{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T01:34:24Z","timestamp":1790040864997,"version":"4.0.1"},"reference-count":48,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:00:00Z","timestamp":1767916800000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Lang &amp; Comm Disor"],"published-print":{"date-parts":[[2026,1]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Children with speech sound disorder (SSD) are at risk of long\u2010term 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.<\/jats:p>\n <\/jats:sec>\n \n Aims<\/jats:title>\n The objective of the MISLToe\u2010SSD study is to develop an evidence\u2010based protocol for collecting routine data on a large\u2010scale so that UK SSD care pathways can be evaluated for clinical\u2010 and cost\u2010effectiveness. The development of the core outcome set (COS) is reported here.<\/jats:p>\n <\/jats:sec>\n \n Methods and Procedures<\/jats:title>\n 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 \u226550%, rising to \u226575% in round two.<\/jats:p>\n <\/jats:sec>\n \n Outcomes and Results<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Implications<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n WHAT THIS PAPER ADDS<\/jats:title>\n \n What is already known on this subject<\/jats:italic>\n \n \n Speech and language therapy services in the United Kingdom are ideally placed to contribute to large\u2010scale evaluations of services provided for children with speech sound disorder (SSD) due to the computerised routine collection of data related to client management and interventions. However, these routine data cannot currently be used to evaluate the effectiveness or efficiency of interventions for children with different subtypes of SSD due to a lack of uniformity in data collection. There are no agreed and validated outcomes, outcome measures, diagnostic protocols or agreed labels and definitions for the evidence\u2010based interventions that can be used by services across the United Kingdom.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n What this study adds to existing knowledge<\/jats:italic>\n \n \n Building on information from an umbrella review and practitioner workshops, a modified Delphi process with 66 SSD expert speech and language therapists from across the United Kingdom, was utilised to develop a core outcome set (COS) and a minimum dataset of common data elements.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n What are the potential or actual clinical implications of this study?<\/jats:italic>\n \n \n The COS and minimum dataset can be used by speech and language therapy services to collect routine data in a way that can contribute to large\u2010scale evaluations of the effectiveness and efficiency of interventions for children with SSD.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/1460-6984.70188","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T12:50:32Z","timestamp":1767963032000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Maximising the Impact of Speech and Language Therapy for Children With Speech Sound Disorder (The MISLToe\u2010SSD) Study: Developing a Core Outcome Set (COS) for Routine Data Collection From UK NHS Speech and Language Therapy Services"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7470-2166","authenticated-orcid":false,"given":"Helen","family":"Stringer","sequence":"first","affiliation":[{"name":"School of Education, Communication and Language Sciences Newcastle University Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4177-2459","authenticated-orcid":false,"given":"Sam","family":"Burr","sequence":"additional","affiliation":[{"name":"Bristol Speech and Language Therapy Research Unit, Bristol, UK"},{"name":"Cardiff Metropolitan University Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0660-1646","authenticated-orcid":false,"given":"Joanne","family":"Cleland","sequence":"additional","affiliation":[{"name":"Department of Psychological Sciences and Health, University of Strathclyde Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5870-2094","authenticated-orcid":false,"given":"Sam","family":"Harding","sequence":"additional","affiliation":[{"name":"Bristol Speech and Language Therapy Research Unit, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne","family":"Wren","sequence":"additional","affiliation":[{"name":"Bristol Speech and Language Therapy Research Unit, Bristol, UK"},{"name":"Cardiff Metropolitan University Cardiff UK"},{"name":"University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"The MISLToe_SSD Expert Panel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,9]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"The Edinburgh Articulation Test","author":"Anthony A.","year":"1971"},{"key":"e_1_2_10_3_1","volume-title":"South Tyneside Assessment of Phonology (STAP)","author":"Armstrong S.","year":"1988"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1044\/0161\u20101461(2010\/09\u20100075)b"},{"key":"e_1_2_10_5_1","volume-title":"CAV\u2010ES (Clinical Assessment of Vowels\u2014English Systems)","author":"Bates S.","year":"2019"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1044\/jshr.3802.446"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/JOURNAL.PONE.0158753"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/13682820310001625589"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/S12913\u2010024\u201010821\u20107"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/1460\u20106984.70052"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1044\/2021_JSLHR\u201020\u201000656"},{"key":"e_1_2_10_12_1","volume-title":"Preschool and Primary Inventory of Phonological Awareness (PIPA)","author":"Dodd B.","year":"2000"},{"key":"e_1_2_10_13_1","volume-title":"Diagnostic Evaluation of Articulation and Phonology","author":"Dodd B.","year":"2002"},{"key":"e_1_2_10_14_1","volume-title":"Therapy Outcome Measure: User Guide and Scales","author":"Enderby P.","year":"2019"},{"key":"e_1_2_10_15_1","volume-title":"Therapy Outcome Measure: Theoretical Underpinning and Case Studies","author":"Enderby P.","year":"2019"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/BMJOPEN\u20102022\u2010068945"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/BMJOPEN\u20102023\u2010081446"},{"key":"e_1_2_10_18_1","unstructured":"Harding S. S.Burr J.Cleland H.Stringer andY.Wren. in review. \u201cUnderstanding the Experiences of Children With Speech Sound Disorder in Speech and Language Therapy Using Emotional Mapping.\u201dChild Language Teaching and Therapy (special issue)."},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1046\/J.1365\u20102648.2000.T01\u20101\u201001567.X"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/1460\u20106984.12416"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/1460\u20106984.12877"},{"key":"e_1_2_10_22_1","volume-title":"The Phonology Screening Assessment CLEAR","author":"Keeling M.","year":"2001"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/J.1365\u20102648.2006.03716.X"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.3109\/17549507.2016.1168483"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1080\/14417040410001669516"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1044\/1092\u20104388(2011\/10\u20100130)"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/BMJHCI-2019-100085"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/1460\u20106984.12425"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/1745\u20106215\u201015\u2010247"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13063\u2010016\u20101555\u20102"},{"key":"e_1_2_10_31_1","unstructured":"RCSLT & ASLTIP.2023.Fail to plan plan to fail: speech and language tehrapy workforce planning in England.https:\/\/www.rcslt.org\/wp\u2010content\/uploads\/2023\/04\/Workforce\u2010planning\u2010in\u2010England.pdf."},{"key":"e_1_2_10_32_1","unstructured":"RCSLT.2024.Clinical information on speech sound disorders | RCSLT.https:\/\/www.rcslt.org\/speech\u2010and\u2010language\u2010therapy\/clinical\u2010information\/speech\u2010sound\u2010disorders\/."},{"key":"e_1_2_10_33_1","unstructured":"Roulstone S. Y.Wren I.Bakopoulou S.Goodlad andG.Lindsay.2012.Exploring interventions for children and young people with speech language and communication needs: A study of practice. Department for Education.https:\/\/www.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/219627\/DFE\u2010RR247\u2010BCRP13.pdf."},{"key":"e_1_2_10_34_1","unstructured":"Speech & Language UK (ICAN).2021.Speaking up for the COVID Generation.https:\/\/speechandlanguage.org.uk\/media\/3753\/speaking\u2010up\u2010for\u2010the\u2010covid\u2010generation\u2010i\u2010can\u2010report.pdf."},{"key":"e_1_2_10_35_1","volume-title":"Children's Speech and Literacy Difficulties: A Psycholinguistic Framework","author":"Stackhouse J.","year":"1997"},{"key":"e_1_2_10_36_1","unstructured":"Statistics Community Health Services Waiting Lists. n.d. Retrieved April 7 2024 fromhttps:\/\/www.england.nhs.uk\/statistics\/statistical\u2010work\u2010areas\/community\u2010health\u2010services\u2010waiting\u2010lists\/."},{"key":"e_1_2_10_37_1","unstructured":"Stringer H.2019.Newcastle Assessment for Phonological Awareness (NAPA) (1st ed.).Newcastle University UK.https:\/\/research.ncl.ac.uk\/phonologicalawareness\/."},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/1460\u20106984.12989"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1576\/TOAG.7.2.120.27071"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/cch.12049"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.EUJIM.2015.07.002"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1177\/1747493018806200"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1111\/1460\u20106984.12840"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460\u20106984.2012.00195.x"},{"key":"e_1_2_10_45_1","volume-title":"The Nuffield Centre Dyspraxia Programme","author":"Williams P.","year":"2004"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13063\u2010017\u20101978\u20104"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/1460\u20106984.12371"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1002\/JCV2.12126"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1111\/1460\u20106984.12599"}],"container-title":["International Journal of Language & Communication Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1460-6984.70188","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1460-6984.70188","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1460-6984.70188","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T12:40:36Z","timestamp":1769172036000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1460-6984.70188"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":48,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/1460-6984.70188"],"URL":"https:\/\/doi.org\/10.1111\/1460-6984.70188","archive":["Portico"],"relation":{},"ISSN":["1368-2822","1460-6984"],"issn-type":[{"value":"1368-2822","type":"print"},{"value":"1460-6984","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2024-08-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70188"}}