Defining the Level of Need and Total Intervention Time in Children's Speech and Language Therapy in Finland:...

Speech and language therapy is essential for supporting the skills and participation of children with disorders that impair their ability to interact, communicate, understand or use language, speak, eat or swallow. However, it might be challenging to outline how much intervention should be recommended for each individual. Currently, there are no guidelines to support clinical decision-making regarding the child's level of need for intervention, and thus, the recommended amount of speech and language therapy. The aim of the present work was to create a consensus-based guideline for clinical use in speech and language therapy in Finland to enhance equitable treatment and purposeful allocation of resources. This guideline was designed to assist in evaluating the child's level of need for intervention and, based on that, the total intervention time of speech and language therapy for children up to 17 years of age.

A work group of Finnish speech and language therapists created a consensus-based guideline regarding the level of need for intervention and total intervention time during a 3-year process. During this time, the guideline was improved through a pilot phase following three comment rounds, including expert evaluations, conducted within the field of speech and language therapy as well as among other stakeholders. The ACCORD guideline was used to report this consensus work.

A guideline including a framework for outlining the level of need for intervention was developed to support clinical decision-making regarding the total intervention time per year of speech and language therapy for children up to 17 years. The guideline is based on the International Classification of Functioning, Disability and Health and the idea of adaptive intervention. Four factors were considered essential: (1) impact the disorder has on participation, (2) need for consultative support, (3) severity of the disorder, and (4) expected benefit of the intervention. Application of the guideline in the Finnish context and expert evaluations on the guideline and its validity are presented.

We developed a guideline to define the child's level of need for intervention and total intervention time. The content validity of the guideline was high based on the ratings by the expert evaluators. We hope that this guideline will support clinical decision-making regarding total intervention time per year in Finland and support the creation of similar guidelines in other contexts.

The present guideline may facilitate both intradisciplinary and interdisciplinary discussion regarding the child's level of need for intervention, and based on that, the recommended total intervention time. Systematic considerations of predefined factors used to define the level of need for intervention may enhance more equitable national practices.