A qualitative exploration of speech-language pathologists’ intervention and intensity provision for children with phonological impairment

Abstract

Purpose

The aim of this study was to explore the reasons behind speech-language pathologists’ (SLPs’) current clinical practices (intervention and intensity provision) for children (0–18 years) with phonological impairment.

Method

Three focus groups each with five SLPs and six 1:1 interviews with SLP managers from one region of the UK (n = 21) were carried out. A thematic analysis was undertaken.

Result

SLPs often used an eclectic mix of familiar approaches with easily-accessible therapy materials. SLPs only reported deviating from their core approach if the child did not progress in therapy. Mixed responses were gathered on the perceived feasibility of transferring evidence-based intervention intensities into clinical practice. The importance of parents to increase intensity provision at home was noted. Barriers to SLPs’ evidence-based decision-making included: time; confidence levels; service-related restrictions and; difficulty replicating research in practice. Having peer support and access to decision-making pathways and manualised intervention protocols were considered ways to overcome these barriers.

Conclusion

There is a research-practice gap in which SLPs’ current practices are driven by organisational factors, their own preferences and child-specific factors. To narrow this gap, SLPs suggested the development of time-saving, evidence-based tools.

Keywords:

• phonological impairment
• evidence-based practice
• qualitative

Ethical approval

All participants gave their written informed consent to participate. Ethical approval was granted from the Research Governance Filter Committee, Institute of Nursing and Health Research at Ulster University. Research governance was approved for all five Northern Ireland HSCTs.

Acknowledgements

Thanks to all SLPs and HSCTs in Northern Ireland for their participation in this work. Thanks to Professor Sharynne McLeod for her contributions to this paper.

Declaration of interest

The authors declare no declarations of interest.

Notes

1 These specialist units/schools are designated for children with specific severe speech, language and communication needs. The children placed in these units receive specialist, intensive input from SLPs alongside teachers.

Additional information

Funding

This work has been completed through a PhD studentship awarded to Natalie Hegarty by the Department for Employment and Learning (DEL).