own
knowledge and skills to do so. Their confidence also varied
widely across many different aspects of AAC telepractice
(e.g., evaluating progress, working with families, planning
for and conducting direct and consultation/coaching ser-
vices, and selecting and utilizing appropriate modalities or
technologies for telepractice). Several factors predicted vari-
ability across SLPs. Although both age and having prior
telepractice experience significantly contributed to predict-
ing SLPs’ confidence, the more powerful predictors were
the “negative” predictors of (a) being a school-based SLP
and (b) having 3 years or fewer of experience working with
students who use aided AAC and the “positive” predictors
of (a) accessing a greater number of different types of train-
ing and (b) spending a greater percentage of work time
each week on telepractice. Findings also provided descrip-
tive insight into what professional resources SLPs were
accessing related to AAC telepractice during the early
months of the pandemic (i.e., most often web-based presen-
tations, support from colleagues, and social media posts or
groups) and their desires for future training and support.
These findings provide important insight into issues of pre-
paredness and support for SLPs to use telepractice to serve
students who use aided AAC during the COVID-19 pan-
demic, but the implications for research and practice extend
beyond the context of the pandemic.
SLPs’ Confidence Related to AAC
Telepractice
One of the important ways that this research
expands existing knowledge is the insight it provides into
14 Language, Speech, and Hearing Services in Schools • 1–25
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Semipartial correlation Standardized coefficient p
0.05 −.12 −.14 .04
1.76 .13 .13 .02
0.99 −.26 −.24 < .01
1.33 −.24 −.25 < .01
0.45 .20 .18 < .01
0.35 .21 .22 < .01
0.35 −.01 −.01 .93
0.34 .03 .03 .60
the variability of SLPs with regard to their confidence for
AAC telepractice, including differences between school-
based and nonschool-based SLPs. One thing that is partic-
ularly interesting is that there were minimal differences in
the professional networks between the two groups, yet
confidence still differed. Furthermore, even when holding
constant the different factors related to SLPs’ professional
networks, being a school-based SLP was one of the stron-
gest predictors of lower confidence, only exceeded in
power to explain variance by being new to working with
students who use aided AAC. When it comes to under-
standing “why” these differences exist for school-based
SLPs, the nature of our survey data is better suited for
generating hypotheses rather than conducting confirma-
tory analysis. However, other researchers have similarly
found that school-based SLPs were less confident than
nonschool-based SLPs in other areas, such as related to
working with particular populations of students (Pelatti
et al., 2019). In our own earlier findings from this larger
survey, we found that school-based SLPs were also more
likely to rate telepractice as being “less effective” com-
pared to their colleagues in nonschool-based settings. Fur-
thermore, we found that this was connected to how differ-
ent factors played out during the shift to telepractice for
school-based SLPs, including (a) broader factors (e.g., pol-
icies and funding); (b) practice-level factors (e.g., technol-
ogy access and limitations, nature and type of services);
and (c) factors related to the child, their parents and fam-
ily members, and SLPs themselves (e.g., parent involve-
ment and availability, knowledge and comfort with tech-
nology, and SLP time and demands; Biggs, Therrien,
Douglas, & Snodgrass, 2022). These issues all raise impor-
tant considerations related to the different experiences of
school-based SLPs during the pandemic.
This research also provides important insight into
the specific areas of AAC telepractice for which SLPs
reported higher or lower confidence (see Figure 1). As a
group, SLPs rated their confidence much higher for knowing
how to protect confidentiality and follow the code of ethics
when conducting telepractice than they did for any other
area. Whereas ratings for most of the other areas were fairly
 similar, their ratings as a group were the lowest for know-
ing how to evaluate students’ progress through teleprac-
tice. One important consideration is that our survey asked
SLPs to rate their confidence for AAC telepractice, which
means we cannot separate the contribution of these two
different facets—that is, confidence for serving students who
use aided AAC and confidence to serve these students using
telepractice during the pandemic. However, given that we
found being new to AAC was the strongest predictor of
lower confidence (when looking at the amount of variance
explained), we would assert that AAC-related confidence
was likely a critical contributor to confidence for AAC tele-
practice and not just telepractice-related confidence. Other
research shows that a long-standing problem in the field has
been SLPs’ limited training and support to work with stu-
dents who have AAC needs, particularly in the schools
(Heilmann & Bertone, 2021; Marvin et al., 2003). Although
recent research has suggested that speech-language pathol-
ogy training programs in the United States have increased
their preservice training in AAC over the past decade,
approximately two thirds (66%) of program representatives
from one survey thought few of their graduates were actu-
ally prepared to provide AAC services (Johnson & Prebor,
2019). Alongside this broader research, participants in this
study underscored their need for preparation and support in
the area of AAC, with one out of every five participants
responding that one of their greatest needs for future train-
ing was something in the area of working generally with stu-
dents who use aided AAC (e.g., “how to implement and do
AAC,” “goal writing for AAC,” and “anything AAC!”).
Role of Professional Networks in SLPs’ AAC
Telepractice Confidence
We also found that the size and diversity of SLPs’
professional networks seems to be associated with their
levels of confidence for AAC telepractice—at least when
looking at the number of different types of training. When
interpreting the role of training, it is worth noting that the
survey items specifically asked SLPs whether they had
received or participated in training related to using tele-
practice with students who use aided AAC, not simply tele-
practice more generally. It is not clear whether training
on telepractice more generally would have had the same
strength of association with confidence. Other earlier find-
ings from the larger survey project also found that train-
ing was related to SLPs’ views about telepractice, with
SLPs who had received training being more likely to see
telepractice as a more useful service delivery option for
students who use aided AAC (Biggs et al., in press). This
finding was further explained by analyzing SLPs’ open-
ended responses, which suggested that training may have
helped practitioners have a greater understanding about
“what” telepractice actually was and “how” it could be
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used effectively, including through the strategic use of dif-
ferent technologies (e.g., videoconferencing, asynchronous
modules, recorded video feedback, e-mail, and texts; Biggs
et al., in press).
Although accessing different types of training had a
role in SLPs’ confidence, there was no evidence that
receiving support from a greater number of people in dif-
ferent types of roles (e.g., colleagues and supervisors) was
associated with higher confidence. Conclusions cannot be
drawn, but there are a number of reasons why this might
have been the case. The broader literature on adult learn-
ing is clear that more personal types of adult learning
strategies (e.g., coaching, guided reflection to promote
critical thinking and self-directed learning, and just-in-time
mentorship) are highly effective—much more so, in fact,
than one-shot training models (Trivette et al., 2009).
Therefore, we do not believe that it would be appropriate
to conclude that this type of highly individualized sup-
port would not be associated with SLPs’ confidence for
AAC telepractice. It is important to recognize that—
because of the scope of the survey—we did not ask SLPs
to report anything about the nature or quality of per-
sonal support, but only that they received some type of
personal support (i.e., defined on the survey as advice,
help, individual training, or any other personal support).
Given that so many SLPs were experiencing the rapid,
forced shift to telepractice at the same time, one explana-
tion for the failure to find a significant association could
have been that these individuals providing support were
no more experienced or confident than the SLPs them-
selves who participated in this study.
SLPs’ Perspectives on Needed Supports
Our findings also provide insight into how SLPs
obtained training and support for AAC telepractice during
the early months of the pandemic and the support they
desire for the future. The resources that SLPs most fre-
quently reported accessing were recorded and live web-
based presentations, support from familiar and unfamiliar
colleagues, and social media. Although some of these may
be driven by the unique context of the pandemic (e.g.,
increased availability of web-based trainings on the topic
and decreased in-person options), these most accessed
resources are remarkably similar to those that other
researchers have found SLPs access when faced with clini-
cal problems, even outside the pandemic. For example,
Nail-Chiwetalu and Ratner (2007) found that SLPs,
alongside other professionals (e.g., physicians and allied
health providers), reported that they would most often ask
a colleague when they were confronted with challenges or
clinical questions, rather than looking to professional jour-
nal articles or other similar types of resources. In Nail-
Chiwetalu and Ratner’s study, seeking advice from
Biggs et al.: Preparedness and Support for AAC Telepractice 15
 colleagues was followed in popularity by searching the
Internet and pursuing continuing education opportunities.
Given the role of training, including web-based
trainings, in supporting SLPs’ confidence in this study,
efforts to improve the quality and accessibility of web-
based trainings may be especially worthwhile. That is, if
used to successfully disseminate scientific, evidence-based
practices in practical, practice-focused ways, high-quality
web-based trainings could be used to fill important train-
ing needs for SLPs in the future—including those related
to both AAC and telepractice. The value of web-based
trainings may especially be related to their feasibility, con-
venience, and acceptability to SLPs, but attention to qual-
ity is critical. There is likely considerable variability in the
quality of training opportunities for SLPs (and the extent
to which they emphasize evidence-based practices) on
issues of both AAC and telepractice, particularly since
current procedures for approving CEUs do not involve
approving or evaluating the actual content (ASHA, 2021).
However, it is important to recognize that issues related to
supporting continuing education for SLPs in critical areas
such as AAC telepractice also extend to researchers.
Other researchers have found that limited time to read
journal articles and informational literacy skills are bar-
riers to moving research to practice in speech-language
pathology (Hoffman et al., 2013; Nail-Chiwetalu &
Ratner, 2007), but so also are the barriers of the cost/fees
of journal access; predominance of research focused on
controlled research settings rather than complex, natural
settings; and the reality that researchers are rarely incentiv-
ized or held accountable for developing practitioner-facing
resources over researcher-facing venues (e.g., peer-reviewed
journals).
Limitations and Directions for
Future Research
There are several limitations to this research that
should be considered and that suggest pathways for future
research. First, although resource generators are an effec-
tive and efficient means of collecting data on professional
resource networks, they do not provide a detailed look at
individual resources. For example, our data reflect the
number of different types of trainings and people who
provided support, not the actual number or how much
time was spent in any particular training. This might have
led to differences in demonstrated effects, including poten-
tially underestimating the size and diversity of networks
for some SLPs. Similarly, resource generators collect data
on quantity of resources and not quality. It is likely that
SLP perceptions of the quality and relevance of their
resources impacted their confidence in providing AAC tele-
practice. If future researchers wanted to explore profes-
sional resource networks of SLPs with greater depth and
16 Language, Speech, and Hearing Services in Schools • 1–25
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nuance, they might do so through network-focused quali-
tative interviews, with a smaller sample of SLPs for feasi-
bility. Future mixed methods or qualitative research could
be beneficial for many reasons, including that it could
uncover and explain more about the findings, such as why
school-based SLPs are less confident than their colleagues
in out-of-school settings, why this might matter for the
future, and what could be done to best support school-
based SLPs effectively.
Second, we felt it was necessary to use a multi-
pronged recruitment approach, but this also meant that
we cannot calculate a response rate. Therefore, the sample
should be considered a convenience sample, and we can-
not be certain how representative it is. Third, this study
was cross-sectional, which means our data reflect a single
snapshot from one time point—specifically in the earlier
months of the pandemic. It is likely that SLPs’ confidence
and resource networks have changed over time, particu-
larly as schools have reopened to in-person teaching in
different forms and at different timelines as the pandemic
has unfolded. Furthermore, timing of data collection dur-
ing the earlier months of the pandemic may explain some
differences between school-based and nonschool-based
SLPs (e.g., if school-based SLPs might have had substan-
tially different in-person to remote transition experiences).
Therefore, future research could explore these issues.
Fourth, we collected limited information about the
work settings of SLPs. Because of this, it was difficult to
know how to treat SLPs who worked across settings, and
we opted to exclude them from comparative analyses
between school-based and nonschool-based SLPs. Simi-
larly, we were not able to explore whether or how differ-
ences related to service delivery (e.g., group or individual
sessions and billing concerns) might be associated with
these issues, including across school- and nonschool-based
SLPs. Finally, we treated SLPs’ confidence as our depen-
dent variable and did not attempt to understand how pro-
fessional resource networks might also impact student-
related outcomes, such as service quality or student goal
attainment. Future research should be used to explore
these issues.
Implications for Practice
There are several relevant implications of these find-
ings, including for SLPs, school administrators, and other
stakeholders. First, we believe it is important to acknowl-
edge how findings about SLPs’ professional resource net-
works highlight their resourcefulness and dedication in
navigating the sudden shift to telepractice in the midst of
a global crisis—even with their own personal lives chang-
ing dramatically, as well (e.g., working from home, child
care needs, and financial stressors). The dedication and
professionalism of SLPs to pursue training and additional
 resources to help them use telepractice to serve their stu-
dents well is something that should be recognized. Beyond
this, an encouraging finding with clear implications for
practice is that SLPs who accessed a greater number of
different types of training and who spent more time using
telepractice were more confident in their abilities. We do
not think the takeaway of this finding is that SLPs should
complete every training they can find, particularly given
the amount of stress many SLPs experience in their jobs
both under “normal” circumstances and during the pan-
demic (Ewen et al., 2021). Instead, the best takeaways
seem to be that SLPs approach building their skills both
for telepractice and to serve students who use AAC with a
growth mindset—a mindset not only in which SLPs
embrace and persist through the challenges of serving stu-
dents during this global pandemic but also in which they
believe their skills can be developed, kindle a desire to
learn in themselves and in their school communities, use
careful self-reflection to identify key areas for professional
growth, and then pursue high-quality training that can
help them meet these development goals.
Second, the findings about differences for school-
based SLPs emphasize the need for school administrators
to identify barriers that school-based SLPs might be
experiencing related to serving students who use aided
AAC, particularly through telepractice and during the
pandemic. Although our findings that school-based SLPs
were less confident were specifically focused on using tele-
practice to serve students who use aided AAC, other
researchers have found that SLPs want and need greater
support related to their work with students with AAC
needs, even outside this context (Heilmann & Bertone,
2021; Iacono & Cameron, 2009). Administrators should
know that prior research has shown that self-efficacy and
confidence of SLPs in their abilities to serve their students
are not just important as an outcome in its own right but also
in its association with student-level outcomes such as inter-
vention or service quality (Biancone et al., 2014) and with
SLP-level outcomes such as retention (Ewen et al., 2021;
Farquharson et al., 2020). Given long-persisting and increas-
ing concerns of SLP personnel shortages (Farquharson et al.,
2020), this underscores the importance that school adminis-
trators partner with SLPs to identify effective supports to
help improve SLPs’ confidence in this area.
Third, as the emphasis on telepractice grows, there
is a growing body of empirical evidence about how to use
telepractice effectively, including to serve students who use
aided AAC (Akemoglu et al., 2020; Camden et al., 2020).
However, much of the knowledge found in research arti-
cles is not disseminated well or widely enough, particu-
larly for this knowledge to be consumed and actually
employed by practicing SLPs. In this study, journal arti-
cles were rarely accessed by the SLPs as a resource for
learning about AAC telepractice. In prior research, the
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findings are remarkably similar, showing that few SLPs
seek out or utilize scholarly journal articles when faced
with challenges with clinical cases (Nail-Chiwetalu &
Ratner, 2007). This provides important implications for
issues related to the dissemination of research findings and
ensuring that clinically relevant evidence-based informa-
tion goes quickly into the hands of those who could bene-
fit most from it. The findings from this and the larger
body of research suggest that doing so could have impor-
tant implications for SLPs’ confidence and self-efficacy to
serve their students well.
Author Contributions
Elizabeth E. Biggs: Conceptualization (Lead), For-
mal analysis (Lead), Writing – original draft (Lead), Writing –
review & editing (Lead). Elizabeth Burnett Rossi: Formal
analysis (Supporting), Writing – original draft (Supporting),
Writing – review & editing (Supporting). Sarah N. Douglas:
Conceptualization (Supporting), Formal analysis (Support-
ing), Writing – original draft (Supporting), Writing – review &
editing (Supporting). Michelle C. S. Therrien: Conceptualiza-
tion (Supporting), Formal analysis (Supporting), Writing –
original draft (Supporting), Writing – review & editing
(Supporting). Melinda R. Snodgrass: Conceptualization
(Supporting), Formal analysis (Supporting), Writing – original
draft (Supporting), Writing – review & editing (Supporting).
Acknowledgments
The use of REDCap for survey distribution and
management was funded by National Center for Advancing
Translational Sciences Grant UL1 TR000445, awarded to
Vanderbilt University. The authors would like to thank
Madison Ross and Allyson Arserio for their help in the
development of the survey and with data collection for this
project.
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Biggs et al.: Preparedness and Support for AAC Telepractice 19
 Appendix (p. 1 of 6)
AAC Telepractice Survey Items Used for Analysis in This Article

Survey item Answer options Answer format

Participants
Please tell us your role. 1. A school-based speech-language pathologist (SLP) One selection
2. An SLP who is not school based (e.g., clinic, hospital
outpatient facility, and private practice)
3. An SLP who works in both school-based
and nonschool-based settings
4. I am not an SLP.
Do you provide services for at least one child 1. Yes One selection
aged 3–21 years who uses aided AAC, including 2. No
picture symbols, a communication board or
book, or a speech-generating device (SGD)?
Do you work in the United States? 1. Yes One selection
2. No
Please select your state. 50 states and District of Columbia One selection
Please select your gender. 1. Male One selection
2. Female
3. Prefer to self-describe
If your gender was not listed and you prefer to Text entry
self-describe, please describe.
Please describe your race/ethnicity by selecting 1. Hispanic or Latino More than one
all that apply. 2. White selection
3. Black or African American possible
4. American Indian or Alaska Native
5. Asian or Asian American
6. Native Hawaiian
7. Pacific Islander
8. Prefer to self-describe
If you prefer to describe your race/ethnicity, Text entry
please describe.
What is your highest level of education? 1. Master’s degree One selection
2. Doctoral degree
3. Other
If other, please describe. Text entry
What best describes the community in which 1. Rural More than one
you provide services to children? Select all 2. Suburban selection
that apply. 3. Small urban (50,000–250,000 people) possible
4. Large urban (< 250,000 people)
How many years have you been a speech- 1 or less than 1 to 30+ in increments of 1 year One selection
language pathologist?
Of the years that you have been a speech- 1 or less than 1 to 30+ in increments of 1 year One selection
language pathologist, how many years have
you worked with children (aged 3–21 years)
who use aided augmentative and alternative
communication (AAC)?
Characteristics of students served
Including children who use aided AAC and other Text entry
clients who do not use aided AAC, how many
individuals are currently on your caseload?
Of this full caseload, how many clients are children Text entry
(aged 3–21 years) who use aided AAC, such
as picture symbols, a communication board or
book, or a speech-generating device (SGD)?
What are the ages of the children who use aided 1. 3–5 years of age More than one
AAC that you currently provide services for? 2. 6–8 years of age selection
Select all that apply. 3. 9–12 years of age possible
4. 13–17 years of age
5. 18–21 years of age
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 Appendix (p. 2 of 6)
AAC Telepractice Survey Items Used for Analysis in This Article
Survey item Answer options Answer format
Thinking of the children who use AAC that you 1. Autism More than one
currently serve, under what primary or secondary 2. Deaf-blindness selection
IDEA disability categories do they receive special 3. Deafness possible
education services? Select all that apply. 4. Developmental delay
5. Emotional disturbance
6. Hearing impairment
7. Intellectual disability
8. Multiple disabilities
9. Orthopedic impairment
10. Other health impairment
11. Specific learning disability
12. Speech or language impairment
13. Traumatic brain injury
14. Visual impairment (including blindness)
Thinking of the children who use AAC that you 1. Walk independently More than one
currently serve, what best describes their 2. Walk with assistance (e.g., hands held) selection
degree of physical mobility? Check all that 3. Walk with a supportive device (e.g., walker possible
apply. and crutches)
4. Independent use of power wheelchair
5. Use of power wheelchair with assistance
6. Independent use of manual wheelchair
7. Use of manual wheelchair with support
8. Other
If “other,” please describe. Text entry
Thinking of the children who use AAC that you 1. Preintentional: behaviors can be interpreted, but More than one
currently serve, what best describes their no clearly demonstrated communicative intent selection
expressive communication? Check all that 2. Intentional, prelinguistic: uses intentional possible
apply. communication at a presymbolic level (e.g.,
gestures, vocalizations or sounds, and real
objects)
3. Emerging symbolic: uses a small number (< 30)
of words, picture symbols, manual signs, or
symbols on a speech-generating device
4. Early linguistic: regularly use symbolic language
to communicate but still has a variety of language-
based needs
5. Proficient AAC: proficient with language-based
AAC systems
Do you currently work with children who use 1. Yes One selection
aided AAC such as picture exchange or 2. No
communication boards?
How do the children you serve access these 1. A finger or part of the hand to touch the screen More than one
different forms of aided AAC? Check all that or symbol selection
apply. 2. Another body part to touch the screen or symbol possible
3. Eye gaze
4. Head pointer or head-mounted laser
5. Switch scanning
6. Partner-assisted scanning
7. Other
If “other,” please describe. Text entry
SLP’s experience with telepractice
Which of the following describes your experience 1. I have started using telepractice to provide services One selection
with telepractice? In your response, consider to children in response to the COVID-19 crisis.
your use of telepractice with children aged 2. I was already using telepractice to provide services
3–21 years, including but not limited to children to children before the COVID-19 crisis, and I am
who use aided AAC. continuing to do this.
3. I have used telepractice to provide services to
children in the past, but I am not currently.
4. I have never used telepractice with children, and
I am not currently using telepractice with children.
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 Appendix (p. 3 of 6)
AAC Telepractice Survey Items Used for Analysis in This Article
Survey item Answer options Answer format
Have you ever used telepractice with any 1. Yes. To provide birth-to-3 services One selection
population? 2. Yes. To provide adult services to clients over the
age of 21 years
3. No. I have never used telepractice.
What are the primary reasons you have not used Text entry
telepractice to provide services to children aged
3–21 years?
What are the primary reasons you stopped using Text entry
telepractice to provide services to children
aged 3–21 years?
How long have you been providing telepractice 1. Less than a year One selection
for children (aged 3–21 years)? 2. 1–2 years
3. 3–5 years
4. More than 5 years
Prior to the COVID-19 crisis, approximately what 1. Less than 10% One selection
portion of your work time was devoted exclusively 2. 10%–24%
to telepractice (including planning and conducting 3. 25%–49%
intervention through telepractice)? 4. 50%–74%
5. 75%–100%
Prior to the COVID-19 crisis, was any of the 1. Yes One selection
telepractice that you provided focused on children 2. No
who used aided AAC?
How long have you been providing telepractice 1. Less than a year One selection
for children who use aided AAC? 2. 1–2 years
3. 3–5 years
4. More than 5 years
Thinking of your work prior to the COVID-19 crisis, 1. 1 One selection
approximately how many children who used 2. 2–5
aided AAC did you provide telepractice services to? 3. 6–10
4. 11–20
5. 21–30
6. More than 30
Prior to the COVID-19 crisis, how confident did you 1. Not at all confident One selection
feel in your abilities to use telepractice to provide 2. A little confident
effective services to children who used aided AAC? 3. Somewhat confident
4. Quite confident
5. Very confident
Prior to the COVID-19 crisis, how often did you Text entry
provide each of the following types of telepractice
services to children who used aided AAC? You may
have provided both direct services and consultation/
coaching services for the same children.
Direct services with children 1. Never One selection
2. Rarely
3. Occasionally
4. Somewhat frequently
5. Very frequently
Consultation/coaching services 1. Never One selection
2. Rarely
3. Occasionally
4. Somewhat frequently
5. Very frequently
What were the primary reasons you began using Text entry
telepractice to provide services to children who
used aided AAC?
Many factors may impact how we provide telepractice Text entry
services, such as child-related, family-related, or
technology-related considerations; job expectations;
etc. Prior to the COVID-19 crisis, what factors
influenced your decisions about whether to use
telepractice to provide services to different children
who used aided AAC?
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 Appendix (p. 4 of 6)
AAC Telepractice Survey Items Used for Analysis in This Article
Survey item Answer options Answer format
Prior to the COVID-19 crisis, how did different factors Text entry
influence what type of services you would provide
with telepractice (e.g., direct, consultation/coaching,
both coaching and direct)?
Currently, in light of the COVID-19 crisis, approximately 1. Less than 10% One selection
what portion of your work time is devoted exclusively 2. 10%–24%
to telepractice (including planning and conducting 3. 25%–49%
intervention through telepractice)? 4. 50%–74%
5. 75%–100%
How many children who use aided AAC are you 0–25+, in increments of 1 One selection
providing telepractice services to?
How many children on your caseload who use aided 0–25+, in increments of 1 One selection
AAC are not receiving telepractice services during
the COVID-19 crisis?
Professional networks for AAC
Have you ever received or participated in any of
the following forms of training related to using
telepractice for children who use aided AAC?
Formal university coursework 1. Never More than one
2. In the last 3 months selection
3. In the last 4–12 months possible
4. More than a year ago
5. More than 5 years ago
Group training (e.g., professional development 1. Never More than one
workshop) 2. In the last 3 months selection
3. In the last 4–12 months possible
4. More than a year ago
5. More than 5 years ago
On-the-job, individual training 1. Never More than one
2. In the last 3 months selection
3. In the last 4–12 months possible
4. More than a year ago
5. More than 5 years ago
An in-person conference presentation 1. Never More than one
2. In the last 3 months selection
3. In the last 4–12 months possible
4. More than a year ago
5. More than 5 years ago
A live web-based presentation 1. Never More than one
2. In the last 3 months selection
3. In the last 4–12 months possible
4. More than a year ago
5. More than 5 years ago
A recorded web-based presentation 1. Never More than one
2. In the last 3 months selection
3. In the last 4–12 months possible
4. More than a year ago
5. More than 5 years ago
Have you received personal support (e.g., advice,
help, and individual training) from anyone related
to using telepractice for children who use aided
AAC?
A familiar colleague (e.g., another SLP) 1. Never More than one
2. In the last 3 months selection
3. In the last 4–12 months possible
4. More than a year ago
5. More than 5 years ago
An unfamiliar colleague (e.g., another SLP) 1. Never More than one
2. In the last 3 months selection
3. In the last 4–12 months possible
4. More than a year ago
5. More than 5 years ago
(table continues)

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 Appendix (p. 5 of 6)
AAC Telepractice Survey Items Used for Analysis in This Article
Survey item Answer options Answer format
A supervisor or an administrator 1. Never More than one
2. In the last 3 months selection
3. In the last 4–12 months possible
4. More than a year ago
5. More than 5 years ago
A consultant 1. Never More than one
2. In the last 3 months selection
3. In the last 4–12 months possible
4. More than a year ago
5. More than 5 years ago
A representative from a device company 1. Never More than one
2. In the last 3 months selection
3. In the last 4–12 months possible
4. More than a year ago
5. More than 5 years ago
A university instructor or professor 1. Never More than one
2. In the last 3 months selection
3. In the last 4–12 months possible
4. More than a year ago
5. More than 5 years ago
In the last 3 months, have you accessed any other 1. Yes One selection
information or received other support related to 2. No
using telepractice for children who use aided AAC?
This might include things like getting information
or ideas from a website, reading posts on social
network sites, reading research articles, listening
to a podcast, receiving support from someone
not listed above, etc.
Please list each resource (up to 10) about telepractice Text entry
that you have accessed in the last 3 months on a
separate line below.
Confidence measures
How confident do you feel in your knowledge and
skills within each of these specific areas related
to using telepractice with children who use aided
AAC?
Protecting children’s privacy and confidentiality 1. Not at all confident One selection
and following the code of ethics 2. A little confident
3. Somewhat confident
4. Quite confident
5. Very confident
Selecting appropriate technologies to use 1. Not at all confident One selection
2. A little confident
3. Somewhat confident
4. Quite confident
5. Very confident
Using different features on videoconferencing 1. Not at all confident One selection
platforms (e.g., screen sharing, screen casting a 2. A little confident
tablet, session recording, and annotation tools) 3. Somewhat confident
4. Quite confident
5. Very confident
Determining the approach for telepractice that 1. Not at all confident One selection
will be successful for specific students (e.g., direct 2. A little confident
services, consultative, coaching, hybrid) 3. Somewhat confident
4. Quite confident
5. Very confident
Planning for direct telepractice sessions with 1. Not at all confident One selection
children 2. A little confident
3. Somewhat confident
4. Quite confident
5. Very confident
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AAC Telepractice Survey Items Used for Analysis in This Article
Survey item Answer options Answer format
Conducting direct sessions with children 1. Not at all confident One selection
2. A little confident
3. Somewhat confident
4. Quite confident
5. Very confident
Planning for consultative/coaching sessions 1. Not at all confident One selection
with parents or other communication partners 2. A little confident
3. Somewhat confident
4. Quite confident
5. Very confident
Providing consultation/coaching for parents 1. Not at all confident One selection
or other communication partners 2. A little confident
3. Somewhat confident
4. Quite confident
5. Very confident
Communicating with parents and families about 1. Not at all confident One selection
telepractice 2. A little confident
3. Somewhat confident
4. Quite confident
5. Very confident
Evaluating progress when using AAC telepractice 1. Not at all confident One selection
2. A little confident
3. Somewhat confident
4. Quite confident
5. Very confident
Knowledge needs
At this point in time, would you want to receive 1. Yes One selection
additional resources, training, or support related 2. No
to using telepractice to provide services to children
who use aided AAC?
On what topics would you want additional resources, Text entry
training, or support?
What form(s) would you most want additional support 1. In-person workshops or trainings More than one
to come in? Select up to three that you would be 2. In-person conference presentations selection
most likely to utilize and find useful. 3. Live web-based presentations possible
4. Recorded web-based presentations
5. Personal support from a familiar colleague
6. Personal support from an unfamiliar colleague
or consultant
7. Personal support from a supervisor
8. Websites or other electronic resources
9. Social network sites
10. Podcasts
11. Research articles
12. Textbooks or book chapters
13. Printed articles, brochures, or other resources
14. Other
If “other,” please describe. Text entry

Note. IDEA = Individuals with Disabilities Education Act.

Biggs et al.: Preparedness and Support for AAC Telepractice 25

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