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Although effective therapies exist, routine clinical implementation often lacks consistent delivery. In the UK, children are managed across NHS and independent speech and language therapy services, yet pathway effectiveness remains unclear due to the absence of systematic recording and analysis of outcomes. The MISLToe-SSD study develops an evidence-based protocol for routine large-scale data collection and reports the core outcome set (COS).",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/maximising-the-impact-of-speech-and-language-therapy-for-children-with-speech-sound-disorder-the-misltoe-ssd-study-developing-a-core-outcome-set-cos-for-routine-data-collection-from-uk-nhs-speech-and-language-therapy-services/460996/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/maximising-the-impact-of-speech-and-language-therapy-for-children-with-speech-sound-disorder-the-misltoe-ssd-study-developing-a-core-outcome-set-cos-for-routine-data-collection-from-uk-nhs-speech-and-language-therapy-services/460996.png","ImageObject",300,407,{"name":92,"@type":93},"Fahsai","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why is a core outcome set (COS) needed for children with speech sound disorder (SSD)?","Question",{"text":113,"@type":114},"Because pathway effectiveness is unclear: there is currently no systematic recording or analysis of SSD intervention outcomes. A COS supports consistent routine data collection.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What is the main objective of the MISLToe-SSD study?",{"text":118,"@type":114},"To develop an evidence-based protocol for routine data collection at scale so UK SSD care pathways can be evaluated for clinical and cost effectiveness.",{"name":120,"@type":111,"acceptedAnswer":121},"How is the COS developed in the MISLToe-SSD study?",{"text":122,"@type":114},"The document reports development using a modified Delphi process following the Core Outcome Measures in Effectiveness Trials methodology.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},460996,1790832791,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146,"preview_page_count":4},549768702563,"https://ap-avatar.wpscdn.com/avatar/8000c4aa63b76e948b?x-image-process=image/resize,m_fixed,w_180,h_180&k=1786536092046926083","International Journal of Language & Communication Disorders  \nRESEARCH REPORT   \nMaximising the Impact of Speech and Language Therapy for Children With Speech Sound Disorder (The MISLToe-SSD) Study: Developing a Core Outcome Set (COS) for Routine Data Collection From UK NHS Speech and Language Therapy Services  \nHelen Stringer1   Sam Burr2, 3   Joanne Cleland4   Sam Harding2   Yvonne Wren2, 3, 5  The MISLToe_SSD Expert Panel*  \n1 School of Education, Communication and Language Sciences, Newcastle University, Newcastle upon Tyne, UK  2 Bristol Speech and Language Therapy Research Unit, Bristol, UK  3 Cardiff Metropolitan University, Cardiff, UK  4 Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK  5University of Bristol, Bristol, UK  \nCorrespondence: Helen Stringer ([helen.stringer@newcastle.ac.uk](helen.stringer@newcastle.ac.uk))  \nReceived: 17 August 2024  Revised: 7 November 2025  Accepted: 19 December 2025  \nKeywords: core outcome set (COS) | Delphi | speech sound disorder (SSD) | minimum dataset  \nABSTRACT  \nBackground: Children with speech sound disorder (SSD) are at risk of long-term 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 NHSand 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.  \nAims: The objective of the MISLToe-SSD study is to develop an evidence-based protocol for collecting routine data on a large-scale so that UK SSD care pathways can be evaluated for clinical-and cost-effectiveness. The development of the core outcome set (COS) is reported here.  \n\n| *The MISLToe_SSD Expert Panel:\u003Cbr>Catherine Allison (Cambridgeshire Community Services NHS Trust); Meriem Amer-El-Khedoud (City University); Anna Arrowsmith (Berkshire Healthcare NHS Foundation Trust); Charlie Ayling (Birmingham Community Healthcare NHS Foundation Trust & Birmingham City University); Sarah Baird (University College London Hospitals NHS Foundation Trust); Lorraine Bamblett (Birmingham City University); Sally Bates (Plymouth Marjon University); Vicky Baxter (North Tees and Hartlepool NHS Foundation Trust); Allison Biddle (Reading University); Jan Broomfield (Speech Therapy 4 Kids); Carol Bulloch (NHS Lothian); Shula Burrows (University College London Hospitals NHS Foundation Trust); Maria-Katharina Fortunato-Carpio (Eden Speech Therapy); Lisa Crampin (NHS Greater Glasgow and Clyde); Anne Dodd (North Cumbria Integrated Care NHS Foundation Trust); Stephanie Dunstan (Livewell SouthWest); Helen Finlayson (NHS Lothian); Gillian Hackett (Shropshire Community Heath NHS Trust); Jeni Halls (Livewell SouthWest); Emily Harkin-White (Oxleas NHS Foundation Trust); Emma Harvey (University College London Hospitals NHS Foundation Trust); Nicola Head (Northumbria Healthcare NHS Foundation Trust); Alex Jones (Hywel Dda University Health Board); Lauren Jones (Aneurin Bevan University Hospitals Health Board); Pooja Kulkarni (Clear Speech Kids); Hannah Lane (Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust); Amandine Lepachelet (Central London Community Healthcare NHS Trust); Natalie Lodge (NHS Lothian); Tania Long (Buckinghamshire Healthcare NHS Trust); Maria Mamalikopoulou (Barts Health NHS Trust); Lizzie Marks (Kent Community Health NHS Foundation Trust); Hilary Mawdesley (Sandwell and West Birmingham Hospitals NHS Trust); Stephanie McCormick (Alder Hey NHS Foundation Trust); Claire Milligan (NHS Lanarkshire); Linda Mulgrew (Southern Health and Social Care Trust); Keri Murphy (Somerset NHS Foundation Trust); Kerry Newman (NHS Lothian); Di Nicholson (Northumbria Healthcare NHS Foundation Trust); Catherine O’","cbCaiu55stBngzJo","https://ap.wps.com/l/cbCaiu55stBngzJo","pdf",774413,14,"English","# Abstract\n## Background\n## Aims\n## Methods and Procedures","[{\"question\":\"Why is a core outcome set (COS) needed for children with speech sound disorder (SSD)?\",\"answer\":\"Because pathway effectiveness is unclear: there is currently no systematic recording or analysis of SSD intervention outcomes. A COS supports consistent routine data collection.\"},{\"question\":\"What is the main objective of the MISLToe-SSD study?\",\"answer\":\"To develop an evidence-based protocol for routine data collection at scale so UK SSD care pathways can be evaluated for clinical and cost effectiveness.\"},{\"question\":\"How is the COS developed in the MISLToe-SSD study?\",\"answer\":\"The document reports development using a modified Delphi process following the Core Outcome Measures in Effectiveness Trials methodology.\"}]","Maximising the Impact of Speech and Language Therapy for Children With Speech Sound Disorder (The MISLToe-SSD) Study - Developing a Core Outcome Set (COS) for Routine Data Collection From UK NHS Speech and Language Therapy Services | PDF",1790760275,35]