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Clinical Reasoning for Speech Sound Disorders: Diagnosis and Intervention in Speech-Language Pathologists' Daily Practice. 2020

Sanne Diepeveen, and Leenke van Haaften, and Hayo Terband, and Bert de Swart, and Ben Maassen
HAN University of Applied Sciences, Nijmegen, the Netherlands.

Purpose This study aims to give an insight in clinical reasoning (diagnosis and intervention) of speech-language pathologists (SLPs) in the Netherlands for children with speech sound disorder (SSD). Method The study featured a mixed-method (qualitative and quantitative) design. Semistructured interviews containing nondirective, open-ended questions were conducted with 33 SLPs, which were analyzed using a constant comparative analysis. Other SLPs (137) filled out a questionnaire on the same topics. Multiple-choice questions were analyzed by descriptive frequencies, while open-ended questions were analyzed thematically. Results The results indicate that SLPs use a variety of assessments to diagnose SSD, complemented by observation and, often, case history. In total, 85 different diagnostic labels were reported. The choice of intervention is based on what is appealing to the child and what matches his or her age as well as on the specific diagnosis and severity. Interventions are used for multiple speech disorders, and according to SLPs, parents play a large role in diagnostics and intervention. Conclusion These results reveal the need for (a) a clear and consistent terminology of diagnoses in the field of pediatric SSD, (b) a fast and easy-to-administer comprehensive differential diagnostic instrument in combination with an instrument to assess participation in everyday life, and (c) a tool to conduct a case history online.

UI MeSH Term Description Entries
D009426 Netherlands Country located in EUROPE. It is bordered by the NORTH SEA, BELGIUM, and GERMANY. Constituent areas are Aruba, Curacao, and Sint Maarten, formerly included in the NETHERLANDS ANTILLES. Holland,Kingdom of the Netherlands
D011795 Surveys and Questionnaires Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions. Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000072142 Pathologists Physicians who assess changes in cellular or tissue structure and function to diagnose disease processes. Pathologist
D000086723 Clinical Reasoning Process by which clinicians collect signs and process information to understand the patient's medical situation or problem, and then plan and implement appropriate medical interventions. Clinical Judgement,Clinical Judgements,Judgement, Clinical,Judgements, Clinical,Reasoning, Clinical
D013060 Speech Communication through a system of conventional vocal symbols. Public Speaking,Speaking, Public
D013066 Speech-Language Pathology The study of speech or language disorders and their diagnosis and correction. Language Pathology,Speech Pathology,Pathology, Language,Pathology, Speech,Pathology, Speech-Language,Pathology, Speech Language,Speech Language Pathology
D066229 Speech Sound Disorder Persistent difficulty with speech sound production such that it interferes with verbal communication. Phonological Disorder,Disorder, Phonological,Disorder, Speech Sound,Disorders, Phonological,Disorders, Speech Sound,Phonological Disorders,Speech Sound Disorders

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