Title: Maximising the impact of speech and language therapy for children with speech sound disorder
Funder: Department of Health and Social Care

Abstract: Background: 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. Aims and objectives: 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 develop work are therefore to: 1. Develop a protocol for collection of a COS and minimum dataset for children with SSD; 2. Agree a standard diagnostic process for identifying subtypes of SSD; 3. Determine the range and specification of interventions for SSD in UK NHS SLT services; 4. Identify the process for future health economic analysis. Development Work plan The development work comprises three workstreams (WS): WS1: Literature-based activity to create preliminary content for all four objectives (to inform objective 1); WS2: Virtual participatory workshop to refine the COS and minimum dataset (objective 1) and to agree the diagnostic process (objective 2) and list of interventions (objective 3); WS3: Expert panel to finalise content for the COS and minimum dataset (objective 1). PPI input has guided plans so far and will continue to be a key part of all activity. A follow-on study will work with ten NHS SLT teams to begin collection of the COS and minimum dataset. We will determine what barriers may exist to collection of data and how these may be overcome in order to establish a process for collection of a large dataset which, subject to consent, can be used to address a wide range of questions relevant to this population. These data will be used to compare outcomes across different care pathways. Timelines for delivery: Deliverables for WS1 will be available from month 4 and for WS2 from month 8. Work on WS3 will begin in month 6 and continue to month 13. The deliverables from all three work-streams will inform plans for the PGfAR submission in month 17. Anticipated Impact and Dissemination: This research will facilitate the consistent collection of data within clinical SLT services that can then be used to address clinically relevant research questions. This team will use the data to determine the most effective and cost-effective care pathways for children with SSD, leading to improved outcomes and a reduction in negative sequalae (e.g., impact on education) and cost savings for the NHS. A paper will be submitted to an international peer-reviewed journal and presentations made at one national and one international conference to promote engagement in data collection and awareness of the resource as well as a model for replication with other client groups. PPI will enable us to translate key messages for a wider public audience.

Lay abstract: Aims of the research: Every year over 70,000 children with speech sound disorders receive different types of speech and language therapy. We don t know which is most effective. We want to collect information which will help us work out which type works best. This study will enable us to agree what information we should collect. Background to the research: Many children have difficulties learning to speak and some of these have a speech sound disorder. These children can be difficult to understand or sound different to their friends. If their problems persist, they are less likely to do well in school and may struggle to make friends or get jobs in adulthood. NHS services provide speech and language therapy for these children in different ways. We want to find out which way is best. This will benefit the child as they will be easier to understand and there will be less impact on their education and social development. This will also save money for the NHS. Design and methods used: We will use information from previous research to work out what information would be helpful to collect. We will run workshops with speech and language therapists and also with young people and parents of children with speech sound disorders to find out what information they think we should collect. A panel of experts will help us to establish a process for collecting information from NHS services. This will mean that information can be compared across NHS services. We will be able to list the different types of therapy and record the amount of progress children make. We will use this information to determine which types are most effective. Patient and public involvement (PPI): Parents of children referred to speech and language therapy have told us that effectiveness of therapy should be a priority for research. Our PPI group will include parents of children with speech sound disorder as well as young people who had speech sound disorder as a child. They will help to ensure that the study includes what they think matters. Dissemination: We will report the results of our research at two conferences for speech and language therapists (one national and one international) and in academic journals. We will ask our PPI partners to help with dissemination via social media. The outcome from this project will be an agreed process for collecting information about the speech and language therapy provided for individual children and how much their speech improved. We will use this process to work out which therapies are most effective and which offer best value for money.

Research activity codes: 8.4 RESEARCH DESIGN AND METHODOLOGIES (HEALTH SERVICES)
Health categories: GENERIC HEALTH RELEVANCE