Making the case for the collection of a minimal dataset for children with speech sound disorder

Learner training for phonetic transcription of typical and/or disordered speech: A scoping review

BACKGROUND

Phonetic transcription is a core skill of speech and language therapists/pathologists (SLT/Ps) for clinical assessment of speech sounds and/or errors, and linguists for investigation of phonetic phenomena in various languages; hence, it is included in the curriculum of the corresponding degree programme. Many experts and course instructors have discussed their opinions on different aspects of phonetic transcription teaching and/or reported their own training programmes. However, no review has systematically summarized the types of expert recommendations and training methodology reported in the literature. Such information is important for mapping the knowledge gaps, refining current teaching and planning further research.

AIMS

To systematically summarize (1) the materials and procedures for delivering and evaluating phonetic transcription training programmes, and (2) the opinions from experts in phonetic transcription teaching regarding but not limited to the content, rationale(s), format and structure, and timing of teaching phonetic transcription of typical speech and/or disordered speech reported in the literature.

METHODS & PROCEDURES

A scoping review was carried out by following the Joanna Briggs Institute methodology. PubMed, EBSCOhost and Web of Science were searched and citation searching of included papers was completed. The included papers were divided into training programme reports, of which data (e.g., type and number of speech stimuli used, type and number of learners, outcome measures) were charted, and expert opinion papers, analysed using content analysis.

MAIN CONTRIBUTION

A total of 565 studies were retrieved. After excluding duplicates and irrelevant papers and merging two sources that reported the same training, a total of 23 sources on training programmes and six opinion papers were analysed. Most training were for English and for SLT/P students, with some for the linguistics students. There are variations in the training content (with phonetic transcription practice as the main procedure), delivery mode (some presented via websites or computer software), stimuli (audio recordings of typical adults and children with speech disorders were most used), feedback (mostly immediate feedback using answer keys) and outcome measures (mainly transcription accuracy of learners and user opinions). Content analysis of opinion papers determined five main categories: rationale for training; aspects of the delivery of training; transcription; problem areas noted; and strategies/resources.

CONCLUSIONS & IMPLICATIONS

Implications and considerations for teaching are discussed, along with recommendations for research in the design of evidence-based training. The findings can contribute to the development of general guidelines about phonetic transcription training in educational programmes and the establishment of pre-registration competencies.

WHAT THIS PAPER ADDS

What is already known on this subject Phonetic transcription is a core skill of SLT/Ps and linguists for clinical speech assessment and research, and it is an important component in the curriculum of the relevant degree programmes. Many experts and course instructors have discussed their opinions regarding phonetic transcription teaching and/or reported their own training programmes in various sources such as books and book chapters, research papers and conference proceedings. What this paper adds to the existing knowledge The paper reports a scoping review that systematically summarized the materials and procedures for delivering and evaluating phonetic transcription programmes and experts' opinions and recommendations for phonetic transcription teaching, reported in the literature. The data from these two types of sources allowed an integrated discussion of the various aspects of phonetic transcription training, such as content, format and structure, materials and timing of teaching and the evaluation of training efficacy. What are the potential or actual clinical implications of this work? The data synthesized and discussed provide a foundation for a review of current practice in phonetic transcription teaching in SLT education. The findings can contribute to the development of general guidelines about phonetic transcription training in educational programmes and the establishment of pre-registration competencies.

Outcome measures for children with speech sound disorder: an umbrella review

OBJECTIVE

Speech sound disorder (SSD) describes a 'persistent difficulty with speech sound production that interferes with speech intelligibility or prevents verbal communication'. There is a need to establish which care pathways are most effective and efficient for children with SSD. Comparison of care pathways requires clearly defined, evidence-based, interventions and agreement on how to measure the outcomes. At present, no definitive list of assessments, interventions or outcomes exists. The objective of this umbrella review paper is to provide a rigorous and detailed list of assessments, interventions and outcomes which target SSD in children.

DESIGN

In December 2022, a systematic search of Ovid Medline, OVID Embase, CINAHL, PsycInfo and Cochrane and a number of grey literature platforms were undertaken. 18 reviews were included, and subsequently 415 primary research articles were assessed for data related to assessments, interventions or outcomes. The AMSTAR (Assessing the Methodological Quality of Systematic Reviews) framework was used to assess the quality of the retained reviews.

SETTING

Reviews were retained which took place in any setting.

PARTICIPANTS

The population is children of any age with a diagnosis of SSD of unknown origin.

PRIMARY AND SECONDARY OUTCOME MEASURES

Reviews reporting outcomes, assessment and interventions for children with SSD.

RESULTS

Extraction and analysis identified 37 assessments, 46 interventions and 30 outcome measures used in research reporting of SSD. Not all of the listed outcomes were linked to specific outcome measurement tools, but these were measurable through the use of one or more of the assessments extracted from the retained reviews.

CONCLUSIONS

The findings of this review will be used to develop a Core Outcome Set for children with SSD. The findings are part of a rigorous process essential for advancing healthcare research and practice in the specific area of speech and language therapy for children with SSD.

PROSPERO REGISTRATION NUMBER

CRD42022316284.

The Multilevel Word Accuracy Composite Scale: A Novel Measure of Speech Production in Childhood Apraxia of Speech

PURPOSE

The Multilevel word Accuracy Composite Scale (MACS) is a novel whole-word measure of speech production accuracy designed to evaluate behaviors commonly targeted in motor-based intervention for childhood apraxia of speech (CAS). The MACS yields a composite score generated through ratings of segmental accuracy, word structure maintenance, prosody, and movement transition. This study examined the validity of the MACS through comparison to established measures of speech accuracy. Reliability was also examined within and between practicing speech-language pathologists (SLPs).

METHOD

The MACS was used to rate 117 tokens produced by children with severe CAS. Ratings were performed in the laboratory setting by two expert raters and by practicing SLPs (N = 19). Concurrent validity was estimated through comparison of expert MACS ratings (i.e., MACS score and each component rating) to measures of speech accuracy (percent phoneme correct and the 3-point scale) using correlational analyses. Reliability was examined between expert raters and across SLP raters using the intraclass correlation coefficient to examine interrater reliability of expert ratings, in addition to inter- and intrarater reliability of SLP ratings.

RESULTS

Correlation analyses between MACS ratings (i.e., MACS score and component ratings) and existing measures of speech accuracy revealed small to large positive correlations between measures. Reliability analyses revealed moderate to excellent reliability for MACS ratings performed by expert raters and between (interrater) and within (intrarater) SLP raters.

CONCLUSIONS

Analyses of concurrent validity indicate that the MACS aligns with established measures, yet contributes novel elements for rating speech accuracy. Results further support the MACS as a reliable measure for rating speech accuracy in children with severe speech impairment for ratings performed by expert raters and practicing clinicians.

Outcome measures for children with speech sound disorder: an umbrella review protocol

INTRODUCTION

Speech sound disorder (SSD) describes a 'persistent difficulty with speech sound production that interferes with speech intelligibility or prevents verbal communication'. There is a need to establish which care pathways are most effective and efficient for children with SSD. Comparison of care pathways requires clearly defined, evidence-based interventions and agreement on how to measure the outcomes. At present, no list of assessments, interventions or outcomes exists.The objective of this paper is to provide a rigorous and detailed protocol for an umbrella review of assessments, interventions and outcomes that target SSD in children. The protocol details the development of a search strategy and trial of an extraction tool.

METHODS AND ANALYSES

The umbrella review has been registered with PROSPERO (CRD42022316284). Papers included can use a review methodology of any sort but must include children of any age, with an SSD of unknown origin. In accordance with the Joanna Briggs Institute scoping review methods guidelines, an initial search of the Ovid Emcare and Ovid Medline databases was conducted. Following this, a final search strategy for these databases were produced. A draft extraction form was developed.

ETHICS AND DISSEMINATION

Ethical approval is not needed for an umbrella review protocol. Following the systematic development of an initial search strategy and extraction form, an umbrella review of this topic can take place. Dissemination of findings will be through peer-reviewed publications, social media, and patient and public engagement.

'I think that's what I heard? I'm not sure': Speech and language therapists' views of, and practices in, phonetic transcription

BACKGROUND

Phonetic transcription is recognized in regulatory standards as an essential skill for Speech and Language Therapists (SLTs) in the assessment, diagnosis and management of clients with speech difficulties. Previous research has identified that approaches to phonetic transcription vary, and that SLTs often lack confidence in transcribing. However, SLTs' views and working practices have not been investigated in detail, particularly in terms of whole service approaches and following the recent increase in telehealth.

AIMS

To investigate SLTs' views about phonetic transcription, their working practices at both individual and service levels, and the factors that influence these.

METHODS & PROCEDURES

A total of 19 SLTs from the UK were recruited to online focus groups via social media and local networks. Participants discussed their views of, and practices in, phonetic transcription. Themes were identified using reflexive thematic analysis.

OUTCOMES & RESULTS

Three broad themes were generated division and unity; one small part of a big job; and fit for purpose. SLTs were uniformly proud of their ability to phonetically transcribe and viewed this as a unique skill, but clear differences existed between different groups of SLTs in their views and practices. Investing in phonetic transcription was not always a priority for SLTs or services, and although many felt under-confident in their skills they considered these to be adequate for the populations they usually encounter. SLTs make an early judgement about possible therapy targets, which influences the level of detail used in their phonetic transcription. Practical barriers are often not addressed at service level, and assessment via telehealth poses some specific challenges.

CONCLUSIONS & IMPLICATIONS

SLTs and services would benefit from increased investment in phonetic transcription in terms of time, opportunities for continuing professional development (CPD) and initiatives such as electronic patient records (EPRs) which support the use of phonetic symbols. Identifying target sounds at an early stage raises questions about the implications of disregarding other features of speech, and the selection of appropriate intervention approaches. Further research is needed to analyse actual rather than reported practices, and to consider the relationship between phonetic transcription and intervention approaches. Future studies could also identify precise CPD requirements and evaluate the effectiveness of CPD.

WHAT THIS PAPER ADDS

What is already known on the subject Previous research has demonstrated that SLTs often lack confidence in phonetic transcription and that practices are varied, with relatively little use of narrow transcription. SLTs are interested in opportunities to maintain and develop transcription skills but do not often undertake CPD for transcription. What this paper adds to existing knowledge By using focus groups as a forum for discussions, this study provides a rich and detailed insight into SLTs' views about clinical transcription and their working practices, with previously unreported details about the reasons for these practices in a clinical context and at a service-wide level. What are the potential or actual clinical implications of this work? Transcription is often de-prioritized in non-specialist contexts, with practical barriers and a lack of clear and consistent protocols at a whole-service level. There is an opportunity for service managers to address the systemic difficulties in using transcription effectively by raising the profile and value of transcription amongst clinicians, and promoting CPD opportunities, using the findings of this study as a rationale for funding this. Together, these recommendations have the potential to improve client outcomes through more accurate assessment and diagnosis, and hence more appropriate intervention.

Optimizing Outcomes for Children With Phonological Impairment: A Systematic Search and Review of Outcome and Experience Measures Reported in Intervention Research

PURPOSE

Reporting of outcome and experience measures is critical to our understanding of the effect of intervention for speech sound disorders (SSD) in children. There is currently no agreed-upon set of measures for reporting intervention outcomes and experiences. In this article, we introduce the Speech Outcome Reporting Taxonomy (SORT), a tool designed to assist with the classification of outcome and experience measures. In a systematic search and review using the SORT, we explore the type and frequency of these measures reported in intervention research addressing phonological impairment in children. Given the integral relationship between intervention fidelity and intervention outcomes, reporting of fidelity is also examined.

METHOD

Five literature databases were searched to identify articles written or translated into English published between 1975 and 2020. Using the SORT, outcome and experience measures were extracted and categorized. The number of intervention studies reporting fidelity was determined.

RESULTS

A total of 220 articles met inclusion criteria. The most frequently reported outcome domain was broad generalization measures (n = 142, 64.5%), followed by specific measures of generalization of an intervention target (n = 133, 60.5%). Eleven (5.0%) articles reported measures of the impact of the phonological impairment on children's activity, participation, quality of life, or others. Twenty articles (9.1%) reported on parent, child, or clinician experience or child engagement. Fidelity data were reported for 13.4% of studies of interventions.

CONCLUSIONS

The measurement of intervention outcomes is challenging yet important. No single type of measure was reported across all articles. Through using tailored measures closely related to intervention targets in combination with a universal set of measures of intelligibility, the impact of phonological impairment on children's lives, and the experience of receiving and providing intervention, researchers and clinicians could work together to progress insights and innovations in science and practice for children with SSD.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.19497803.