Maximising the Impact of Speech and Language Therapy for children with Speech Sound Disorder

76,000 children with Speech Sound Disorder (SSD) are referred to speech and language therapy (SLT) in the UK every year. Untreated, SSD leads to poor outcomes in education, employment, and mental health. SLT intervention in the UK is delivered via care pathways and these are often resource rather than evidence driven and there is significant national variation. There is a pressing need to identify which care pathways are most effective and efficient within NHS service constraints to improve outcomes and maximise cost-effectiveness. Before we can determine which care pathways are most effective and efficient, we must establish a Core Outcomes Set (COS) and minimum dataset.

The objectives of this work are as follows:
1. Develop a robust protocol for collection of a COS and minimum dataset for children with SSD that is meaningful to stakeholders and can be feasibly implemented within SLT services;
2. Agree a standard approach to the diagnostic process for identification of subtypes of SSD;
3. Determine the range and specification of interventions provided for SSD subtypes in UK NHS SLT services;
4. Identify process for future health economic analysis.


Chief Investigator: Dr Yvonne Wren
Director of Bristol Speech and Language Therapy Research Unit (BSLTRU), North Bristol NHS Trust

Dr Sam Harding (BSLTRU)
Dr Joanne Cleland (University of Strathclyde)
Dr Helen Stringer (University of Newcastle)
Sam Burr (BSLTRU)
Dr Sarah Wallace (University of Queensland)
Carolyn Hawkes (Lead Clinical SLT, NHS Lothian)
Lesley Hemmings (SLT, Sirona Health and Care)
Linda Lascelles (CEO, Association for All Speech Impaired Children)

Further Study Information

Current Stage: Ongoing
Date: March 2022 - August 2023
Funding source(s): NIHR RfPB (NIHR202766)

Health Area

Disease Category: Child health, Ear, nose, & throat

Disease Name: Speech sound disorders

Target Population

Age Range: 0 - 25

Sex: Either

Nature of Intervention: Any

Stakeholders Involved

- Charities
- Families
- Patient/ support group representatives
- Researchers
- Service providers
- Service users

Study Type

- COS for clinical trials or clinical research
- COS for practice
- Minimum dataset


- Delphi process
- Focus group(s)
- Semi structured discussion
- Survey
- Systematic review

This study comprises 3 workstreams:

WS1: Umbrella review of current literature to create preliminary content for all four objectives
WS2: Virtual participatory workshop to refine the COS and minimum dataset and to agree the diagnostic process and list of interventions
WS3: A two-round modified Delphi process and expert panel meeting to finalise content for the COS and minimum dataset.

PPI input has guided plans so far and will continue to be a key part of all activity.

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