A systematic review and classification of interventions for speech‐sound disorder in preschool children

Wren, Yvonne; Harding, Sam; Goldbart, Juliet; Roulstone, Sue

doi:10.1111/1460-6984.12371

Cited by 42 publications

(53 citation statements)

References 61 publications

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“…Alternatively, it may reflect the range of complex theories in the different areas of impairment, with evidence so far failing to support any one particular approach over any another (e.g., Wren et al . ).…”

Section: Discussionmentioning

confidence: 97%

‘It depends’: Characterizing speech and language therapy for preschool children with developmental speech and language disorders

Morgan

Marshall

Harding

et al. 2019

Intl J Lang & Comm Disor

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BackgroundSeveral studies have suggested that practitioners hold speech and language therapy (SLT) practice as tacit and consequently it is difficult for the therapist to describe. The current study uses a range of knowledge elicitation (KE) approaches, a technique not used before in SLT, as a way of accessing this tacit knowledge. There is currently no agreed framework that establishes key factors underpinning practice for preschool children with speech and language disorders. This paper attempts to address that gap.AimsTo develop a framework of SLTs’ practice when working with preschool children with developmental speech and language disorders (DS&LD).Methods & ProceduresA mixed‐methods approach was adopted for this study. Data were collected iteratively, from 245 SLTs with experience of working with preschool children with DS&LD across sites in England, by means of focus groups and national events. There were three stages of data collection: local sites, specific‐interest groups and two national events. KE techniques were used to gather data, with initial data being collected in local site focus groups. Findings from groups were taken to subsequent larger groups where a combination of concept mapping, teach‐back and sorting exercises generated a more detailed description of practice, using discussion of consensus and disagreement to stimulate further exploration and definition and provide validatory evidence.Outcomes & ResultsThis paper provides a high‐level framework of therapy for preschool children with DS&LD that makes practice explicit in this area. The framework proposes that therapists’ aims for this group of children fall into three categories: addressing children's areas of impairment and skills; achieving functionally meaningful skills and carryover; and supporting adults to provide a supportive communication environment. The exact configuration is shaped by the child's context and needs.Conclusions & ImplicationsThe framework highlights themes that are well researched in the literature (e.g., speech) and others that have been little studied (e.g., adult understanding), indicating a disconnect between research evidence and practice. The research also highlights the complex nature of interventions for preschool children with DS&LD and the importance therapists attribute to tailoring therapy to individual needs. The framework provides a scaffold upon which SLTs can focus their clinical practice and encourages the profession to understand and explore better the gaps between research evidence and clinical practice for preschool children with DS&LD.

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Section: Discussionmentioning

confidence: 97%

‘It depends’: Characterizing speech and language therapy for preschool children with developmental speech and language disorders

Morgan

Marshall

Harding

et al. 2019

Intl J Lang & Comm Disor

Self Cite

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“…The findings of the current study concur with the sentiments of Wren et al . () in that an increased amount of high‐quality research studies is necessary to inform SLTs’ clinical practices with children with phonological impairment.…”

Section: Discussionmentioning

confidence: 99%

Intervention for children with phonological impairment: Knowledge, practices and intervention intensity in the UK

Hegarty

Titterington

McLeod

et al. 2018

Intl J Lang & Comm Disor

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The most commonly used intervention approaches identified in the current survey (i.e., speech discrimination, conventional minimal pairs and phonological awareness therapy) may be used eclectically by SLTs, which could impact upon the effectiveness and efficiency of treatment for phonological impairment. The current study also highlighted that almost half the participants always/often used traditional articulation therapy to remediate phonological impairment, even though this approach has been found to be less effective for this difficulty. Additionally, it appears that the currently provided intervention intensity for phonological impairment in the UK is significantly lower than what is indicated in the literature. Therefore, a research-practice gap exists for SLTs in the UK working with children with phonological impairment.

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“…This may, in part, explain difficulties with evidence implementation, impacting our potential to make reasonably informed decisions. Furthermore, while some areas of speech-language pathology practice, such as phonological interventions, now have a relatively strong empirical evidence base 11,12 compared with some other areas of speechlanguage pathology practice, there is a low likelihood that the discipline's evidence base will ever be complete and that efficacy evidence will ever be sufficient to support treatment evaluations. 1,13 THE COMPLEXITIES OF INTERVENING We contend that EBP insufficiently acknowledges the complexities of the treatment process and the multiplicity of factors that can impact treatment outcomes.…”

Section: What Is Evidence-based Practice Exactly?mentioning

confidence: 99%

“…There are some examples of research contributing to our knowledge in this area. Interventions for phonological disorders in childhood, for example, have been generally well described in terms of treatment theory including mechanisms of action, 53 and Wren et al 11 have mapped details of intervention components. Surveys of clinical practice and clinical decision making such as that conducted as part of the Better Communication Research Program (BCRP) 54 have provided clinician reports (practice evidence) on intervention approaches, models, theories, and targets of intervention, including for phonological difficulties.…”

Section: Evidence and Knowledge Not Explicitly Recognized In Ebpmentioning

confidence: 99%

Moving Beyond Traditional Understandings of Evidence-Based Practice: A Total Evidence and Knowledge Approach (TEKA) to Treatment Evaluation and Clinical Decision Making in Speech-Language Pathology

2019

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Evidence-based practice (EBP) is a well-established framework for supporting clinical decision making in the discipline of speech-language pathology. The benefits of using evidence to inform clinical practice are acknowledged by clinicians and researchers alike. Even so, after over two decades of EBP advocacy, much clinical uncertainty remains and models supporting the evaluation of interventions require review and reconsideration. The EBP model, while promoting positive principles, can be argued to be conceptually flawed because it suffers from a lack of attention to and explicit valuing of other forms of knowledge crucial to the formation of realistic and judiciously informed decisions. We propose that the evaluation of interventions would be better supported by an explicit knowledge management approach reflecting a range of evidence and knowledge. One worked example is presented to demonstrate what using such an approach can produce in terms of intervention information.

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A systematic review and classification of interventions for speech‐sound disorder in preschool children

Cited by 42 publications

References 61 publications

‘It depends’: Characterizing speech and language therapy for preschool children with developmental speech and language disorders

‘It depends’: Characterizing speech and language therapy for preschool children with developmental speech and language disorders

Intervention for children with phonological impairment: Knowledge, practices and intervention intensity in the UK

Moving Beyond Traditional Understandings of Evidence-Based Practice: A Total Evidence and Knowledge Approach (TEKA) to Treatment Evaluation and Clinical Decision Making in Speech-Language Pathology

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