Implementation fidelity of a computer-assisted intervention for children with speech sound disorders

Abstract

Background: Implementation fidelity refers to the degree to which an intervention or programme adheres to its original design. This paper examines implementation fidelity in the Sound Start Study, a clustered randomised controlled trial of computer-assisted support for children with speech sound disorders (SSD).

Method: Sixty-three children with SSD in 19 early childhood centres received computer-assisted support (Phoneme Factory Sound Sorter [PFSS] – Australian version). Educators facilitated the delivery of PFSS targeting phonological error patterns identified by a speech-language pathologist. Implementation data were gathered via (1) the computer software, which recorded when and how much intervention was completed over 9 weeks; (2) educators’ records of practice sessions; and (3) scoring of fidelity (intervention procedure, competence and quality of delivery) from videos of intervention sessions.

Result: Less than one-third of children received the prescribed number of days of intervention, while approximately one-half participated in the prescribed number of intervention plays. Computer data differed from educators’ data for total number of days and plays in which children participated; the degree of match was lower as data became more specific. Fidelity to intervention procedures, competency and quality of delivery was high.

Conclusion: Implementation fidelity may impact intervention outcomes and so needs to be measured in intervention research; however, the way in which it is measured may impact on data.

Keywords:

• speech sound disorders
• intervention
• implementation fidelity
• service delivery

Acknowledgements

This research was supported under Australian Research Council’s Discovery Projects funding scheme (project number DP130102545) and funding from the NSW Department of Education and Communities. The authors acknowledge the support of Dr Paul White, Dr Tamara Cumming, Charlotte Howland, Felicity McKellar, Patrick Howard, Julian Milthorpe, Jessica Gibson and Samantha Youn. The authors would like to thank all the children, families, educators and preschools who participated.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Yvonne Wren and Sue Roulstone are co-authors of the Phoneme Factory Sound Sorter software and receive a share of the royalties of sales.

Supplementary material

Supplemental data for this article can be accessed at http://dx.doi.org/10.1080/17549507.2017.1293160