Supporting speech and language therapists' application of evidence-based practice in the management of children with consistent phonological impairment

Background: This thesis has found that speech and language therapists' (SLTs') often use two elements of evidence-based practice in their management of children with phonological impairment (i.e., internal clinical data and child/parent preferences integrated through SLTs' experiences), but do not regularly use the third element: research evidence. Indeed, SLTs often use long-standing approaches with development target selection criteria (e.g. conventional minimal pairs) despite some research suggesting that interventions with more complex target selection criteria (e.g. the complexity approaches or multiple oppositions) may provide greater system-wide change for children with certain clinical presentations. Moreover, recent research has found that SLTs' intervention intensity provision is lower than provision in the literature. Narrowing this research-practice gap is necessary to achieve evidence-based practice.
Aim: To inform and develop an intervention to support SLTs' use of evidence-based practice in the clinical management of children with consistent phonological impairment.
Methods: This thesis used an explanatory sequential mixed methods design. There were five stages: (1) systematic review; (2) online survey; (3) focus groups and interviews; (4) resource co-production workshops and; (5) face validity exploration. Descriptive statistics were generated from the quantitative data and the qualitative data was analysed thematically. This thesis was guided by the Medical Research Council, the Knowledge to Action framework and the Intervention Mapping framework, including the use of logic modelling and the socio-ecological model.
Findings: Using information gathered throughout this thesis and through co-production with SLTs, this work resulted in the development of an online, evidence-based resource that aimed to support SLTs' use of research in practice in the clinical management of children with consistent phonological impairment. The resource is called SuSSD (Supporting and understanding Speech Sound Disorder) and was found to have high face validity.
Conclusion: Integrating SuSSD into SLTs' decision-making could support their use of research in practice and potentially improve outcomes for children with phonological impairment. Further research is necessary to determine if SuSSD can effectively increase SLTs' use of research in practice and improve speech outcomes for children with consistent phonological impairment.