Development of an assessment protocol for children with speech sound disorders in Sri Lanka

Speech sound disorders (SSDs) are the most common form of communication disorders in children. SSDs impact on children’s abilities to make themselves understood to their listeners and can influence a child’s social and emotional well-being as well as their academic achievements. Therefore, it is important to identify children with an SSD early on in order to provide appropriate interventions. A comprehensive assessment by a speech and language therapist (SLT) enables a diagnosis and the identification of the nature and severity of the SSD along with any other co-occurring difficulties. The results of the assessment then contribute to the planning and provision of an evidence-based intervention. A wealth of information on the best practices in the assessment of children with SSDs are available in countries where the speech and language therapy (SALT) profession is well established. However, in Sri Lanka, SALT is a relatively new profession, and there is scarce evidence to support the assessment of paediatric SSDs. Anecdotally, clinicians rely on informal assessment methods due to a lack of normative data and culturally and linguistically appropriate assessment procedures. Therefore, there is a real need to establish a protocol that can be used to assess children with SSDs in Sri Lanka in order to ensure holistic and comprehensive approaches in order to support the choice of appropriate goals and intervention. The overall aim of this study was to establish a consensus around a protocol for assessing Sri Lankan children with SSDs that is grounded in evidence and is culturally appropriate. A modified Delphi method was implemented to gather data from the SLTs currently working in Sri Lanka. The research involved three rounds of data collection which were related to their current assessment practices in Sri Lanka, and then ranking these practices in order of priority and establishing a consensus on a proposed assessment protocol. The proposed assessment protocol was based on the results of all three rounds of the modified Delphi method as well as previously published best practice guidelines. All of the components of the proposed assessment protocol achieved consensus in terms of the content, format, presentation and cultural appropriateness of the protocol and the potential for its use within the Sri Lankan contexts. The aim of the project was that the protocol would contribute to improving the area of paediatric SSD assessment in Sri Lanka and add to the emerging evidence on culturally and linguistically appropriate healthcare practices in the country.