Caregiver Perceptions of an Asynchronous Video-Based Training on Developmental Language Disorder: A Mixed-Methods Study

Abstract

Purpose:

Caregivers of children with developmental language disorder (DLD) face numerous challenges, including limited evidence-backed options for learning about oral language and DLD. This explanatory sequential, mixed-methods study quantified and described caregiver perceptions of learning about DLD through an online asynchronous training.

Method:

We used quantitative methods to measure self-perceived knowledge of DLD as well as self-efficacy for supporting the child before and after participation in the training. We also measured usability and overall satisfaction with the training. We conducted 1:1 structured interviews with a subset of participants and used an inductive approach to thematic analysis to explain and expand upon quantitative results.

Results:

Caregivers reported higher knowledge and self-efficacy related to DLD after completing the training. Usability and satisfaction ratings were high. Qualitative data provided nuanced explanation of quantitative findings, indicating that the training can increase caregiver knowledge and self-efficacy and can positively impact interactions, support, and understanding of the child. We also found that while caregivers find learning about DLD helpful, they also seek additional information and support related to their own child.

Conclusion:

Online asynchronous learning is a useful, satisfactory means by which to disseminate information about DLD to caregivers.

Developmental language disorder (DLD) is a neurobiological condition impacting language understanding and/or use (McGregor et al., 2020) that occurs in approximately 7% of children (Norbury, et al., 2016). DLD varies in its presentation and can include difficulty with word learning, morphosyntax, vocabulary, and discourse (Lancaster & Camarata, 2019). Many children with DLD demonstrate comorbid word reading difficulty, as in dyslexia (Catts et al., 2006), and most demonstrate reading comprehension difficulty (Catts et al., 2002). DLD is associated with academic (see Ziegenfusz et al., 2022, for a review) and social–emotional challenges (Conti-Ramsden & Botting, 2008). DLD is pervasively underidentified in early elementary school (Hendricks et al., 2019; Tomblin et al., 1997), and public awareness is limited (Kim et al., 2022; McGregor et al., 2020).

Caregivers of Children With DLD

In the current study, we define a caregiver as an individual who is primarily responsible for caring for a child. While often a parent, we intentionally used this term to maximize inclusivity. Caregivers of children with DLD face myriad challenges, including stress (Bonifacci et al., 2016) and stigmatization (Macharey & von Suchodoletz, 2008) related to the child's difficulties. These challenges arise not only from difficulty supporting the child but also from reduced knowledge and understanding of DLD itself. Caregivers of children with DLD describe challenges with understanding their child's language difficulty (Ash et al., 2020; Porter et al., 2020), such as understanding diagnostic and clinical terminology (Ash et al., 2020). Even when the child has been identified and is receiving supports, caregivers may lack opportunities to learn about their child's language disorder (Glogowska & Campbell, 1999). In light of this, recent calls for improved dissemination of critical information about DLD to families (Ash et al., 2020; Porter et al., 2020; Tighe & Namazi, 2022) are well founded. Areas in which caregivers may benefit from learning more about DLD include terminology related to oral language (Ash et al., 2020), understanding of the diagnosis of DLD itself (Ash et al., 2020, Porter et al., 2020), understanding how to support the child at home (Glogowska & Campbell, 2020; Marshall et al., 2007), and awareness of related external supports (Dyson, 2010). Caregivers who seek out opportunities to learn more about DLD may gain useful information they can use to enhance their children's language skills.

Historically, there has been wide variation in terminology used to refer to language disorder, with relatively recent consensus to use the term DLD (Bishop et al., 2016, 2017). Within the public school setting, children with DLD may qualify for supports under multiple eligibility categories, including developmental delay, communication impairment, speech or language impairment, and specific learning disability (IDEA, 2018). Also, terminology used to refer to DLD in the United States can vary within the same child over time in that many children qualify for services under the category of speech or language impairment in early elementary school and under the category of specific learning disability later in elementary school (Georgan et al., 2023). This can be confusing for caregivers, who may incorrectly infer that the child's diagnosis has changed, whereas in fact the label has changed, but the impairment has stayed the same. Furthermore, awareness of DLD lags as compared to other, similarly common neurobiological conditions, such as dyslexia and attention-deficit/hyperactivity disorder (Bishop, 2010; McGregor et al., 2020). This contributes to low public awareness of DLD (Kim et al., 2022) and may contribute to a need for increased learning for caregivers related to oral language and DLD.

Caregiver Education

Knowledge is critical for caregiver empowerment (Hsiao et al., 2017), which, in turn, improves educational experiences (Connor & Cavendish, 2017). Education can be provided in multiple modalities, including face-to-face and through use of technology. To the best of our knowledge, no prior studies have examined the effects of caregiver education about DLD, regardless of modality. However, studies examining online learning for other related conditions have demonstrated positive results. This includes use of online learning for caregivers of children with autism spectrum disorder (Kobak et al., 2011; Pickard et al., 2016) and complex communication needs (Douglas et al., 2017). Success has also been demonstrated for use of online learning to share information about typical language development in young children (Timms et al., 2021). Our related, preliminary work indicates that caregivers of early elementary–aged children (e.g., those in kindergarten through second grade) may be most interested in learning about language and language difficulty through online asynchronous means as compared to other formats, such as in-person learning (Saxon et al., 2023). However, to the best of our knowledge, no available studies have examined caregiver perceptions of learning about DLD, either in general or through online asynchronous means. Also, while training materials for caregivers on the topic of DLD are available online (DLD Project, 2024), they are primarily designed for an Australian-based audience, not United States–based audience. Furthermore, dissemination of information about DLD by clinicians varies (Tambyraja et al., 2017) despite caregivers' desire for specific, practical information (Ash et al., 2020; Porter et al., 2020). Thus, evidence-based materials supporting caregiver education on the topic of DLD are much needed.

Materials for caregiver education must be developed with the user at the forefront of design to maximize usability and overall satisfaction. Usability, or the ease of use of a tool or intervention (Lyon et al., 2019), is essential for the development of impactful materials (Rolland et al., 2021). It is a key determinant of successful implementation, as it informs understanding of an intervention's efficiency and effectiveness (Lyon et al., 2019). Overall user satisfaction, or general enjoyment and engagement, is also critical for thorough evaluation of caregiver education materials and has been a focus on prior studies evaluation of such programs (Coughler et al., 2020; Douglas et al., 2017; Pickard et al., 2016; Timms et al., 2021). Educational materials must also be beneficial for bolstering caregivers' knowledge of targeted concepts. This includes caregivers' perceptions of their knowledge of taught concepts. Caregiver self-efficacy, or confidence in one's ability to perform a specific task related to the child, is of considerable importance (Wittkowski et al., 2017). Self-efficacy encompasses the individual's perception of and confidence in their abilities (Bandura, 1977) and is associated with their ability to apply knowledge and skills (Bandura, 1997). Caregiver self-efficacy is associated with positive home environments, improved child well-being (Jones & Prinz, 2005), and greater involvement in the child's interventions (Kurzrok et al., 2021). Broadly, interventions for caregivers of young children with neurodevelopmental disabilities may be effective for increasing self-efficacy related to supporting the child (Hohlfeld et al., 2018). A robust body of prior research has investigated the effects of caregiver-mediated interventions, or training parents to provide interventions to their children (see Heidlage et al., 2020, for a review). Some have used an online format to accomplish this (Tang et al., 2024; van Balkom et al., 2010). However, to the best of our knowledge, no studies to date have examined the impacts of online education about DLD on either caregiver self-perceived knowledge or self-efficacy. In other words, studies have examined the impacts of teaching caregivers to implement language intervention, but they have not examined the impacts of teaching caregivers about language disorder itself.

The Current Study

We used an explanatory sequential, mixed-methods approach to quantify and describe caregiver perceptions of an online self-paced, asynchronous DLD training for caregivers of early elementary–aged children (kindergarten, first grade, and second grade). We selected caregivers of early elementary children for this initial study of learning about DLD given that these grades are foundational for later academic success. Participants completed an initial questionnaire, participated in the DLD training, and then completed a second questionnaire. The training included an overview of oral language, the definition of DLD, the presentation of DLD, and evidence-based suggestions for supporting children with DLD. This work is significant, as opportunities for learning about DLD are limited (Glogowska & Campbell, 2020; Tambyraja et al., 2017) despite caregivers' desire for clear information about language and language disorder (Ash et al., 2020; Porter et al., 2020). The potential impact of this work includes improving caregiver awareness and knowledge of DLD, refining a means by which clinicians can augment caregiver education, and improving caregiver understanding and ability to support the child.

Our rationale for the use of a mixed-methods approach centers on this methodology using both quantitative and qualitative data to gain insight into the caregiver experience of learning about DLD beyond what could be learned from either quantitative or qualitative data alone. Specifically, our use of an explanatory sequential mixed-methods design allows for explanation of quantitative results (Creswell, 2022). Quantitative data are adequate to summarize general information regarding the impact of the training on caregivers' self-perceived knowledge and self-efficacy. Quantitative data also provide a helpful summary of participants' perceptions of training usability and overall satisfaction with the training. However, additional use of qualitative methods has the potential of explaining quantitative results by revealing novel insights about the caregiver experience of learning about DLD. This is particularly important for this study given that little is known about caregivers' experiences learning about DLD. Thus, use of quantitative measures alone would run the risk of missing important nuances in caregivers' perceptions of the training, given a lack of comprehensive research tools designed to measure constructs related to learning about DLD.

We examined the following four research questions.

• Research Question 1 (RQ1): Did caregivers' self-perceived knowledge of DLD change after participation in a video-based training on the topic of DLD? Based on promising results from studies of online learning for caregivers on related topics (Douglas et al., 2017; Kobak et al., 2011; Timms et al., 2021), we hypothesized that caregivers would report greater self-perceived knowledge after completing the training.

• Research Question 2 (RQ2): Did caregivers' self-efficacy for supporting their child, as related to language and DLD, change after participation in the video-based training on the topic of DLD? We expected that caregivers would report increased self-efficacy for supporting their child after participating in the training. This would be consistent with what is known regarding self-efficacy of caregivers of children with disabilities following interventions in general (Hohlfeld et al., 2018).

• Research Question 3: Do caregivers perceive online video-based training as a usable and satisfactory means for learning about DLD? We expected positive findings regarding usability and satisfaction with online learning on this topic based on our pilot work examining caregivers' preferred methods for learning about language and language difficulty. Our findings indicated that online asynchronous training is a preferable modality for learning for caregivers of early elementary children (Saxon et al., 2023).

• Research Question 4: What are caregivers' perceptions of the experience of learning about DLD, and how can these experiences inform training improvements? Here, we used inductive qualitative methodology to provide a deeper explanation of quantitative results and to support our ability to refine the training. To the best of our knowledge, no studies to date have described caregiver experiences learning about DLD through this type of online asynchronous training. Due to the inductive approach, we did not prescribe preconceived hypotheses when addressing this research question.

Method

We used the Mixed Methods Reporting in Rehabilitation & Health Sciences checklist to guide the reporting of this study (Tovin & Wormley, 2023). The research team included investigators with extensive expertise in use of mixed-methods design and caregiver education, as well as extensive clinical expertise in the field of speech-language pathology and DLD.

Design

The current study used an explanatory sequential, mixed-methods design, with qualitative results weighted more heavily than quantitative results (quan → QUAL). First, we collected quantitative (questionnaire) data. We analyzed quantitative data, comparing caregivers' responses to the pre- and posttraining questionnaires. Then, we conducted 1:1 structured interviews with a subset of caregivers to further explain quantitative results. Figure 1 depicts the process for data collection, analysis, and integration of quantitative and qualitative findings.

Figure 1.

Explanatory sequential mixed-methods process for data collection, analysis, and integration. DLD = developmental language disorder.

Participants

Participants were 35 caregivers of children in kindergarten (n = 9), first grade (n = 9), or second grade (n = 17). Terminology used to refer to language difficulty, including use of the term DLD, is persistently inconsistent (Georgan et al., 2023) despite achieved consensus (Bishop et al., 2016, 2017). Therefore, study eligibility criteria did not include a prior diagnosis of DLD itself. Rather, during screening procedures, participants confirmed that the child was currently receiving speech-language pathology services addressing receptive and/or expressive oral language and did not have any exclusionary diagnoses associated with other language (e.g., autism) or cognitive difficulties (e.g., Down syndrome). Per caregiver report, 27 (79.41%) of children had goals for receptive language, 24 (70.59%) had goals for expressive language, and 19 (55.88%) had goals targeting both. Demographic and background information for participants and children is presented in Table 1. Notably, demographics in terms of race, in particular, did not align with expectations based on the U.S. population (Shrider et al., 2020). Specially, individuals identifying as Black were overrepresented in the sample. This was likely an artifact of our method for participant recruitment.

Table 1.

Caregiver demographic information for the larger study and for follow-up interviews.

	Larger study		Follow-up interview
	n = 35	%	n = 6	%
Race
American Indian/Alaska Native	4	11.43	0	0
Asian	0	0	0	0
Black/African American	22	62.86	3	50.00
Native Hawaiian/Pacific Islander	0	0	0	0
White	4	11.43	3	50.00
Mixed	0	0	0	0
Not reported	5	14.29	0	0
Ethnicity
Hispanic/Latino	0	0	0	0
Not Hispanic/Latino	35	100	6	100
Not reported	9	25.71	0	0
Household income
Less than $20,000	6	17.14	0	0
$20,000–$44,999	11	31.43	1	16.67
$45,000–$139,999	9	25.71	2	33.33
$140,000–$149,999	5	14.29	0	0
$150,000–$199,999	2	5.71	1	16.67
$200,000+	2	5.71	2	33.33
Education level
Less than high school	0	0	0	0
High school diploma or GED	1	2.86	0	0
Some college	3	8.57	0	0
Associate's degree/technical certificate	5	14.29	1	16.67
Bachelor's degree	17	48.57	4	66.67
Master's degree or higher	9	25.71	1	16.67
Relationship to child
Mother	14	40.00	4	66.67
Father	21	60.00	2	33.33

Note. GED = General Educational Development.

We used a convenience sampling approach. Twenty-five (73.53%) participants were recruited via social media (e.g., study staff shared a flyer via parent/caregiver groups). Seven (20.00%) were recruited through the children's school-based speech-language pathologist (SLP) who disseminated the study flyer electronically via e-mail with potentially eligible caregivers. Three (8.83%) participants were recruited through an acquaintance who had previously participated in the study. Of the 34 participants who completed the first phase of the study (i.e., the first survey, training, and second survey), six (17.14%) subsequently participated in a 1:1 structured interview with a trained research team member (the fifth author). Participants provided written informed consent electronically. Informed consent included both participation in the first phrase of the study (questionnaires and training) and an optional follow-up interview. All study procedures were approved by the Mass General Brigham Institutional Review Board.

Procedure

Participants completed a pretraining questionnaire, participated in the video-based training about DLD, and then completed a second posttraining questionnaire. The pretraining questionnaire gathered demographic and background information pertaining to the caregiver and the child and queried the participant as to their knowledge of DLD and their self-efficacy for supporting their child. The posttraining questionnaire included the same knowledge and self-efficacy questions, along with additional questions measuring training usability and overall satisfaction. We systematically selected a subset of participants to participate in a follow-up (see below) 1:1 structured interview. Follow-up qualitative data were gathered to provide a more detailed description of caregivers' experiences learning about DLD. Also, we aimed to inform training refinements and to identify additional learning needs.

The Caregiver Training

The online self-paced, asynchronous video training on the topic of DLD was entitled “Understanding Developmental Language Disorder: A Video-Based Training for Parents and Caregivers.” The training was approximately 45 min in total and was divided into three modules: (1) What Is Language? What Is DLD? (17 min of video), (2) Presentation of DLD (14 min of video), and (3) Supporting Children With DLD (12 min of video). The training was designed to maximize accessibility in light of the strong hereditability of DLD (Barry et al., 2006; Bishop et al., 1995). This included provision of close captioning, the option to modify speed of presentation, provision of complete written transcripts for each module, and URLs for suggested resources for ongoing learning. Upon receiving the link to the training, participants were instructed to view it from any tablet or computer at a convenient time and location. Training content was developed based on the existing literature regarding areas in which caregivers may benefit from direct learning about DLD (Ash et al., 2020; Glogowska & Campbell, 2020; Marshall et al., 2007; Porter et al., 2020) as well as based on our preliminary data related to caregivers' preferred learning modalities (online asynchronous; Saxon et al., 2023). The first author developed a training script, which underwent a review process with the last author. Subsequently, a parent of a child with a language-based learning disability and two SLPs with 8 and 10 years of respective experience working with children with DLD and their families provided consultation and feedback. The training script and visual materials were refined based on this expert feedback prior to recording. Table 2 outlines the training structure and content. Participants accessed the training through a web-based platform, for which they received a direct link upon receipt of the first questionnaire.

Table 2.

Training structure and content.

Module	Content
Module 1: What Is Language? What Is DLD?	Definition of language Receptive language Expressive language Speech versus language Definition of DLD DLD as a lifelong condition Causes of DLD Identifying and diagnosing DLD Terminology used to refer to DLD
Module 2: Presentation of DLD	Changing presentation across ages Presentation of DLD in elementary school DLD and written language DLD and socialization DLD and co-occurring conditions
Module 3: Supporting Children With DLD	Strategies for supporting receptive language Strategies for supporting expressive language School-based resources for children with DLD The role of the SLP in supporting children with DLD Other terms used to refer to DLD Resources for ongoing learning about DLD

Note. DLD = developmental language disorder; SLP = speech-language pathologist.

Pre- and Posttraining Questionnaires

Questionnaire data were collected and managed using REDCap electronic data capture tools (Harris et al., 2009) hosted by Mass General Brigham. After consenting to participate in the training, caregivers were sent a link to a pretraining questionnaire, which gathered caregiver and child demographic and background data. It also included 10 items, developed for the purposes of this study to align with training content, measuring self-perceived knowledge on topics related to DLD. Participants rated their degree of knowledge in each area on a 5-point Likert scale (1 = not at all knowledgeable to 5 = extremely knowledgeable). Internal consistency reliability, as assessed by Cronbach's alpha, was .94 (excellent) on the pre-DLD knowledge scale. The pretraining questionnaire also included seven items measuring self-efficacy for supporting the child as related to language difficulty and DLD, again developed for this study and based on training content. These questions were designed to query caregivers' confidence in applying knowledge of DLD to supporting their own child. Participants rated their degree of self-efficacy in each area on a 5-point Likert scale (1 = not at all confident to 5 = extremely confident). Cronbach's α was .92 (excellent) for the pretraining self-efficacy scale. The posttraining questionnaire included the same knowledge and self-efficacy scales. Internal consistency reliability was again excellent (.94) for the knowledge scale and the self-efficacy scale (.92). The second questionnaire included four additional questions measuring usability and two questions measuring overall satisfaction with the training. Questionnaire items are provided in Appendix A.

Interviews

A subset of participants participated in a 1:1 structured interview. We piloted the interview procedure with two mothers of early elementary–aged children to ensure accessibility of the process and clarity of questions. Following the pilot interviews, several questions were modified to maximize clarity. One question related to ongoing learning interests and needs was added at the recommendation of a pilot participant. Supporting visuals (e.g., the interview questions presented in writing) were modified in terms of color and font size. The trained research team member who facilitated the focus groups was specifically chosen due to their knowledge of DLD, experiences working with research participants, and lack of direct involvement with training development. This was an intentional effort to reduce bias and encourage participants to share honest positive and negative feedback. During the virtual caregiver interviews, the interviewer asked questions from a preplanned interview protocol with 19 questions and probed for further explanation and clarification as needed. Questions were presented verbally and with corresponding text on PowerPoint slides to maximize accessibility. The interviews ranged from 12 min 16 s to 38 min 32 s. Text transcripts were generated using Zoom video conferencing software. A trained graduate research assistant with a related bachelor's degree checked each transcript against recorded interview audio for accuracy. Each transcript was confirmed to match the associated recording.

Quantitative Data Analysis

We calculated all descriptive statistics and completed quantitative analyses using RStudio (Version 1.4.1717; RStudio Team, 2021). We addressed RQ1, which aimed to determine if self-perceived knowledge differed after as compared to before the training, using dependent-samples t test. We calculated 95% confidence intervals and Cohen's d to measure effect size (0.2 is a small effect, 0.5 is a medium effect, and 0.8 is a large effect). RQ2 evaluated whether caregivers perceived the training as a usable and satisfactory means by which to learn about DLD. Here, we calculated descriptive statistics, including percentages, means, and standard deviations.

Qualitative Data Analysis

Structured interviews were grounded in theory, both related to caregiving and DLD (Ash et al., 2020; Porter et al., 2020) and potential benefits and challenges associated with online asynchronous learning (Douglas et al., 2017; Kobak et al., 2011; Timms et al., 2021). Interview questions were also informed by the goal of deeply understanding usability and overall satisfaction (Lyon et al., 2019; Rolland et al., 2021). Participants were invited to participate in a follow-up interview based on participant interest (queried in the first survey) and an effort to balance selection of interviewees across race, mothers and fathers, and the grade of the child. Interviews were conducted and transcribed via Zoom videoconferencing software.

We analyzed interview data using an inductive approach to thematic analysis (Braun & Clarke, 2006). Figure 2 provides a visual depiction of the coding process. Use of an inductive approach allowed for examination of caregivers' experiences without preconceived notions. In other words, we allowed for caregivers' words to drive the analysis. The first and second authors, both doctoral researchers and SLPs, engaged in emergent consensus coding (Creswell & Clark, 2017) using NVivo 12 software (Lumivero, 2017). They have extensive experience (15 and 10 years) working with children with language disorders and their families. Their positionality statements are included in Appendix B. The analysis process was ongoing as the interviews were conducted such that sampling could continue until saturation of themes was achieved. We used an inductive thematic saturation approach (Saunders et al., 2018). Before coding began, the coders engaged in repeated readings of caregivers' transcripts independently to become familiar with the conversation during the interviews. Then, they independently identified key words and phrases related to the research question and established initial codes (see Figure 1, Step 1). Next, they established consensus for these initial codes based on the participants' words (see Figure 1, Step 2). A codebook was created, consisting of consensus codes and definitions. Lastly, coders engaged in axial coding: sorting, synthesizing, and organizing the data to refine, collapse, and consolidate themes (see Figure 1, Step 3; Creswell & Clark, 2017). Table 3 presents sample interview questions and maps questions to codes and themes.

Figure 2.

A visual depiction of the inductive, consensus coding process. Each caregiver was responding to the question, “Describe your experience completing the training.” DLD = developmental language disorder.

Table 3.

Sample interview questions mapped to codes and themes.

Sample interview question	Codes	Theme(s)
Please share your thoughts on the format of the training (in other words, your thoughts about learning online, from videos).	Likeable format Ease of access	Caregivers reported that the training was accessible, easy to understand, facilitated learning, and a positive experience.
Please explain ways that the online DLD training impacted your interactions with your child, if any.	Positive impact of the training on interactions with the child Positive impact of training on understanding the child	Caregivers reported that the training positively impacted their interactions, support, and understanding of their child.
What related topics would you like to learn more about in future trainings?	Interest in learning more about DLD and co-occurring conditions Interest in systems that serve children with DLD Provide suggestions for advocating for the child. Share practical suggestions and resources for supporting the child.	Caregivers shared additional learning interests after completing the training. Caregivers shared suggestions for increasing the usability, effectiveness, and reach of the training.

Note. DLD = developmental language disorder.

Integration of Quantitative and Qualitative Data

Lastly, we integrated quantitative and qualitative data. Quantitative data were gathered and analyzed first. Then, qualitative data were collected using 1:1 structured interviews. Qualitative data were coded and analyzed as interviews were ongoing. Qualitative data were mapped to quantitative findings, in terms of instances of alignment and relevant explanation.

Results

In this section, we present the results of our quantitative analyses and qualitative analyses. Then, we integrate key quantitative and qualitative findings and outline implications for both clinical practice and ongoing research.

Quantitative Findings

Dependent-samples t tests indicated that pretraining knowledge scores (M = 33.28, SD = 9.55) increased following the training (M = 42.09, SD = 6.41, p < .0001, t = 5.19, d = 0.90). Dependent-samples t tests also demonstrated that pretraining scores for self-efficacy for supporting the child (M = 25.65, SD = 7.24) increased after completing the training (M = 29.78, SD = 4.86, p < .001, t = 3.99, d = 0.67). We acknowledge use of parametric methods for the analysis of Likert data as an ongoing subject of debate (Mircioiu & Atkinson, 2017). While for these analyses we chose to conduct parametric tests due to similar distributions of pre- and posttraining data, we also conducted Wilcoxon two-sample paired signed-rank tests to rule out differences in results. Results similarly revealed statistically significant increases in knowledge (p < .0001) and confidence (p < .001).

Participants rated training usability on a 5-point Likert scale: strongly disagree to strongly agree. We defined positive ratings as either somewhat agree or strongly agree. The first item was “This type of training (online, video-based) was a helpful way to learn about DLD.” A total of 94.29% of participants provided positive ratings, M = 4.60, SD = 0.69. The second item was “It was easy to use the training.” A total of 88.57% of participants provided positive ratings, M = 4.49, SD = 0.78. The third item was “The training was convenient.” A total of 94.29% of participants provided positive ratings, M = 4.68, SD = 0.64. The fourth item was “I understood the information included in the training.” A total of 85.71% of participants provided positive ratings, M = 4.57, SD = 0.81. Lastly, participants rated overall satisfaction, again on a 5-point Likert scale: strongly disagree to strongly agree. The first item was “I would recommend this training to other parents/guardians.” A total of 82.86% of participants provided positive ratings, M = 4.57, SD = 0.85. The second item was “Overall, I am satisfied with the training.” A total of 94.29% of participants provided positive ratings, M = 4.63, SD = 0.69. Counts and percentages for participant responses to usability and satisfaction questions are presented in Table 4.

Table 4.

Counts and percentages for responses to usability and satisfaction questions.

Questions	Missing	Strongly disagree (1)	Somewhat disagree (2)	Neither agree nor disagree (3)	Somewhat agree (4)	Strongly agree (5)
Training usability
This type of training (online, video-based) was a helpful way to learn about DLD.	0 (0%)	0 (0%)	1 (2.86%)	1 (2.86%)	9 (25.71%)	24 (68.57%)
It was easy to use the training.	0 (0%)	0 (0%)	2 (5.71%)	3 (8.57%)	9 (25.71%)	22 (62.86%)
The training was convenient.	1 (2.86%)	0 (0%)	1 (2.86%)	0 (0%)	8 (22.86%)	25 (71.43%)
I understood the information included in the training.	0 (0%)	0 (0%)	1 (2.86%)	4 (11.43%)	4 (11.43%)	26 (74.29%)
Overall satisfaction
I would recommend this training to other parents/guardians.	0 (0%)	0 (0%)	1 (2.86%)	5 (14.29%)	2 (5.71%)	27 (77.14%)
Overall, I am satisfied with the training.	0 (0%)	0 (0%)	1 (2.86%)	1 (2.86%)	8 (22.86%)	25 (71.43%)

Qualitative Findings

Here, we present four major themes identified from analysis of interview data: (a) Caregivers reported that the training was adequate, accessible, and easy to understand; (b) caregivers reported that the training positively impacted their interactions, support, and understanding of their child; (c) caregivers shared suggestions for increasing the usability and effectiveness of the training; and (d) caregivers shared additional learning interests after completing the training. We provide direct quotations from participants to illustrate how they shared information and the types of participant comments that informed each theme. Quotations for themes with five or more quotes are provided in tables for the purpose of accessibility to the reader.

Caregivers Reported That the Training Was Accessible, Easy to Understand, Facilitated Learning, and a Positive Experience

The first theme captured caregivers' perceptions of the accessibility of the training, including ease of understanding information in the training and the training as generally positive, or satisfactory, experience. Overall, caregivers described the training favorably: Each caregiver commented positively on at least one aspect of the training. This theme included seven codes: (a) ease of access, (b) ease of understanding, (c) likeable format, (d) alignment of training content with child's profile, (e) training as a positive experience, (f) training facilitated learning, and (g) training positively impacted access of resources. Quotes for the first theme are presented in Table 5.

Table 5.

Example quotes for the theme, “Caregivers reported that the training was accessible, easy to understand, and a positive experience.”

Code	Caregiver quotes
Ease of access	“In general, it was easy to navigate.” (Caregiver 1) “They didn't have a lot of unnecessary information … it was straight to the point.” (Caregiver 5) “It was easy to access.” (Caregiver 6)
Ease of understanding	“I thought it was easy to understand.” (Caregiver 3) “It was pretty easy to follow.” (Caregiver 6)
Likeable format	“I liked the format … I think I like everything about it. The fact that there (were) videos and like also like transcripts. That just was a perfect format, so. I don't think I would make any changes.” (Caregiver 1) “I prefer the reading piece, but that's just because I like to read more than watch videos. But … I like having both.” (Caregiver 2) “I like the online video format. I like to be able to see and read things. And then have it as a reference to go back to. I thought it was well done.” (Caregiver 3) “The format of the training was, to me, it was actually okay being that, you know, most things these days have been done virtually. Most persons get more confidence when they are in their own space.” (Caregiver 4)
Alignment of training content with the child's profile	“They were definitely things that, came up through the training that I see my child such as, I wish I wrote them all down. Having trouble understanding humor and sarcasm.” (Caregiver 6) “Yeah, it was exactly what her language impairment looks like.” (Caregiver 3) “I haven't seen anything different.” (Caregiver 5)
Training as a positive experience	“It was a good experience.” (Caregiver 1) “I thought it was phenomenal. I'm so happy to be part of it.” (Caregiver 3) “It was amazing. I loved it.” (Caregiver 5)
Training facilitated learning	“There were, like, lots of information and it was really good learning.” (Caregiver 1) “I got to learn new stuff and I got to learn new ways of communication.” (Caregiver 4) “It was helpful. I think what was surprising was the connection with dyslexia … just that some people with dyslexia also have DLD … I never really knew or understood how that worked.” (Caregiver 6)
Training positively impacted access of resources	“Definitely, I know there were some linked to the training. Oh yeah, I definitely think I already … belong to like DLD and Me and the other one is it RADLD?” (Caregiver 3) “I did. A little bit I want to dig into them more.” (Caregiver 6)

Note. DLD = developmental language disorder; RADLD = Raising Awareness of Developmental Language Disorder.

“Ease of access” captured caregiver reports of ease of accessing the training, including ease of navigation and use of the web-based platform. For example, Caregiver 1 shared, “In general it was easy to navigate.” “Ease of understanding” included direct statement regarding ease of understanding content, as well as descriptions of lack of confusion or subsequent questions about the material. For example, Caregiver 6 described the training as “ … pretty easy to follow.” The code “likeable format” was applied to caregivers' reports of liking the asynchronous video-based format of the training or the provision of written transcripts and occurred for each of the caregivers. For example, Caregiver 3 shared, “I like the online video format. I like to be able to see and read things.” Notably, there was one disconfirming case related to accessibility. Here, Caregiver 2 reported, “It was a little difficult to navigate. I would prefer it to be like, all in one place, like, moving from one to the other, right? Like on its own kind of thing or like a website.”

The code “alignment of training content with the child's profile” captured caregivers' reports of the training as consistent with what they observe in their own child, including describing the training as relatable. For example, Caregiver 3 reported that “ … it was exactly what her language impairment looks like.” Nearly all caregivers shared that information included in the training was relevant to their own child, with only one participant sharing that the training did not fully capture the child's more subtle difficulties with oral language. Similarly, nearly all of the caregivers described the training as an overall positive experience (captured by the code “training as a positive experience”), either through direct use of the word “positive” or through comments generally describing the experience of completing the training in positive terms. The code “training facilitated learning” captured caregivers' reports of stating either that they learned from the training in general or that they learned specific information (e.g., about a specific topic or a strategy for supporting the child). Lastly, the code “training positively impacted access of resources” captured caregivers' statements about using additional resources suggested in the training (such as websites) and caregivers' statements of interest related to desire to continue to use suggested resources.

Caregivers Reported That the Training Positively Impacted Their Interactions, Support, and Understanding of Their Child

The second theme captured caregivers' perceptions of the positive impacts of the training on their interactions with the child, ability to support the child, and ability to understand the child. This theme included three codes: (a) positive impact of training on interactions with the child, (b) positive impact of training on supporting the child, and (c) positive impact of training on understanding the child. The code “positive impacts of the training on interactions with the child” captured comments related to improved interactions with the child with DLD following the training. This included reports of increased patience, improved communication, and use of suggested strategies. For example, Caregiver 1 described increased patience with the child after learning about DLD: “It … made me more open … even more patient. It made our communication even … better because I had to be like really patient, learn new ways so I communicate.” Also, Caregiver 3 shared, “Yes, I think the big thing that I've changed since watching the training … We have a chaotic household with a lot of kids. But when I am communicating to [child's name], I'm very, intentional and saying, okay, first we're gonna go to Target. Second, we're going to the supermarket. Third, then your friends can come over and play.” Caregiver 5 shared, “Now I'm a bit careful when I'm trying to like communicate to them. I know like I'm communicating to someone who has issues and difficulties in this.”

The code “positive impacts of the training on supporting the child” included descriptions of using the information from the training to either advocate for the child or secure supports for the child. For example, Caregiver 2 shared, “Other people's perceptions of her can be like, she's not like friendly or like she's arguing with her friend like those pieces. So it does make me reflect and like try to educate.” Caregiver 6 reported, “It's definitely helped me advocate for her more. The timing of it was I had an IEP meeting a few days after I took the training and it helped me to become more confident in what I was advocating for her even in subjects other than reading, like other than the obvious subjects, like for example for math. It helped me to advocate for her.”

Lastly, the code “positive impacts of the training on understanding the child” included caregivers' descriptions of the utility of information included in the training for understanding the child's language difficulty. For example, Caregiver 5 explained, “At first I wasn't really getting what they are really going through, and how is this is this possible, but after the training I feel like now I get to really understand them on a personal level.” Similarly, Caregiver 6 shared, “I think it does, help with … understanding that my child might not communicate the way that I think … That there are things that she can't quite understand … or communicate like I think I might think she should be able to or that other people might expect from her.”

Caregivers Shared Suggestions for Increasing the Usability, Effectiveness, and Reach of the Training

The third theme captured caregivers' suggestions for improving the training, including its usability, effectiveness, and reach. This theme included five codes: (a) share the training with a wider range of audiences, (b) increase accessibility, (c) provide more visuals, (d) provide suggestions for advocating for the child, and (e) share practical suggestions and resources for supporting the child. Each of the caregivers shared at least one suggestion for either improving or enhancing the training. Table 6 presents example quotes for each code for this theme.

Table 6.

Example quotes for the theme, “Caregivers shared suggestions for increasing the usability, effectiveness, and reach of the training.”

Code	Caregiver quotes
Consider a wider range of audiences	“I would assume that it's easier for, like, a certain demographic to understand … like specific socioeconomic groups … but also profile wise.” (Caregiver 2) “And then probably another [training] would be for classroom teachers like how do you support this? Like within routines and structures that you can just give to everyone. Right? Good practices, best practices.” (Caregiver 2) “So, for example, for teachers who are learning more about the signs of reading who we share resources with. So, like easily shared resources for teachers and other people who want to learn more.” (Caregiver 6)
Increase accessibility	“I'll suggest that training be made much [more] accessible to persons in a sense that the publicity should be made much wider because I believe that there are many persons out there that need to be quick to search knowledge.” (Caregiver 4) “To share with others, just to kind of get the word out. More kind of like how there is so much out there … for dyslexia if you're looking for it. So maybe even just like easier to share information.” (Caregiver 6)
Provide more visuals	“I just think having like handouts with really clear visuals and less text is important and … then download this for a summary of what we talked about, you know, like with visuals I think would be more approachable for more parents or families.” (Caregiver 2) “I think something that could be really beneficial to parents is like, here's a checklist.” (Caregiver 3) “Maybe easy to understand information to share with others. So, for example, I often send like little like infographics of things or things that are like easy … snapshots of information.” (Caregiver 6)
Provide suggestions for advocating for the child	“Just how to convey the meaning the message to teachers and schools. I think parents need that support. Because schools don't identify it as a need like pretty much universally.” (Caregiver 2) “One of the areas that I still as a parent advocating on behalf of their child … was what does evidence-based intervention look like in a school setting for a child with a DLD diagnosis and how could their language needs be supported across all of the curriculum and content areas.” (Caregiver 3)
Share practical suggestions and resources for supporting the child	“More like, more ways to like, enhance communication with my child.” (Caregiver 1) “Much more detailed explanations on language deficiency … meaning the scope and how it can be dealt with.” (Caregiver 4) “Maybe more clear action steps for people who are not … for people who have children who are not yet diagnosed … And, just some more, like practical tips on, like, on helping children with DLD just like, in everyday life.” (Caregiver 6)

Note. DLD = developmental language disorder.

Caregivers' Additional Learning Interests After Completing the Training

The fourth theme captured caregivers' additional learning interests after completing the training. This theme included three codes: (a) share stories of families who have experienced DLD, (b) interest in learning more about co-occurring conditions and vulnerabilities, and (c) interest in systems that serve children with DLD. Caregiver 5 expressed interest in stories of families who have experienced DLD. Specifically, they suggested that it would be helpful to hear from “ … people who ideally [have a child with language difficulty] and they are now okay and they have accepted it and they have gone through [it]. You see they have seen an SLP and … they are now okay. If you can bring them to share their experiences, their stories. So maybe at least bring hope to … parents who have doubts.”

Several caregivers expressed interest in learning more about conditions that co-occur with DLD (e.g., dyslexia) or about co-occurring vulnerabilities. For example, Caregiver 2 suggested that the training include more information about “the connection between the DLD and literacy … I'm always thinking about like what can serve educators and parents at the same time. So that's one thing I would love to see, like, how is this all connected? How DLD actually like relates with dyslexia.” Caregiver 1 expressed similar interest in learning more about DLD and dyslexia: “I would like to learn how DLD actually, like, relates with dyslexia.” Caregiver 2 also expressed interest in learning more about DLD and pragmatics: “I'd love to see, like, how is this all connected? I'd love to learn more about how it all works in the brain … The impact the social pragmatic needs … on social–emotional health.”

Lastly, two caregivers expressed interest in systems that serve children with DLD. Here, caregivers shared concerns regarding barriers to supporting children with DLD. For example, Caregiver 3 expressed concerns: “I think a parent could watch the training and come away with great knowledge and turn around and go to their public school district SLP and present it to them and really be still be steamrolled or gaslit. Or you know, whether the school-based SLPs don't view this as like something that needs to be treated.” Also, Caregiver 2 expressed concerns related to professionals' lack of awareness of DLD: “We're hearing so much about the mental health impact of high schoolers. Right? And all this money being tossed into mental health. And then I talked to a group of psychologists who are like, we have all this anxiety and depression and I'm like, are you teasing out whether there are any language needs, right? Because kids go to psychologists and can't talk to them.” Caregiver 6 expressed specific concerns related to lack of teacher knowledge of DLD: “Knowing what little I knew about DLD as a teacher, and now as a parent, I kind of know that most teachers probably don't know that much about it either unless they had a very specific training [in] dealing with children with DLD.”

Integration of Quantitative and Qualitative Findings

Quantitative results indicated that caregivers' self-perceived knowledge of DLD was significantly higher after completing the training. Qualitative results confirmed this finding and provided explanation of the nature of caregiver knowledge and learning. Nearly all caregivers who participated in an interview specifically shared that the training facilitated learning. Here, qualitative findings align with quantitative findings. Furthermore, qualitative findings provide an explanation of quantitative findings by elucidating the nature of the experience learning about DLD and areas in which caregivers learned. Each participant who shared that they learned about DLD described the experience as a positive one. For example, Caregiver 1 described the training as “really good learning,” and Caregiver 4 described learning as “an awesome experience.” Qualitative data also elucidated specific areas in which caregivers shared that the training supported learning. For example, Caregiver 3 learned about “having conversations with your school-based SLP about DLD,” and Caregiver 6 reported learning about DLD and dyslexia. Lastly, qualitative results expanded upon quantitative results: Several caregivers shared that the training led to improved understanding of their own child. As Caregiver 5 shared, “I get to really get them … At first, I wasn't really getting what they are really going through … but after the training, I feel like now I get to really understand them on a personal level.”

Quantitative results indicated that caregivers' self-efficacy for supporting the child, as related to DLD, was significantly higher after completing the training. Qualitative results aligned with this finding: Each caregiver who participated in an interview shared at least one way in which the training impacted their ability to support or interact with their child. Qualitative data also provided a nuanced explanation of positive impacts of the training on interactions with the child, such as supporting improved patience and changes to communication with the child. Caregivers also shared specific examples of the training's positive impact on supporting the child, both in terms of educating other adults who interact with the child and in terms of finding the information helpful when meeting with the school-based special education team.

Quantitative results indicated that caregivers rated the training as a usable and satisfactory means by which to learn about DLD. Qualitative results aligned with this finding, as each caregiver interviewed described the training as a generally positive experience, and most shared desire in having the training disseminated widely. Caregivers shared that the training was generally easy to access and that they liked the online asynchronous format. Also, qualitative data expanded upon quantitative findings by demonstrating that caregivers appreciated alignment between the training and what they saw in their own child. One participant shared that the training did not reflect her child's more subtle difficulties and suggested adding related information. Caregivers also shared specific information for improving the usability, effectiveness, and reach of the training. This included shared interest in additional visuals (e.g., shareable infographics), areas of interest for additional learning, and desire for practical materials and strategies to augment the ability to support their own child. While caregivers described learning about DLD through this training as positive and helpful, they also shared desire for additional information to support their ability to directly help and advocate for their own child. Caregivers also shared concerns about systems that serve children with DLD, including concerns that many school-based professionals are not aware of DLD and concerns that SLPs do not consistently use the term DLD.

Discussion

We used an explanatory sequential, mixed-methods approach to describe caregiver perceptions of learning about DLD through an online asynchronous video-based training. In this section, we provide an integrated discussion of quantitative and qualitative findings. Qualitative analyses explained and expanded upon quantitative findings, providing detailed insights into participants' perceptions of learning about DLD. Taken together, quantitative and qualitative data indicate that the training can increase caregiver knowledge and self-efficacy. Also, the training can positively impact interactions, support, and understanding of the child. Lastly, we conclude that caregivers find learning about DLD helpful but also seek additional information and support related to their own child.

Online Asynchronous Learning Is a Usable, Satisfactory Means by Which to Improve Knowledge and Self-Efficacy of Caregivers of Children With DLD

Results demonstrated that online asynchronous learning has benefits for increased knowledge and self-efficacy for caregivers of children with DLD. Consistent with our hypothesis and related studies (Douglas et al., 2017; Kobak et al., 2011; Pickard et al., 2016; Timms et al., 2021), caregivers reported that the training was usable, generally satisfactory, and supportive of increased knowledge of DLD and self-efficacy for supporting the child. This also aligns with our preliminary work indicating that caregivers prefer online asynchronous modalities for learning about oral language and DLD (Saxon et al., 2023). This first effort toward documenting the effects of caregiver education about DLD is promising in terms of addressing caregivers' pervasively unmet learning needs and desire for specific practical information about oral language and DLD (Ash et al., 2020, Porter et al., 2020).

Caregivers Reported That the Training Positively Impacted Their Interactions, Support, and Understanding of Their Child

Caregiver self-efficacy, or the ability to perform a specific task related to the child (Wittkowski et al., 2017), is associated with positive home environments, improved child well-being (Jones & Prinz, 2005), and greater involvement with interventions (Kurzrok et al., 2021). Consistent with our hypothesis and related work (Hohlfeld et al., 2018), the training was beneficial for increasing caregivers' self-efficacy related to DLD. Results indicated that the training facilitated improved interactions with the child (e.g., increased patience), improved ability to support the child (e.g., advocate at a special education meeting), and understanding of the child (e.g., understand the nature of the child's language difficulty). While this type of training cannot replace tailored child-specific education and recommendations, these results are promising. They demonstrate that providing straightforward, accessible education on the topic of DLD may have positive impacts on the caregiver's self-efficacy for supporting the child.

Caregivers Reported Valuing Clear Information About DLD but Also Seek Additional Individualized Information and Ongoing Support

Caregivers perceived learning about DLD as a positive experience and valued the type information about DLD that was provided in the training. They overwhelmingly rated and described learning about DLD through this training as positive and helpful. However, follow-up interviews revealed caregivers' desire for information related to directly helping and advocating for their own child. This included suggestions such resource lists of SLPs with DLD expertise, education targeted at the range of professionals that serve children with DLD, and added information related to strategies for supporting communication with the child. Lastly, caregiver education must be contextualized in the ongoing DLD advocacy efforts. Also, it is important to consider that practice patterns related to terminology use referring to language disorder continue to vary. Caregiver education is critical but is one aspect of larger efforts to improve awareness, knowledge, and understanding of DLD. In this study, caregivers expressed concerns about systems that serve children with DLD that should certainly be explored more fully. This included concerns that many school-based professionals are not aware of DLD and concerns that SLPs do not consistently use the term DLD.

Practical Implications for SLPs

This study has key practical implications for SLPs. First, caregivers of early elementary–aged children with DLD find clear explicit information about DLD helpful and perceive learning related to DLD as a generally positive, helpful experience. For clinicians, this suggests that sharing such information is a valuable, important aspect of supporting families. This aligns with recent DLD advocacy efforts (McGregor et al., 2020) and calls for sharing clear diagnostic information with families (Tighe & Namazi, 2022). This type of training (online asynchronous) is a promising means by which clinicians can improve and augment caregiver education in the context of limited discretionary times and large caseloads (ASHA, 2022). It could be shared with caregivers in addition to routine communication, without imposing additional time burdens. However, this type of education must be provided alongside clear diagnostic information about the individual child and must be shared in tandem with resources that are specific to the needs of the family and child. Lastly, caregivers who have learned about DLD may have concerns about persistent variability in use of terminology and inconsistent awareness of DLD itself. Here, we call upon SLPs to use clear diagnostic terminology when referring to language disorder, to disseminate information about DLD, and to advocate for improved awareness of DLD across relevant professions.

Limitations and Future Directions

We acknowledge several key limitations to this work. First, we used a convenience sampling approach. Due to this, our participants do not reflect the demographics of the United States. Rather, our sample overrepresents individuals identifying as Black. This is likely an artifact of our convenience sampling approach. It must be addressed by related follow-up studies, and it limits the generalizability of our results and may be indicative of underlying structural inequities that were not explored under the scope of this study. Likewise, while we put effort into extending interview invitations to participants who represented the broader group of participants in the study, participants did ultimately self-select as to whether to participate an interview. We acknowledge that we may not have captured all participants' views. We intentionally focused on caregivers of early elementary–aged children for this preliminary study. Therefore, our results cannot be generalized to caregivers of younger and older children. Also, in this initial study, we did not collect direct assessment or functional data on children. Subsequent studies could examine child-level downstream impacts. Lastly, larger studies could examine caregiver education and DLD in relationship to the child's profile.

Despite these limitations, this work is novel in its efforts to examine the use of online learning to share information about DLD with caregivers. It differs notably from prior studies that have focused on teaching caregivers to deliver specific interventions. It informs clinical practice related to methods for sharing information and is a crucial first step in learning about caregivers' perceptions of learning about DLD. No other known study to date has examined this phenomenon. This initial study highlights critical areas for further work, including replication with a larger sample that better represents the population of the United States. Investigating differential responses to learning about DLD based on lived experiences, background knowledge, and psychosocial factors will be important. Larger studies may also examine the downstream impacts of caregiver education, such as on child functional outcomes, family quality of life, and impacts on caregiver–child relationships. Lastly, we emphasize that efforts toward disseminating information about DLD and supporting children with DLD cannot focus only on caregivers. Dissemination and improved supports must extend to numerous invested parties, including SLPs, educators, specialists, and administrators.

Conclusions

In this study, we used an explanatory sequential, mixed-methods approach to describe caregiver perceptions of learning about DLD through an online asynchronous video-based training. Results demonstrate positive implications for the effectiveness of the training for increasing caregiver knowledge of DLD and caregiver self-efficacy for supporting the child. Caregivers generally perceived the training as usable and satisfactory. Qualitative findings confirmed and provided detailed explanation of quantitative findings. The results of this study will inform refinements to the training. Also, results elucidate several directions for future studies and inform efforts to support families of children with DLD.

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Appendix A

Questionnaire Items

Pre- and Posttraining Questionnaire Items for Knowledge, Self-Efficacy, Usability, and Overall Satisfaction

Pre- and Posttraining Knowledge Items 1 = Not at all knowledgeable, 2 = Somewhat knowledgeable, 3 = Fairly knowledgeable, 4 = Very knowledgeable, 5 = Extremely knowledgeable

How knowledgeable do you feel about the following topics related to Developmental Language Disorder (DLD)?

The definition of DLD

The causes of DLD

Other terms used to refer to DLD

Signs (presentation) of DLD

Challenges associated with DLD

The relationship between DLD and literacy (reading, writing, spelling)

Strategies for supporting receptive language (language understanding)

Strategies for supporting expressive language (verbal communication)

Available supports for children with DLD

Other resources related to DLD (private services, websites, etc.)

Pre- and Posttraining Self-Efficacy Items 1 = Not at all confident, 2 = Somewhat confident, 3 = Fairly confident, 4 = Confident, 5 = Extremely confident

How confident are you in your ability to do the following?

Explain Developmental Language Disorder (DLD) to others

Understand terminology used in reports about my child's language skills

Explain challenges associated with DLD to others

Support my child's receptive language (listening, following directions) skills

Support my child's expressive language (verbal communication) skills

Identify language-related supports for my child

Find resources to expand my knowledge of DLD

Posttraining Usability and Satisfaction Questions

Please answer the following questions based on your experience completing the training modules about DLD. 1 = Strongly disagree, 2 = Somewhat disagree, 3 = Neither agree nor disagree, 4 = Somewhat agree, 5 = Strongly agree

Please answer the following questions based on your experience completing the training modules about DLD.

This type of training (online, video-based) was a helpful way to learn about DLD

It was easy to use the training

The training was convenient.

I would recommend this training to other parents/guardians.

Overall, I am satisfied with the training.

Appendix B

Positionality Statements

Katharine M. Radville

At the time of this study, Katharine was currently a doctoral research fellow whose research is primarily conducted in collaboration with a large, urban school district and focuses on elementary-school children with developmental language disorder and dyslexia and their families. She is also a speech-language pathologist, literacy specialist, and former general education public-school teacher. Katharine's research is informed by her experiences as a clinician and educator, and by her expertise in both oral and written language. She is also a parent of two elementary-school children. Katharine has frequently provided education and consultation to families of children with language-based learning disabilities. Katharine is a White, monolingual English speaker who does not present with DLD or dyslexia. As both a coder for this project and the primary developer of the education materials being studied, Katharine was as deliberate as possible to objectively consider caregivers' statements in a manner that did not interfere with interpretation.

Tim DeLuca

At the time of this study, Tim DeLuca was a doctoral research fellow whose research leverages implementation science frameworks to improve school-based outcomes for children with developmental language disorder (DLD) and dyslexia as well as those who use augmentative and alternative communication. He is a speech-language pathologist, reading specialist, and clinical instructor. Tim has practiced in public and private schools, community-based clinics, and in private practice. He frequently partners with school-based professionals to improve assessment, instruction, and intervention for children in schools, working both at the individual, school-based, and district-based levels. At the time of this study, Tim continues to practice clinically in private practice. Here, he is frequently providing parent education related to their children's speech and language strengths and vulnerabilities and related diagnoses. Tim is a White, monolingual English speaker who does not present with DLD or dyslexia but frequently works with individuals with these diagnoses and incorporates their feedback into his clinical practice, teaching, and research.

Funding Statement

Research reported in this publication was supported by the American Speech-Language-Hearing Foundation Student Research Grant in Early Childhood Language Development (Principal Investigator [PI]: Radville; mentor: Hogan) and the National Institute on Deafness and Other Communication Disorders of the National Institutes of Health (R01 DC016895; co-PIs: Hogan and Wolter). The content is solely the authors' responsibility and does not necessarily represent the official views of the National Institutes of Health. Danika L. Pfeiffer is currently supported by funding from the American Speech-Language-Hearing Foundation New Investigators Research Grant for work on the topic of DLD.