{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T12:58:55Z","timestamp":1790773135881,"version":"4.1.0"},"reference-count":79,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"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":[[2026,11]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Speech Sound Disorder (SSD) reduces speech intelligibility, affecting a child's ability to make themselves understood. If SSD is not resolved in the early years it will negatively impact children's education and general well\u2010being. Effective and efficient speech and language therapy is known to resolve SSD and mitigate these risks. Intervention for SSD is often provided in inadequate dosages to be effective or efficient. Quantitative dosage is an overarching term for the different aspects of intensity of intervention which may impact outcomes. Existing literature on quantitative dosage indicates that more intensive therapy approaches for SSD appear to be more effective and efficient than less intensive delivery. A scoping review of current research in this area will serve to clarify evidence\u2010based knowledge and understanding about quantitative dosage, how it works, and how different components potentially interact to contribute to outcomes for children with phonological impairment (PI) (a sub\u2010type of SSD), informing future service developments and research.<\/jats:p>\n <\/jats:sec>\n \n Aims<\/jats:title>\n \n This scoping review investigates quantitative dosage elements in interventions for 3\u20108\u2010year\u2010olds with PI within speech and language therapy\u2010led contexts to identify preliminary evidence and inform reflections for practice and future research. It is registered on the Open Science Framework (OSF) registry (\n https:\/\/osf.io\/b3as4\/<\/jats:ext-link>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The review followed the Population, Concept, Context framework (Joanna Briggs Institute) and is reported in line with PRISMA guidance for Scoping Reviews. Key information sources were searched, including MEDLINE, CINAHL, PsycInfo, EMBASE. Grey literature searching included the COSMIN, PROSPERO, FigShare and Open Science Framework, Google scholar (advanced search), and SpeechBite. Data extraction included intervention approach, quantitative dosage of intervention delivery, outcome measurement tools, and context. The PAGER framework was used for analysis and synthesis of the identified patterns.<\/jats:p>\n <\/jats:sec>\n \n Main Contribution<\/jats:title>\n \n Seventy\u2010six papers were extracted for the synthesis. Only four studies specifically investigated the impact of quantitative dosage on outcomes. Three patterns developed across the 76 papers:\n quantitative dosage is an active ingredient; issues reporting quantitative dosage; characteristics of the evidence base<\/jats:italic>\n and are discussed in relation to advances in the field, gaps, evidence for practice and research recommendations. Preliminary evidence for practice highlights that aspects of quantitative dosage make an important contribution to effective and efficient intervention for children with SSD. However, rigour and consistency in reporting quantitative dosage should be improved to support translation of evidence to practice and replication of research. The importance of using benchmarked study designs and appropriate methodologies to support robust research to better\u2010inform evidence\u2010based practice is highlighted.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions\/Implications<\/jats:title>\n This scoping review provides preliminary evidence for quantitative dosage in children with PI. The findings are promising, (with evidence of some stronger research designs for example, randomised controlled trials, multiple baseline SCEDs with multiple participants, and replication of findings). However, further robust research, reporting all aspects of quantitative dosage and considering the potential costs and benefits of more efficient, evidence\u2010based quantitative dosages is urgently needed.<\/jats:p>\n <\/jats:sec>\n \n WHAT THIS STUDY ADDS<\/jats:title>\n \n What is already known on this subject<\/jats:italic>\n \n \n General findings about quantitative dosage for children with SSD show that reporting on dosage is often absent. When dosage is reported it is often under specified or different aspects of dosage are conflated. Reporting standards for dosage need to be agreed. Further research is required about the specific levels of quantitative dosage optimally required before children with SSD are discharged. Previous reviews have mainly extracted evidence about session numbers, session frequency, session length, and dose of practise items per session, across subtypes of SSD.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n What this study adds to the existing knowledge<\/jats:italic>\n \n \n This paper specifically considers how all aspects of quantitative dosage\u00a0are reported on and explored in the\u00a0literature\u00a0with a focus on\u00a0children with phonological impairment\u00a0(PI).\u00a0\u00a0A novel approach\u00a0following the\u00a0PAGER\u00a0framework synthesized\u00a0the data extracted from the papers to\u00a0identify\u00a0Patterns and relate these to\u00a0clinical practice\u00a0and research.\u00a0\u00a0The key patterns\u00a0that\u00a0emerged\u00a0in this scoping review\u00a0were:\u00a0quantitative\u00a0dosage is an active ingredient;\u00a0issues reporting quantitative dosage; and\u00a0characteristics of the evidence base.\u00a0Advances,\u00a0Gaps,\u00a0Evidence\u00a0for practice and\u00a0Research Recommendations\u00a0(the AGER of PAGER)\u00a0are reported\u00a0for each\u00a0Pattern.\u00a0<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n What are the clinical implications of this study?<\/jats:italic>\n \n \n For children with PI, intervention delivered two to four times weekly is likely to be more cost\u2010 and clinically effective than once weekly. More sessions delivered over time with a higher dose of production trials per session are likely to be more effective and efficient than fewer sessions delivered with a lower dose (although an upper threshold may exist). Potentially, more timely intervention is more effective over the longer term, than less timely intervention. Further high\u2010quality research is needed because study design, reporting of quantitative dosage, and exploring the cost benefits of more efficient dosages are weaknesses in current literature.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/1460-6984.70339","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T12:18:35Z","timestamp":1790770715000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Active Ingredients in Quantitative Dosage for Children With Phonological Impairment: A Scoping Review"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5968-158X","authenticated-orcid":false,"given":"Jill","family":"Titterington","sequence":"first","affiliation":[{"name":"Bristol Speech and Language Therapy Research Unit North Bristol NHS Trust Bristol UK"},{"name":"The Speech Doctor Holywood UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0352-665X","authenticated-orcid":false,"given":"Sarah","family":"Rudd","sequence":"additional","affiliation":[{"name":"Library and Knowledge Service North Bristol NHS Trust Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7470-2166","authenticated-orcid":false,"given":"Helen","family":"Stringer","sequence":"additional","affiliation":[{"name":"Speech and Language Sciences, School of Education, Communication and Language Sciences Newcastle University Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4703-3163","authenticated-orcid":false,"given":"Emma","family":"Pagnamenta","sequence":"additional","affiliation":[{"name":"School of Psychology and Clinical Language Sciences University of Reading Reading UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8695-9738","authenticated-orcid":false,"given":"Tomos","family":"Robinson","sequence":"additional","affiliation":[{"name":"Health Economics Group Newcastle University Newcastle upon Tyne 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 North Bristol NHS Trust Bristol UK"},{"name":"Cardiff School of Sport and Health Sciences Cardiff Metropolitan University Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/026565900001600304"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1044\/1092-4388(2012\/11-0076)"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.1998.tb15383.x"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nedt.2025.106822"},{"key":"e_1_2_15_6_1","unstructured":"Aromataris E. 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