Children with phonological problems: a survey of clinical practice.

BACKGROUND Children with phonological problems are a significant proportion of many therapists' caseloads. However, little is known about current clinical practice with these children or whether research on the effects of therapy have influenced this practice. AIMS To investigate the methods of assessment and remediation used by therapists working in the UK. METHODS & PROCEDURES A questionnaire was sent to therapists working with pre- and primary school-aged children. OUTCOMES & RESULTS Ninety-eight clinicians of varying experience responded. Most used the South Tyneside Assessment of Phonology to assess children, were confident in choosing therapy, and were aware of evidence that therapy is beneficial. They used a variety of therapies. Auditory discrimination, minimal contrast therapy, and phonological awareness were popular and often used in combination. Most involved parents. In planning therapy, clinicians were more influenced by children's language and cognitive abilities and the motivation of parents than by the nature of the impairment. CONCLUSIONS Constraints upon clinicians make it difficult for them to convert research findings to practice. In particular, assessments that allow more individualized and targeted interventions appear little used. Clinicians are aware of research but there is a danger that clinical practice and research are diverging.