Abstract：
BACKGROUND: The publication of phase 2 of the CATALISE project in 2017 clarified terminology for children with developmental language disorder (DLD) or delay but unintentionally muddied the water for children with unintelligible speech. A diagnostic label of DLD (phonology) indicates poor prognosis and phonological disorder that persists into middle childhood. However, in contrast to other diagnostic labels that fall under the overarching term of speech sound disorder (SSD), DLD (phonology) does not elucidate the characteristics of the child\'s speech nor does it point us in the direction of appropriate intervention.
OBJECTIVE: The aim of this paper is to discuss terminology in SSD leading to an evidence-based model which builds on the model of DLD developed in CATALISE, supports descriptive diagnosis and signposts intervention.
METHODS: Following a focused review of literature proposing or describing terminology for SSD, an expert group of researchers in developmental SSD proposed a revised model of existing terminology. Groups of UK speech and language therapists (SLTs) who provide services for children with SSD were asked to comment on its acceptability and feasibility.
CONCLUSIONS: A three-level terminology model was developed. This comprised an overarching Level 1 term; Level 2 terms that differentiated SSD of unknown origin from SSD with associated or underlying conditions; and specific diagnostic terms at Level 3 to support further assessment and intervention decisions. Consulted SLTs generally expressed agreement with the proposed terminology and a willingness to adopt it in practice.
CONCLUSIONS: Existing terminology for childhood SSD provides a good basis for clinical decision-making. A modified version of Dodd\'s (2005) terminology was found to be acceptable to UK SLTs. There is an evident overlap of SSD with CATALISE terminology. However more detailed and specialist terminology than \'DLD (phonology)\' is required to support clinical decision-making. It is proposed that endorsement by the UK Royal College of Speech and Language Therapists would obviate the need for a Delphi process.
CONCLUSIONS: What is already known on this subject Over nearly a hundred years, as our knowledge and understanding of speech sound disorder (SSD) has increased, so has the terminology that is used to describe those disorders. Current terminology not only describes subtypes of SSD but can also signpost us to effective interventions. With the publication, in 2017, of phase 2 of CATALISE a new term of \'developmental language disorder (DLD) (phonology)\' was introduced with the unintentional consequence of challenging more specific descriptive terms for SSD. What this paper adds In the context of CATALISE and DLD (phonology), the history and nature of SSD terminology are reappraised. Building on the model of DLD developed in CATALISE, a tiered model that supports descriptive diagnosis and signposts intervention is proposed for discussion. Clinical implications of this study The proposed model of terminology for SSD provides descriptive and detailed labels that will support accuracy in differential diagnosis of developmental SSD by speech and language therapists. Furthermore, a decision-making tree for SSD demonstrates the pathway from diagnostic use of the terminology to the selection of evidence-based, effective interventions.
OBJECTIVE: The aim of this paper is to discuss terminology in SSD leading to an evidence-based model which builds on the model of DLD developed in CATALISE, supports descriptive diagnosis and signposts intervention.
METHODS: Following a focused review of literature proposing or describing terminology for SSD, an expert group of researchers in developmental SSD proposed a revised model of existing terminology. Groups of UK speech and language therapists (SLTs) who provide services for children with SSD were asked to comment on its acceptability and feasibility.
CONCLUSIONS: A three-level terminology model was developed. This comprised an overarching Level 1 term; Level 2 terms that differentiated SSD of unknown origin from SSD with associated or underlying conditions; and specific diagnostic terms at Level 3 to support further assessment and intervention decisions. Consulted SLTs generally expressed agreement with the proposed terminology and a willingness to adopt it in practice.
CONCLUSIONS: Existing terminology for childhood SSD provides a good basis for clinical decision-making. A modified version of Dodd\'s (2005) terminology was found to be acceptable to UK SLTs. There is an evident overlap of SSD with CATALISE terminology. However more detailed and specialist terminology than \'DLD (phonology)\' is required to support clinical decision-making. It is proposed that endorsement by the UK Royal College of Speech and Language Therapists would obviate the need for a Delphi process.
CONCLUSIONS: What is already known on this subject Over nearly a hundred years, as our knowledge and understanding of speech sound disorder (SSD) has increased, so has the terminology that is used to describe those disorders. Current terminology not only describes subtypes of SSD but can also signpost us to effective interventions. With the publication, in 2017, of phase 2 of CATALISE a new term of \'developmental language disorder (DLD) (phonology)\' was introduced with the unintentional consequence of challenging more specific descriptive terms for SSD. What this paper adds In the context of CATALISE and DLD (phonology), the history and nature of SSD terminology are reappraised. Building on the model of DLD developed in CATALISE, a tiered model that supports descriptive diagnosis and signposts intervention is proposed for discussion. Clinical implications of this study The proposed model of terminology for SSD provides descriptive and detailed labels that will support accuracy in differential diagnosis of developmental SSD by speech and language therapists. Furthermore, a decision-making tree for SSD demonstrates the pathway from diagnostic use of the terminology to the selection of evidence-based, effective interventions.
摘要：
背景：2017年CATALISE项目第2阶段的出版澄清了患有发育性语言障碍（DLD）或延迟但无意中混淆了言语难以理解的儿童的术语。DLD（语音）的诊断标签表明预后不良和语音障碍持续到儿童中期。然而,与属于语音障碍(SSD)总体术语的其他诊断标签相比，DLD（语音）没有阐明儿童言语的特征，也没有指出我们适当干预的方向。
目的：本文的目的是讨论SSD中的术语，从而导致基于证据的模型，该模型建立在CATALISE中开发的DLD模型上，支持描述性诊断和路标干预。
方法：在对提出或描述SSD术语的文献进行重点回顾之后，开发SSD研究人员的专家组提出了现有术语的修订模型。为SSD儿童提供服务的英国言语和语言治疗师（SLT）小组被要求对其可接受性和可行性发表评论。
结论：建立了三级术语模型。这包括一个首要的1级术语；2级术语，将未知来源的SSD与相关或潜在条件的SSD区分开来；以及3级的特定诊断术语，以支持进一步的评估和干预决策。经协商的SLT普遍表示同意拟议的术语，并愿意在实践中采用该术语。
结论：儿童SSD的现有术语为临床决策提供了良好的基础。Dodd\（2005）术语的修改版本被英国SLT接受。SSD与CATALISE术语有明显的重叠。然而，需要比“DLD（语音）”更详细和专业的术语来支持临床决策。建议英国皇家言语和语言治疗师学院的认可将消除对Delphi过程的需要。
结论：在这个问题上已经知道了近一百年，随着我们对语音障碍（SSD）的认识和理解的增加，用来描述这些疾病的术语也是如此。当前的术语不仅描述了SSD的亚型，而且还可以指导我们进行有效的干预。随着出版物，2017年，在CATALISE第2阶段，引入了一个新的术语“发育性语言障碍（DLD）（语音）”，其无意的后果是挑战SSD的更具体的描述性术语。本文在CATALISE和DLD(语音)的背景下增加了什么，重新评估SSD术语的历史和性质。在CATALISE中开发的DLD模型的基础上，提出了一个支持描述性诊断和路标干预的分层模型供讨论.这项研究的临床意义提出的SSD术语模型提供了描述性和详细的标签，这些标签将支持言语和语言治疗师对发育性SSD的鉴别诊断的准确性。此外，SSD的决策树展示了从术语的诊断使用到基于证据的选择的途径，有效的干预措施。
目的：本文的目的是讨论SSD中的术语，从而导致基于证据的模型，该模型建立在CATALISE中开发的DLD模型上，支持描述性诊断和路标干预。
方法：在对提出或描述SSD术语的文献进行重点回顾之后，开发SSD研究人员的专家组提出了现有术语的修订模型。为SSD儿童提供服务的英国言语和语言治疗师（SLT）小组被要求对其可接受性和可行性发表评论。
结论：建立了三级术语模型。这包括一个首要的1级术语；2级术语，将未知来源的SSD与相关或潜在条件的SSD区分开来；以及3级的特定诊断术语，以支持进一步的评估和干预决策。经协商的SLT普遍表示同意拟议的术语，并愿意在实践中采用该术语。
结论：儿童SSD的现有术语为临床决策提供了良好的基础。Dodd\（2005）术语的修改版本被英国SLT接受。SSD与CATALISE术语有明显的重叠。然而，需要比“DLD（语音）”更详细和专业的术语来支持临床决策。建议英国皇家言语和语言治疗师学院的认可将消除对Delphi过程的需要。
结论：在这个问题上已经知道了近一百年，随着我们对语音障碍（SSD）的认识和理解的增加，用来描述这些疾病的术语也是如此。当前的术语不仅描述了SSD的亚型，而且还可以指导我们进行有效的干预。随着出版物，2017年，在CATALISE第2阶段，引入了一个新的术语“发育性语言障碍（DLD）（语音）”，其无意的后果是挑战SSD的更具体的描述性术语。本文在CATALISE和DLD(语音)的背景下增加了什么，重新评估SSD术语的历史和性质。在CATALISE中开发的DLD模型的基础上，提出了一个支持描述性诊断和路标干预的分层模型供讨论.这项研究的临床意义提出的SSD术语模型提供了描述性和详细的标签，这些标签将支持言语和语言治疗师对发育性SSD的鉴别诊断的准确性。此外，SSD的决策树展示了从术语的诊断使用到基于证据的选择的途径，有效的干预措施。
