Service delivery and intervention intensity for phonology‐based speech sound disorders
Open accessAbstract
Background: When planning evidence‐based intervention services for children with phonology‐based speech sound disorders (SSD), speech and language therapists (SLTs) need to integrate research evidence regarding service delivery and intervention intensity within their clinical practice. However, relatively little is known about the optimal intensity of phonological interventions and whether SLTs’ services align with the research evidence. Aims: The aims are twofold. First, to review external evidence (i.e., empirical research evidence external to day‐to‐day clinical practice) regarding service delivery and intervention intensity for phonological interventions. Second, to investigate SLTs’ clinical practice with children with phonology‐based SSD in Australia, focusing on service delivery and intensity. By considering these complementary sources of evidence, SLTs and researchers will be better placed to understand the state of the external evidence regarding the delivery of phonological interventions and appreciate the challenges facing SLTs in providing evidence‐based services. Methods & Procedures: Two studies are presented. The first is a review of phonological intervention research published between 1979 and 2016. Details regarding service delivery and intervention intensity were extracted from the 199 papers that met inclusion criteria identified through a systematic search. The second study was an online survey of 288 SLTs working in Australia, focused on the service delivery and intensity of intervention provided in clinical practice. Main Contributions: There is a gap between the external evidence regarding service delivery and intervention intensity and the internal evidence from clinical practice. Most published intervention research has reported to provide intervention two to three times per week in individual sessions delivered by an SLT in a university clinic, in sessions lasting 30–60 min comprising 100 production trials. SLTs reported providing services at intensities below that found in the literature. Further, they reported workplace, client and clinician factors that influenced the intensity of intervention they were able to provide to children with phonology‐based SSD. Conclusions & Implications: Insufficient detail in the reporting of intervention intensity within published research coupled with service delivery constraints may affect the implementation of empirical evidence into everyday clinical practice. Research investigating innovative solutions to service delivery challenges is needed to provide SLTs with evidence that is relevant and feasible for clinical practice.
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Better support for reaching the recommended session duration would increase the likelihood that dose reaches and surpasses the recommended minimum level of 50 production efforts per session.
“Even though better support for reaching the recommended session duration does not allow control of the number of ‘production efforts’ per session, it would increase the likelihood that dose reaches and surpasses the recommended minimum level of 50 per session (Sugden et al. 2018).”
From Self‐Supervised App‐Based Speech Training for Children With Speech Sound Disorder—A Single‐Case Experimental Design Study (2026) · cites this paper as Sugden et al. 2018
The Discussion of Study 2 (p. 24) identifies 50–99 production trials per session as the recommended benchmark, and the review reports that 100 trials were typically delivered in 30–45-minute sessions (p. 12). The paper does not establish that better support for reaching a recommended session duration would increase the likelihood of meeting that dose; that is the citing authors’ inference. (LLM, conf=0.83)
Experimental — accuracy not yet measuredSugden et al. (2018) recommend treatment should be individual, occur 2-3 times per week, each session lasting 30-60 min, and include at least 50-100 production efforts per treatment session.
“Based on their systematic review of phonological intervention, Sugden and colleagues (2018) outline recommendations that treatment should be individual, occur 2–3 times per week, each session lasting for 30–60 min, and including at least 50–100 ‘production efforts’ per treatment session”
From Self‐Supervised App‐Based Speech Training for Children With Speech Sound Disorder—A Single‐Case Experimental Design Study (2026) · cites this paper as Sugden et al. 2018
High-enough dose and dose frequency are important ingredients of intervention delivery.
“An important ingredient of intervention delivery is high‐enough dose, involving the child producing target sounds many times during a training session, and high‐enough dose frequency, that is, involving regular scheduling of training sessions (Sugden et al. 2018).”
From Self‐Supervised App‐Based Speech Training for Children With Speech Sound Disorder—A Single‐Case Experimental Design Study (2026) · cites this paper as Sugden et al. 2018
The observed dose of 7 to 14 production efforts per session in the present study is remarkably lower than recommended levels of 50-100 production efforts per session suggested by Sugden and colleagues (2018).
“Regarding dose, the observed dose of 7 to 14 production efforts per session in the present study is remarkably lower than recommended levels of 50–100 ‘production efforts’ per session, as suggested by Sugden and colleagues (2018) in their review.”
From Self‐Supervised App‐Based Speech Training for Children With Speech Sound Disorder—A Single‐Case Experimental Design Study (2026) · cites this paper as Sugden et al. 2018
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Strömbergsson, S., Edlund, E., Pettersson, M., Phan, N., & Kurimo, M. (2026) · International Journal of Language & Communication Disorders · doi:10.1111/1460-6984.70163
- Authors
- Sugden, E., Baker, E., Munro, N., Williams, A. L., & Trivette, C. M.
- Affiliations
- The University of Sydney (AU)
- East Tennessee State University (US)
- Corresponding author
- Sugden, Eleanor
- Venue
- International Journal of Language & Communication Disorders
- Publisher
- Wiley
- Published
- 2018-06-14
- Volume
- 53
- Issue
- 4
- Pages
- 718-734
- ISSN
- 1368-2822 (ISSN-L)
- 1460-6984
- OpenAlex
- W2808569359
- Cited by
- 51
- References
- 1
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 11 · 2023: 6 · 2022: 9 · 2021: 6 · 2020: 7 · 2019: 5
- FWCI
- 0.86
- Type
- journal article
- Language
- en
- Open access
- Locations
- International Journal of Language & Communication Disorders (publishedVersion)
- PubMed (publishedVersion)
- Strathprints: The University of Strathclyde institutional repository (University of Strathclyde) (acceptedVersion)
- Cross Connect (Southern Cross University) (submittedVersion)
- Digital Commons - East Tennessee State University (East Tennessee State University) (submittedVersion)
- Topics
- Social Sciences › Psychology › Developmental and Educational Psychology › Language Development and Disorders
- Health Sciences › Medicine › Physiology › Voice and Speech Disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Phonetics and Phonology Research
- Keywords
- phonological intervention, intervention intensity, service delivery, speech-language pathologists, evidence-based practice, clinical practice, children, intervention reporting, evidence-based practice implementation
- MeSH terms
- Child, Humans, Phonetics, Speech Therapy, Speech Sound Disorder
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