City Research Online

Abstract

Speech Sound Disorder (SSD) and Developmental Language Disorder (DLD) are common childhood conditions which often co-occur. A co-occurring profile in the pre-school years is associated with negative longer term outcomes in literacy, communication, and mental health. A shared underlying area of difficulty in both SSD and DLD is phonology (i.e. how sounds are organised to produce language). Yet, interventions within the pre-school years tend to target SSD or DLD features, and do not draw on shared theoretical underpinnings.

The aim of this study was to co-design a novel intervention for pre-school children with features of a (consistent phonological) SSD and DLD in four phases:

Phase 1- a systematic review with narrative synthesis to identify intervention techniques for expressive vocabulary and speech comprehensibility, and relate to underlying theory

Phase 2- a survey of UK clinical practice to explore how speech and language therapists (SLTs) would provide an intervention within their clinical practice

Phase 3- an e-Delphi with expert UK SLTs to gain consensus on the core elements of a new intervention

Phase 4- interviews with parents from under-represented communities to enhance the prospective acceptability of the intervention.

A project steering group oversaw all four study phases and co-designed the intervention elements that gained consensus in phase 3.

As a result of this study, an initial protocol for a novel intervention for pre-schoolers with a co-occurring profile, titled ‘SWanS’ (‘Supporting Words and Sounds’), has been developed. The protocol is based on the 44 core elements which achieved consensus in phase 3, and recommended refinements which arose from the parent interviews in phase 4. A Theory of Change has also been developed to make explicit the hypothesised relationship between the different intervention elements, which are grounded in behaviour change and linguistic theory.

There are direct and indirect implications of this body of work. Involving professionals and people with lived experience within all stages of the intervention development process has increased the face validity and prospective acceptability of the SWanS protocol. This provides a strong foundation for future trialling, thus bringing us one step closer to providing appropriate intervention for pre-schoolers with a co-occurring SSD/DLD profile. Indirect benefits include learnings gleaned from employing a combined theory-partnership intervention development approach, which can be used to inform future intervention development processes.

Publication Type:	Thesis (Post-Doctoral)
Subjects:	R Medicine > RA Public aspects of medicine R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
Departments:	School of Health & Medical Sciences > Department of Allied Health School of Health & Medical Sciences > School of Health & Medical Sciences Doctoral Theses Doctoral Theses

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