Maximising the Impact of Speech and Language Therapy for children with Speech Sound Disorders (SSD) (The MISLToe_SSD Study)
To date, the work to develop MISLToe_SSD has been funded by a National Institute for Health Research (NIHR) Research for Patient Benefit (RfPB) grant. The Chief Investigator for the study was Dr Yvonne Wren. In this study, Yvonne led an international, multidisciplinary team of academics, SLTs and PPI members to work together to establish a Core Outcomes Set (COS) and minimum dataset for children with SSD. This prioritisation and design of this study is informed by our PPI members, who include children and young people with, or who have a history of, SSD, as well as parents of children with SSD.
The work undertaken so far consists of three work streams:
- Firstly, an umbrella review of existing evidence will help us identify a comprehensive list of potential content for the COS and minimum dataset, including outcomes, interventions and assessments for SSD.
- Secondly, SLTs from five NHS sites, and parents of children with SSD, across the UK will join participatory workshops to discuss the processes by which children with SSD are currently assessed and diagnosed in NHS services. These discussions will lead to an agreed process for SSD diagnosis. An online survey and card sorting activity will be undertaken by SLTs in clinical practice to determine a full list of SSD interventions in current practice to be included in the COS and minimum dataset.
- Thirdly, the results of the umbrella review, workshops and surveys will be presented for discussion to an expert panel of SLTs, academics and PPI members.
Then next steps (funding pending) will work with ten NHS SLT teams to begin collection of the COS and minimum dataset. We will determine what barriers may exist to collection of data and how these may be overcome in order to establish a process for collection of a large dataset which, subject to consent, can be used to address a wide range of questions relevant to this population. These data will be used to compare outcomes across different care pathways.
The MISLToe_SSD Study
Diagnostic Protocol for SSD & List of Interventions
The Core Outcome Set and Minimum Dataset for Speech Sound Disorder
| Outcomes | 75% consensus threshold | Baseline | Outcome | Progress |
|---|---|---|---|---|
| Increased speech intelligibility (Primary) | 100% | ICS* | ICS* | ICS* |
| Improved communicative activity and participation | 97% | No reliable measure | No reliable measure | No reliable measure |
| Increased Percentage Consonants Correct (PCC) | 94% | DEAP | DEAP | DEAP |
| Increased confidence when talking | 94% | No reliable measure | No reliable measure | No reliable measure |
| Increased stimulability | 89% | DEAP | DEAP | DEAP |
| Increase in number of phonemes | 89% | DEAP | DEAP | DEAP |
| Increase in Percentage vowels correct (PVC) | 87% | DEAP | DEAP | DEAP |
| Increase in Percentage phonemes correct (PPC) | 85% | DEAP | DEAP | DEAP |
| Increase in phonological awareness+ | 84% | NAPA | NAPA | NAPA |
| Common data element | Data format | When collected |
|---|---|---|
| Date of data collection point | Dd/mm/yyyy | Each time (all) |
| Age at data collection point | YY;MM | Each time (months) |
| Sex assigned at birth | Male/female/unknown | First entry |
| Socio-economic status | Postcode XXX(X) X (alphanumeric) | First entry |
| Total time in intervention | Hours:minutes | End of Episode of Care (EoC) |
| Agent of intervention | Multiple choice drop-down menu | End of EoC |
| Name of intervention | Multiple choice drop-down menu | End of EoC |
| Duration of session | Minutes | End of EoC |
| Frequency of sessions | Multiple choice drop-down menu | End of EoC |
| Length of Episode of Care | Calculated from baseline and outcome dates (weeks) | End of EoC |
| Number of previous EoC before study? | XX (min value 0) | First entry |
| Number of episodes of care in study | XX | Cumulative to dosage |
| Homework given to anyone between sessions | Yes/no | End of EoC |
| Location of sessions | Multiple choice drop-down menu | End of EoC |
| SSD Diagnostic label 1 | Multiple choice drop-down menu | End of EoC |
| SSD Diagnostic label 2 | Multiple choice drop-down menu | End of EoC |
| Other Diagnostic label | Multiple choice drop-down menu | End of EoC |
| Language(s) spoken at home | Multiple choice drop-down menu | First entry |
| Ethnicity | Multiple choice drop-down menu | First entry |
| Religion or belief | Multiple choice drop-down menu | First entry |
Meet the team
Contact us and mailing list sign-up
Email misltoe@nbt.nhs.uk for more information about the study or to be added to our mailing list.
Latest news and publications
Phase one of MISLToe_SSD is complete and we are awaiting funding outcomes for Phase two, which will start in summer 2025.
Follow us on X(Twitter) for more information @MISLToe_SSD