Bristol Speech and Language Therapy Research Unit (BSLTRU)

About the lab

The Bristol Speech and Language Therapy Research Unit (BSLTRU) was founded in 1987 by Professor Pam Enderby with the support of a grant from the Underwood Trust. Now, with an illustrious history behind us, we are continuing to investigate speech and language therapy; how it is implemented with the changing contexts of primary and secondary care and its impact of those receiving it.
Since BSLTRU was established, it has received significant funding from The Underwood Trust, this generosity has enabled us to develop and strengthen our programme of research. We have worked with many academic institutions, and have had particularly close relationships with the University of the West of England, Bristol (UWE) and the University of Bristol (UoB).

Featured projects (1)

I. What is the impact of mask wearing for People Who Stammer? II. What is the impact of using virtual meeting platforms for People Who Stammer? III. How has COVID-19 affected referrals of children and adults who stammer to Speech and Language Therapy? IV. How has COVID-19 impacted contact with support services for people who stammer?

Featured research (5)

This review outlines the findings of the rapid review and provides a number of recommendations. The review concludes that there is no one single tool which reaches the threshold for scientific measures whilst also screening for the recommended communication skills spanning for the age group. This is true for both children from English speaking backgrounds and those from bilingual or multilingual backgrounds.
Objective: To provide comparison data on the Intelligibility in Context Scale (ICS) for a sample of 3-year-old English-speaking children born with any cleft type. Design: Questionnaire data from the Cleft Collective Cohort Study were used. Descriptive and inferential statistics were carried out to determine difference according to children's cleft type and syndromic status. Participants: A total of 412 children born with cleft lip and/or palate whose mothers had completed the ICS when their child was 3 years old. Main outcome measure(s): Mothers' rating of their children's intelligibility using the ICS. Results: The average ICS score for the total sample was 3.75 (sometimes-usually intelligible; standard deviation [SD] = 0.76, 95% CIs = 3.68-3.83) of a possible score of 5 (always intelligible). Children's speech was reported to be most intelligible to their mothers (mean = 4.33, SD = 0.61, 95% CIs = 4.27-4.39) and least intelligible to strangers (mean = 3.36, SD = 1.00, 95% CIs = 3.26-3.45). There was strong evidence (P < .001) for a difference in intelligibility between children with cleft lip only (n = 104, mean = 4.13, SD = 0.62, 95% CIs = 4.01-4.25) and children with any form of cleft palate (n = 308, mean = 3.63, SD = 0.76, 95% CIs = 3.52-3.71). Children born with cleft palate with or without cleft lip and an identified syndrome were rated as less intelligible (n = 63, mean = 3.28, SD = 0.85, 95% CIs = 3.06-3.49) compared to children who did not have a syndrome (n = 245, mean = 3.72, SD = 0.71, 95% CIs = 3.63-3.81). Conclusions: These results provide preliminary comparative data for clinical services using the outcome measures recommended by the International Consortium for Health Outcomes Measurement.
Background: Children with and without speech sound disorders (SSDs) are exposed to different patterns of infant feeding (breast/bottle-feeding) and may or may not engage in non-nutritive sucking (NNS) (pacifier/digit-sucking). Sucking and speech use similar oral musculature and structures, therefore it is possible that early sucking patterns may impact early speech sound development. The objective of this review is to synthesise the current evidence on the influence of feeding and NNS on the speech sound development of healthy full-term children. Summary: Electronic databases (PubMed, NHS CRD, EMBASE, MEDLINE) were searched using terms specific to feeding, NNS and speech sound development. All methodologies were considered. Studies were assessed for inclusion and quality by 2 reviewers. Of 1,031 initial results, 751 records were screened, and 5 primary studies were assessed for eligibility, 4 of which were included in the review. Evidence from the available literature on the relationship between feeding, NNS and speech sound development was inconsistent and inconclusive. An association between NNS duration and SSDs was the most consistent finding, reported by 3 of the 4 studies. Quality appraisal was carried out using the Appraisal Tool for Cross-Sectional Studies (AXIS). The included studies were found to be of moderate quality. Key Messages: This review found there is currently limited evidence on the relationship between feeding, NNS and speech sound development. Exploring this unclear relationship is important because of the overlapping physical mechanisms for feeding, NNS and speech production, and therefore the possibility that feeding and/or sucking behaviours may have the potential to impact on speech sound development. Further high-quality research into specific types of SSD using coherent clinically relevant assessment measures is needed to clarify the nature of the association between feeding, NNS and speech sound development, in order to inform and support families and health care professionals.
Aim: To explore a novel and efficient way of calculating transcription reliability of connected speech data using the concept of near functional equivalence. Using this approach, differences between two transcribed phonemes that are nearly phonetically equivalent are disregarded if both reflect two plausible and acceptable pronunciations for the word produced. Method: The study used transcriptions of connected speech samples from 63 five-year-olds who participated in a large-scale population study. Each recording was phonetically transcribed by two speech and language therapists. Two independent researchers then examined agreement -between the two sets of transcripts, marking differences in vowels, consonants and diacritics and identifying segments which represented near functional equivalence. Results: Overall percentage agreement between the transcripts was 77%. One quarter of the differences between the two transcripts were identified as showing near functional equivalence. When this category was excluded, the transcripts showed 82% reliability. Conclusions: This study demonstrates the issues to consider when calculating transcription reliability. Other methods are often time-intensive and may highlight differences between transcribed units which are audibly very similar and would be negligible in ordinary conversation. Inclusion of the concept of "near functional equivalence" can result in higher reliability scores for transcription, without loss of rigour.
Background: Several studies have suggested that practitioners hold speech and language therapy (SLT) practice as tacit and consequently it is difficult for the therapist to describe. The current study uses a range of knowledge elicitation (KE) approaches, a technique not used before in SLT, as a way of accessing this tacit knowledge. There is currently no agreed framework that establishes key factors underpinning practice for preschool children with speech and language disorders. This paper attempts to address that gap. Aims: To develop a framework of SLTs' practice when working with preschool children with developmental speech and language disorders (DS&LD). Methods & procedures: A mixed-methods approach was adopted for this study. Data were collected iteratively, from 245 SLTs with experience of working with preschool children with DS&LD across sites in England, by means of focus groups and national events. There were three stages of data collection: local sites, specific-interest groups and two national events. KE techniques were used to gather data, with initial data being collected in local site focus groups. Findings from groups were taken to subsequent larger groups where a combination of concept mapping, teach-back and sorting exercises generated a more detailed description of practice, using discussion of consensus and disagreement to stimulate further exploration and definition and provide validatory evidence. Outcomes & results: This paper provides a high-level framework of therapy for preschool children with DS&LD that makes practice explicit in this area. The framework proposes that therapists' aims for this group of children fall into three categories: addressing children's areas of impairment and skills; achieving functionally meaningful skills and carryover; and supporting adults to provide a supportive communication environment. The exact configuration is shaped by the child's context and needs. Conclusions & implications: The framework highlights themes that are well researched in the literature (e.g., speech) and others that have been little studied (e.g., adult understanding), indicating a disconnect between research evidence and practice. The research also highlights the complex nature of interventions for preschool children with DS&LD and the importance therapists attribute to tailoring therapy to individual needs. The framework provides a scaffold upon which SLTs can focus their clinical practice and encourages the profession to understand and explore better the gaps between research evidence and clinical practice for preschool children with DS&LD.

Lab head

Yvonne Wren
  • Bristol Speech and Language Therapy Research Unit/Bristol Dental School/School of Sport and Health Sciences

Members (12)

Sam A Harding
  • North Bristol NHS Trust
Sue Roulstone
  • University of the West of England, Bristol
Brian Petheram
  • North Bristol NHS Trust
Lydia Morgan
  • North Bristol NHS Trust
Katherine Broomfield
  • Sheffield Hallam University
Rosemarie Hayhow
  • Bristol Speech & Language Therapy Research Unit
Lucy Southby
  • East of England Cleft Lip and Palate Network (Cleft.NET.East)/Cambridge University Hospitals NHS Foundation Trust/Bristol Speech and Language Therapy Research Unit/North Bristol NHS Trust
Sam Burr
  • North Bristol NHS Trust & Solent NHS Trust