Online speech and language therapy in small groups for children with developmental language disorders: guided interviews to identify requirements, attitudes, and barriers

Developmental language disorders (DLD, ICD-11 6A01.2) represent the most common indication for speech and language therapy in children. In Germany, language therapy is predominantly delivered as individual, face-to-face sessions. Within the framework of the project “Effectiveness of an Online Interval Small-Group Therapy for Children with Developmental Language Disorders” (THEON), this study is being conducted to investigate whether video-assisted group language therapy is as effective as conventional face-to-face individual treatment in children with DLD. Prior to the implementation of the randomized controlled trial (RCT), a preliminary qualitative interview study was conducted with parents, speech and language therapists (SLTs), and physicians to explore their attitudes, requirements, and perceived barriers regarding this novel form of therapy delivery. This manuscript presents the findings of this preparatory qualitative study. Ten semi-structured interviews were conducted by two trained researchers with four parents of children with DLD, four SLTs, and two physicians. Participants were asked about their views on online group speech and language therapy. A semi-structured interview guide served as the basis for the virtual interviews. The guide addressed themes that were identified in advance through a literature search while also allowing room for open discussion and the emergence of additional relevant aspects. Interviews were audio-recorded, transcribed verbatim, and analyzed using qualitative content analysis supported by MAXQDA. Online therapy was perceived as particularly suitable for older children and children with clearly defined speech or language disorders. The advantages perceived included improved access to care, no travel time, and the possibility of recording sessions. Concerns related to reduced concentration and compliance, technical problems, limited methodological flexibility, and changes in therapeutic relationships due to the required presence and active role of caregivers. The findings informed the development of a mixed-methods process evaluation accompanying the THEON trial, including a standardized questionnaire assessing feasibility, satisfaction, acceptance, and implementation barriers among parents and SLTs. Overall, stakeholders perceived online group therapy as a feasible complementary approach under specific conditions, particularly for older children and clearly defined disorders. At the same time, the interviews highlighted the importance of adequate technical infrastructure, active caregiver involvement, and careful patient selection for successful implementation into routine care.