Helen Stringer

Dr. Helen Stringer

orcid

Research Focus & Metrics

Academic Career Length

42Years (1985-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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28 August 2012 in BMC Health Services Research
Verified
Journal Article
Open access
PDF file
AWAnne Whitworth
Anne Whitworth
SHShona Haining
Shona Haining
HSHelen Stringer
Helen Stringer
With current policy in healthcare research, in the United Kingdom and internationally, focused on development of research excellence in individuals and teams, building capacity for implementation and translation of research is paramount among the professionals who use that research in daily practice. The judicious use of research outcomes and evaluation of best evidence and practice in healthcare is integrally linked to the research capacity and capabilities of the workforce. In addition to promoting high quality research, mechanisms for actively enhancing research capacity more generally must be in place to address the complexities that both undermine and facilitate this activity.

7 December 2023 in International Journal of Language & Communication Disorders
Verified
Journal Article
Open access
HSHelen Stringer
Helen Stringer
JCJoanne Cleland
Joanne Cleland
YWYvonne E Wren
Yvonne E Wren
RRRachel Rees
Rachel Rees
PWPam Williams
Pam Williams
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.Aims: 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.Discussion: 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.What this paper adds: 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.

9 September 2011 in Child Language Teaching and Therapy
Verified
Journal Article
Closed access
PDF file
JLJames Law
James Law
CPCharlene C Plunkett
Charlene C Plunkett
HSHelen Stringer
Helen Stringer
Speech, language and communication needs (SLCN) and social, emotional and behaviour difficulties (SEBD) commonly overlap, yet we know relatively little about the mechanism linking the two, specifically to what extent it is possible to reduce behaviour difficulties by targeted communication skills. The EPPI Centre systematic review methodology was applied to the intervention literature related to primary school aged children with both SLCN and SEBD. Studies were graded for study quality. Nineteen studies including 148 children met the inclusion criteria. Heterogeneity was high in terms of symptoms, methodology, interventions and outcomes. All studies reported positive effects of intervention on both communication and behavioural outcomes although the majority were graded as being of relatively low quality. Despite study limitations the findings suggest that this is a promising direction of enquiry. There remain many gaps in the evidence, for example study quality needs to improve, comparative work is rare and it is difficult to use these interventions to reflect on the type of systemic classroom models of service delivery recommended for many of these children. The results have implications for both clinical practice and further research.

7 May 2016
Verified
Conference Paper
Open access
RMRoisin Mcnaney
Roisin Mcnaney
MOMohammad Othman
Mohammad Othman
DRDan Richardson
Dan Richardson
PDPaul Dunphy
Paul Dunphy
TATelmo Amaral
Telmo Amaral
JVJohn Vines
John Vines
We present Speeching, a mobile application that uses crowdsourcing to support the self-monitoring and management of speech and voice issues for people with Parkinson's (PwP). The application allows participants to audio record short voice tasks, which are then rated and assessed by crowd workers. Speeching then feeds these results back to provide users with examples of how they were perceived by listeners unconnected to them (thus not used to their speech patterns). We conducted our study in two phases. First we assessed the feasibility of utilising the crowd to provide ratings of speech and voice that are comparable to those of experts. We then conducted a trial to evaluate how the provision of feedback, using Speeching, was valued by PwP. Our study highlights how applications like Speeching open up new opportunities for self-monitoring in digital health and wellbeing, and provide a means for those without regular access to clinical assessment services to practice and get meaningful feedback on their speech.

16 September 2023 in International Journal of Language & Communication Disorders
Verified
Journal Article
Open access
JBJo Baker
Jo Baker
HSHelen Stringer
Helen Stringer
CMCristina McKean
Cristina McKean
Background: Treatment fidelity refers to the degree to which an intervention is implemented as intended. Promoting treatment fidelity is important to achieve a valid comparison in intervention research. However, it is often underreported: few studies detail the use and development of fidelity measures. This study aims to promote the treatment fidelity of a modified version of the Derbyshire Language Scheme (M‐DLS), a manualised intervention for children with language difficulties, by exploring participants’ opinions on training and intervention delivery. Results inform development of a checklist and scoring system to monitor and promote treatment fidelity in a comparison trial.Method: Ten student speech and language therapists (SLTs) and two research assistants (RAs) participated in the study. All received training on the M‐DLS, and 10 were video‐recorded completing role‐plays of an M‐DLS session in small groups. Feedback was gathered after training and role‐plays in focus groups and interviews. Feedback was interpreted using the constructs of the Theoretical Domains Framework (TDF). A treatment fidelity checklist was then developed using the feedback. The first author and two RAs rated role‐play videos using the checklist to trial it to inform amendments and to promote interrater reliability. Interrater agreement was calculated using Spearman's test of correlation.Results: Participants discussed the importance of having clear materials and time to practise sessions. They suggested amendments to the materials and training to promote treatment fidelity. The checklist and scoring system accounted for participants’ suggestions, with amendments detailed in a log. Spearman's correlation results suggested agreement between the raters was strong.Conclusions: Results emphasise the importance of training quality, practice and reflective opportunities and clear materials to promote treatment fidelity. The construction of the checklist and scoring system was described in detail, informing the development of future checklists. After further trialling, the checklist can be used to ensure the M‐DLS is delivered with high treatment fidelity in the comparison trial.What this paper adds: What is already known on this subject: Treatment fidelity is an essential component of intervention effectiveness and efficacy studies, ensuring the intervention is delivered as intended. It is also an essential component of evidence-based clinical practice. However, few research studies report the treatment fidelity process or publish the checklists used, depriving clinicians of useful information for implementation. What this study adds: This study describes in detail the iterative process of treatment fidelity checklist development, engaging those implementing the intervention in development. This ensured clarity and interrater reliability of the checklist. Furthermore, a novel scoring system was developed so that accuracy of implementation can be easily compared across users and across practice attempts. What are the clinical implications of this work?: The importance of treatment fidelity when implementing effective and efficacious interventions cannot be overstated. The treatment fidelity checklist developed for research can be easily adopted to support accurate implementation in clinical practice through an audit process.

21 January 2015 in Clinical Linguistics & Phonetics
Verified
Journal Article
Open access
YKYalda Kazemi
Yalda Kazemi
TKThomas Klee
Thomas Klee
HSHelen Stringer
Helen Stringer
This study examined the diagnostic accuracy of selected language sample measures (LSMs) with Persian-speaking children. A pre-accuracy study followed by phase I and II studies are reported. Twenty-four Persian-speaking children, aged 42 to 54 months, with primary language impairment (PLI) were compared to 27 age-matched children without PLI on a set of measures derived from play-based, conversational language samples. Results showed that correlations between age and LSMs were not statistically significant in either group of children. However, a majority of LSMs differentiated children with and without PLI at the group level (phase I), while three of the measures exhibited good diagnostic accuracy at the level of the individual (phase II). We conclude that general LSMs are promising for distinguishing between children with and without PLI. Persian-specific measures are mainly helpful in identifying children without language impairment while their ability to identify children with PLI is poor.