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Maximising the Impact of Speech and Language Therapy for Children with Speech Sound Disorder (the MISLToe-SSD) Study: Developing a Core Outcome Set (COS) for Routine Data Collection from UK NHS Speech and Language Therapy Services

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Title: Maximising the Impact of Speech and Language Therapy for Children with Speech Sound Disorder (the MISLToe-SSD) Study: Developing a Core Outcome Set (COS) for Routine Data Collection from UK NHS Speech and Language Therapy Services
Language: English
Authors: Helen Stringer (ORCID 0000-0002-7470-2166), Sam Burr (ORCID 0000-0002-4177-2459), Joanne Cleland (ORCID 0000-0002-0660-1646), Sam Harding (ORCID 0000-0002-5870-2094), Yvonne Wren, The MISLToe_SSD Expert Panel
Source: International Journal of Language & Communication Disorders. 2026 61(1).
Availability: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
Peer Reviewed: Y
Page Count: 14
Publication Date: 2026
Document Type: Journal Articles
Reports - Research
Descriptors: Speech Therapy, Speech Language Pathology, Speech Impairments, Phonology, Data Collection, Foreign Countries, Children, Outcome Measures
Geographic Terms: United Kingdom
DOI: 10.1111/1460-6984.70188
ISSN: 1368-2822
1460-6984
Abstract: Background: Children with speech sound disorder (SSD) are at risk of long-term adverse consequences if appropriate intervention is not provided in a timely way. Although there are interventions of proven efficacy, these are often not implemented with good fidelity in clinical practice. Children with SSD in the United Kingdom are commonly managed in care pathways within NHS and independent speech and language therapy services. It is not known which care pathways are most effective because there is currently no systematic recording or analysis of intervention outcomes for children with SSD. Aims: The objective of the MISLToe-SSD study is to develop an evidence-based protocol for collecting routine data on a large-scale so that UK SSD care pathways can be evaluated for clinical- and cost-effectiveness. The development of the core outcome set (COS) is reported here. Methods and Procedures: Following the Core Outcome Measures in Effectiveness Trials methodology, a modified Delphi process was used to reach a consensus on a COS for SSD interventions. The Delphi process comprised two online survey rounds and one online meeting. Anonymity between panel members was maintained during the online survey rounds. Round one required a consensus of [greater than or equal to]50%, rising to [greater than or equal to]75% in round two. Outcomes and Results: A group of 66 UK speech and language therapists identified as experts in SSD by their peers were recruited through specialist clinical and research networks. A long list of 30 outcome statements was reduced by consensus to a final list of seven outcomes with associated measurement instruments. Increased speech intelligibility was agreed as the primary outcome by 100% of panel members. Six secondary outcomes were identified. Conclusions and Implications: The final COS can be used in future research to evaluate care pathways and intervention effectiveness for children with SSD. Furthermore, it provides a basis for measuring outcomes in future intervention trials for SSD.
Abstractor: As Provided
Entry Date: 2026
Accession Number: EJ1495199
Database: ERIC
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  Data: Maximising the Impact of Speech and Language Therapy for Children with Speech Sound Disorder (the MISLToe-SSD) Study: Developing a Core Outcome Set (COS) for Routine Data Collection from UK NHS Speech and Language Therapy Services
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  Data: <searchLink fieldCode="AR" term="%22Helen+Stringer%22">Helen Stringer</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-7470-2166">0000-0002-7470-2166</externalLink>)<br /><searchLink fieldCode="AR" term="%22Sam+Burr%22">Sam Burr</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-4177-2459">0000-0002-4177-2459</externalLink>)<br /><searchLink fieldCode="AR" term="%22Joanne+Cleland%22">Joanne Cleland</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-0660-1646">0000-0002-0660-1646</externalLink>)<br /><searchLink fieldCode="AR" term="%22Sam+Harding%22">Sam Harding</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-5870-2094">0000-0002-5870-2094</externalLink>)<br /><searchLink fieldCode="AR" term="%22Yvonne+Wren%22">Yvonne Wren</searchLink><br /><searchLink fieldCode="AR" term="%22The+MISLToe%5FSSD+Expert+Panel%22">The MISLToe_SSD Expert Panel</searchLink>
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  Data: <searchLink fieldCode="SO" term="%22International+Journal+of+Language+%26+Communication+Disorders%22"><i>International Journal of Language & Communication Disorders</i></searchLink>. 2026 61(1).
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  Data: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
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  Data: <searchLink fieldCode="DE" term="%22Speech+Therapy%22">Speech Therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Speech+Language+Pathology%22">Speech Language Pathology</searchLink><br /><searchLink fieldCode="DE" term="%22Speech+Impairments%22">Speech Impairments</searchLink><br /><searchLink fieldCode="DE" term="%22Phonology%22">Phonology</searchLink><br /><searchLink fieldCode="DE" term="%22Data+Collection%22">Data Collection</searchLink><br /><searchLink fieldCode="DE" term="%22Foreign+Countries%22">Foreign Countries</searchLink><br /><searchLink fieldCode="DE" term="%22Children%22">Children</searchLink><br /><searchLink fieldCode="DE" term="%22Outcome+Measures%22">Outcome Measures</searchLink>
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  Data: 10.1111/1460-6984.70188
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  Data: 1368-2822<br />1460-6984
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  Data: Background: Children with speech sound disorder (SSD) are at risk of long-term adverse consequences if appropriate intervention is not provided in a timely way. Although there are interventions of proven efficacy, these are often not implemented with good fidelity in clinical practice. Children with SSD in the United Kingdom are commonly managed in care pathways within NHS and independent speech and language therapy services. It is not known which care pathways are most effective because there is currently no systematic recording or analysis of intervention outcomes for children with SSD. Aims: The objective of the MISLToe-SSD study is to develop an evidence-based protocol for collecting routine data on a large-scale so that UK SSD care pathways can be evaluated for clinical- and cost-effectiveness. The development of the core outcome set (COS) is reported here. Methods and Procedures: Following the Core Outcome Measures in Effectiveness Trials methodology, a modified Delphi process was used to reach a consensus on a COS for SSD interventions. The Delphi process comprised two online survey rounds and one online meeting. Anonymity between panel members was maintained during the online survey rounds. Round one required a consensus of [greater than or equal to]50%, rising to [greater than or equal to]75% in round two. Outcomes and Results: A group of 66 UK speech and language therapists identified as experts in SSD by their peers were recruited through specialist clinical and research networks. A long list of 30 outcome statements was reduced by consensus to a final list of seven outcomes with associated measurement instruments. Increased speech intelligibility was agreed as the primary outcome by 100% of panel members. Six secondary outcomes were identified. Conclusions and Implications: The final COS can be used in future research to evaluate care pathways and intervention effectiveness for children with SSD. Furthermore, it provides a basis for measuring outcomes in future intervention trials for SSD.
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      – SubjectFull: Speech Impairments
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