Speech-language pathologists' confidence levels and professional development needs in motor neurone disease: An Australian survey

Abstract

Clinician confidence is vital for effective patient-professional relationships, yet limited research has explored speech-language pathologists' (SLPs) confidence in supporting people with motor neurone disease (MND). This study investigated speech-language pathologists' self-reported confidence across key speech-language pathology domains (swallowing, oral secretions, oral hygiene, airway management and communication) in MND. It also investigated associated demographic variables, barriers, facilitators and professional development needs. Seventy-two speech-language pathologists from Australia completed an online questionnaire, covering the above topics. Quantitative data were analysed using descriptive statistics and regression analysis, while content analysis was applied to open-ended responses. Participants reported varied confidence levels, with higher confidence with general interventions, including diet/fluid modification and clear speech strategies, but lower confidence in motor neurone disease-specific interventions, including voice preservation, secretion management, and electronic alternative and augmentative communication devices. Demographic and background factors including years of experience, motor neurone disease caseload proportion, multidisciplinary team structure, and clinician age were statistically significantly associated with confidence. Participants described various facilitators and barriers to confidence development, categorised into four themes: Support systems and collaboration, resources, knowledge and skills, and interactions and communication. Participants highlighted key insights they wish they had known when starting to work with people with motor neurone disease, which informed the development of practical tips for new clinicians. These findings highlight the complex interplay of factors influencing speech-language pathologists' confidence when supporting people with motor neurone disease, emphasising the need for targeted measures to address identified gaps. A set of recommendations has been developed to advance multidisciplinary team research and clinical practice in this area. Enhancing speech-language pathologist confidence has the potential to improve both clinician satisfaction and patient care. Further research is needed to implement and evaluate these recommendations.