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Co-design to consensus: Identifying the core elements of a novel intervention for pre-school children with
Lucy Rodgers1,2, Nicola Botting1, Helen Stringer3
1Department of Language and Communication Sciences, City St George's, London, United Kingdom.
Insights
This study identified core elements for a new intervention for preschool children with speech and language disorders. The "SWanS" intervention aims to improve expressive vocabulary and speech clarity in young children.
Area of Science:
- Pediatric Speech-Language Pathology
- Childhood Communication Disorders
Background:
- Few interventions exist for preschool children with co-occurring phonological speech sound disorder (P-SSD) and developmental language disorder (DLD).
- Expressive vocabulary and speech comprehensibility are key areas for intervention in this population.
Purpose of the Study:
- To achieve consensus on the core elements of a novel intervention, "SWanS" (Supporting Words and Sounds), for preschool children with co-occurring P-SSD and DLD.
- To jointly improve expressive vocabulary and speech comprehensibility.
Main Methods:
- A co-design process generated 47 potential intervention elements with a diverse steering group.
- A two-round e-Delphi survey with expert Speech and Language Therapists (SLTs) was used to reach consensus.
- Consensus was defined as >75% agreement with a specific inter-quartile range.
Main Results:
- Consensus was achieved on 44 out of 47 initial statements after revisions.
- Round 1 achieved consensus on 42 statements; revisions led to 8 statements in Round 2, all reaching consensus.
- The final set of 44 statements represents the core elements of the SWanS intervention.
Conclusions:
- Core elements for a novel intervention for children with co-occurring P-SSD and DLD were identified.
- Co-design and expert consensus were crucial in defining the intervention's core components.
- Flexibility in intervention elements was necessary to achieve consensus, with implications for future implementation.
Introduction:
Although frequently seen in clinical services, there are few interventions which have been developed specifically to meet the needs of pre-school children with co-occurring features of a phonological speech sound disorder (P-SSD) and developmental language disorder (DLD). This study aims to achieve consensus on the core elements of a novel intervention for pre-school children with co-occurring features of P-SSD and DLD ("SWanS"- Supporting Words and Sounds), where expressive vocabulary and speech comprehensibility are joint outcomes of interest.
Methods:
Forty-seven potential core intervention elements, based on a priori findings and the wider literature, were generated by a diverse steering group of professionals and people with lived experience within a systematic co-design process. This was followed by a modified, two round, e-Delphi with expert Speech and Language Therapists (SLTs) to achieve consensus on the elements. Consensus was defined as over 75% of participants (minimum 30 SLTs) rating the elements as either appropriate or very appropriate on a Likert of 1-5, with an inter-quartile range of one or below. If consensus was not achieved in round 1, free text comments were used to generate amended statements for the second round.
Results:
Consensus was achieved on 42/47 statements in round 1. During the revision process, one statement was discarded; six statements which did not achieve consensus were re-worded; two statements which required further clarity had examples added; four statements were merged into two statements. Consensus was reached on 8/8 statements presented in round 2, resulting in 44 final statements achieving consensus in total.
Conclusions:
Core elements of a novel intervention have been identified through co-design with a diverse group of stakeholders followed by consensus with expert SLTs. Additional flexibility was required within some core elements in order to achieve consensus. Implications for future implementation are discussed.
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