Towards an Agreed Labelling System and Protocol for the Diagnosis of Speech Sound Disorder Subtypes in the United Kingdom

IF 2.1 3区医学 Q2 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

International Journal of Language & Communication Disorders Pub Date : 2025-05-10 DOI:10.1111/1460-6984.70052

Joanne Cleland, Sam Burr, Sam Harding, Helen Stringer, Yvonne Wren

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引用次数: 0

Abstract

Background

There is no single classification system or diagnostic protocol for speech sound disorder (SSD). This makes it difficult to collect large-scale outcome data and determine which interventions work best for which subtypes of SSD. The United Kingdom is unique in that its publicly funded healthcare system allows the collection of such outcome data across large numbers of children; however, a necessary first step towards this is to agree on a consistent diagnostic protocol and classification system for SSD that is feasible for use in the UK healthcare system.

Aims

This study aimed to achieve an initial clinician-led UK consensus on a diagnostic protocol and classification system for SSD of unknown origin.

Methods and Procedures

A mixed methods participatory design was used. Five UK health services provided SSD paperwork such as local guidelines and protocols for content analysis. Two participatory workshops were used to agree on: (1) a classification system, (2) subtype labels and definitions, and (3) a feasible diagnostic protocol for SSD. The finalised consensus was presented to a national meeting of 283 SLTs to determine the feasibility of the protocol for clinicians across the whole of the United Kingdom.

Outcomes and Results

Workshop participants agreed that the Differential Diagnostic Classification System was preferred for the United Kingdom. A minimum diagnostic protocol, with additional assessment for complex SSD, was agreed. Over 90% of the national SLT meeting agreed that they could implement the definitions and protocol.

Conclusions and Implications

A preliminary diagnostic protocol, classification system, and subtype names and definitions were agreed upon and are broadly in line with those proposed by Dodd (2014). Future work will trial the consensus protocol and classification system in the United Kingdom to investigate treatment outcomes and refine the protocol.

WHAT THIS PAPER ADDS

What is already known on this subject

There are three main classification systems for speech sound disorder (SSD) that are popular globally: the Speech Disorder Classification System (SDCS) (Shriberg et al. 2019); the Differential Diagnostic Classification System (Dodd 2014); and the Psycholinguistic Framework (Stackhouse and Wells 1993). It is not clear which of these, if any, is most used in the United Kingdom. Moreover, previous research suggests that clinicians employ a wide range of different terms for subtypes of SSD and different diagnostic methods to arrive at these subtypes. This lack of consistency, even within the United Kingdom, is confusing for parents, carers, and practitioners and makes it difficult to compare outcomes.

What this study adds

We showed that most clinicians in the United Kingdom use the Differential Diagnostic Classification System (Dodd 2014). We therefore suggest that this is now used consistently in the United Kingdom, with some modifications. A feasible diagnostic protocol which includes using the assessment designed specifically for this classification system, the Diagnostic Evaluation of Articulation and Phonology (Dodd et al. 2002), was agreed for clinical use.

What are the clinical implications of this work?

Clinicians in the United Kingdom can use the subtype labels and diagnostic protocol described here to diagnose subtypes of SSD in a consistent manner. Children with more complex SSD or concomitant disorders will require additional assessments.

Abstract Image

查看原文本刊更多论文

在英国为语音障碍亚型的诊断建立一个议定的标签系统和协议

语音障碍（SSD）没有单一的分类系统或诊断方案。这使得收集大规模结果数据和确定哪种干预措施对哪种亚型SSD最有效变得困难。英国的独特之处在于，其公共资助的医疗保健系统允许收集大量儿童的此类结果数据；然而，实现这一目标的必要的第一步是就SSD的一致诊断协议和分类系统达成一致，这在英国医疗保健系统中是可行的。目的本研究旨在达成临床医生主导的英国对不明原因SSD的诊断方案和分类系统的初步共识。方法与步骤采用混合参与式设计。5个英国保健服务机构提供了SSD文书工作，例如用于内容分析的当地指导方针和协议。两个参与性研讨会被用来达成以下共识：(1)分类系统；(2)子类型标签和定义；(3)SSD的可行诊断方案。最终的共识提交给283名slt的全国会议，以确定整个英国临床医生的方案可行性。结果和结果研讨会的与会者一致认为鉴别诊断分类系统在英国是首选的。会议同意了一个最小诊断方案，并对复杂SSD进行了额外的评估。超过90%的国家SLT会议同意他们可以实施定义和协议。初步诊断方案、分类系统、亚型名称和定义已达成一致，与Dodd（2014）提出的基本一致。未来的工作将在英国试用共识方案和分类系统，以调查治疗结果并完善方案。目前全球流行的语音障碍（SSD）主要有三种分类系统：语音障碍分类系统（SDCS）（Shriberg et al. 2019）；鉴别诊断分类系统（Dodd 2014）；心理语言学框架（Stackhouse and Wells, 1993）。目前尚不清楚，如果有的话，其中哪一种在英国使用最多。此外，先前的研究表明，临床医生对SSD亚型使用了广泛的不同术语和不同的诊断方法来确定这些亚型。即使在英国，这种缺乏一致性的情况也让父母、护理人员和从业人员感到困惑，并使比较结果变得困难。这项研究补充了什么？我们发现，英国的大多数临床医生使用鉴别诊断分类系统（Dodd 2014）。因此，我们建议，这是现在在英国一致使用，与一些修改。一个可行的诊断方案，包括使用专门为该分类系统设计的评估，发音和音系诊断评估（Dodd et al. 2002），被同意用于临床使用。这项工作的临床意义是什么？英国的临床医生可以使用这里描述的亚型标签和诊断方案以一致的方式诊断SSD的亚型。患有更复杂的SSD或伴随疾病的儿童将需要额外的评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Language & Communication Disorders AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY-REHABILITATION

CiteScore

3.30

自引率

12.50%

发文量

116

审稿时长

6-12 weeks

期刊介绍： The International Journal of Language & Communication Disorders (IJLCD) is the official journal of the Royal College of Speech & Language Therapists. The Journal welcomes submissions on all aspects of speech, language, communication disorders and speech and language therapy. It provides a forum for the exchange of information and discussion of issues of clinical or theoretical relevance in the above areas.