Background Children with speech sound disorders (SSD) are at higher risk of communication breakdown, but the impact of having an SSD may vary from child to child. Determining the severity of SSD helps speech-language therapists (SLTs) to recognise the extent of the problem and to identify and prioritise children who require intervention. Aims This study aimed to identify severity factors for SSD in order to develop a multifactorial Speech Sound Disorder Severity Construct (SSDSC) using SLTs’ views and the International Classification of Functioning, Disability and Health (ICF). Method In an explorative five-staged qualitative study, the research question was answered: ‘How do SLTs determine the severity of SSD in children?’. A total of 91 SLTs from The Netherlands participated in data collection and analysis. The iterative process included three different qualitative research methodologies (thematic analysis [TA], constructivist grounded theory [CGT] and content analysis [CA]) to ensure validation of the results by means of method triangulation. Results SLTs considered nine themes: intelligibility, speech accuracy, persistence, the child's perception, impact, communicative participation, concomitant factors, professional point of view, and environmental factors. The themes were summarised in three main severity factors: (I) Speech accuracy, (II) The child's perception of the impact of their speech, and (III) Intelligibility in communication. Other severity factors were concomitant factors and impact. Expertise and support were identified as facilitators or barriers that may worsen or relieve the severity of SSD. Conclusions This study highlights the need for SLTs to rethink how they think about severity as a simplistic construct reflecting only speech accuracy. It is recommended that a broader holistic approach to measuring severity is adopted.
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In a class or group of twenty children, - statistically - one child has a developmental language disorder (DLD). For children with DLD it is very difficult to keep up at school. The problems in the language also easily lead to miscommunication, which can cause behavioral problems. The timely recognition of a DLD is of great importance for early treatment. This way you can prevent or reduce problems at school, at home and in the children's leisure time. At the moment, children with DLD are not always identified early.Problems in language development can be identified early, for example at the age of two by child health workers. Parents, kindergarten teachers and elementary school teachers can also identify problems in children's language development. This requires a language screening instrument that can easily determine whether a child's language is 'at risk' or 'not at risk'. Early identification of language problems is important, but until today children are still missed. In this dissertation I present a new instrument for the identification of problems in the language development of children from one to six years old, the Early Language Scale (ELS). I also describe the development of the milestones in the language development of children, how good the current screening at the age of two at the health care office is and what parents think of this language screening. The ELS appears to detect DLD in young children well and can therefore make an important contribution to the detection of these problems at the primary health care.
Purpose:Our aim was to develop consensus on the definition and operationalization of communicative participation (CP)in 2- to 8-year-old children with language disorders (LDs).A clear definition and operationalization can facilitate the discussion about children’s communication problems in daily life between parents and professionals. Method: In an online Delphi study, anonymized thoughts and opinions were collected on the definition and operationalization of CP in young children with LD. The 47 Delphi panel members were Dutch parents, young adults with LDs, teachers and assistants, speech-language pathologists, clinical linguists,and clinical researchers. Thematic content analysis was used to develop a concept definition and items operationalizing CP.The Delphi panel rated the suitability of concept definitions using a 7-point Likert scale. Concept definitions were revised with feedback from the Delphi panel until consensus was achieved. The Delphi panel rated items on how well they operationalize CP, using the same Likert scale. Results: The majority (79%) of the Delphi panel indicated that the essence of CP was captured by the definition:“CP is understanding and being understood in a social context,by applying verbal and non-verbal communication skills.”In addition, 33 behavioral items were developed.Conclusion:This study resulted in strong consensus on the definition of CP between Dutch parents and professionals.Items were developed that can inform speech-language pathologists on the type of questions to ask a child’s parents or teacher when discussing CP. Further research is needed on how the items can best be used in clinical practice.
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