S who are at risk of educational and social problems even if taught by teachers who are skilled at supporting children’s communication. These are the children who need additional help beyond targeted help in the classroom and who should be referred to a SLT/ SLP for more detailed evaluation and intervention tailored to their specific needs. Given this focus, we deemed it appropriate to have predominant representation of SLT/ SLPs, as this is the professional group that has particular expertise in children’s speech and language difficulties. However, we thought it was GSK089 biological activity important also to include representation of different professions involved with these children, including those from education, psychology, audiology and medicine, so that a variety of views could be aired and discussed. Our goal was to have a mix of individuals who had strong research credentials in this field and those who had extensive clinical experience, with some panel members combining both of these. In addition, we included representatives from charities whose primary focus is on supporting families affected by language impairments in children. We restricted consideration to English-speaking countries. The issues we focused on are equally challenging in other countries, but manifestations of language difficulty, and terminology used to describe these, differ across languages [21]. Given that there are an estimated 6500 languages in the world, it would be unfeasible to cover all of them. Rather than encompassing all languages, we aimed to produce a study that might form a model for future studies in other languages. Nevertheless, we note that in many of the countries we included, significant proportions of the population speak more than one language, and we included items relevant to multilingual contexts. Our focus was predominantly on the United Kingdom, but we aimed to include on the panel representatives of the other large English-speaking countries, i.e., Australia, Canada, Ireland, New Zealand and USA. Our rationale was that we were aware that experts in other countries planned to conduct their own consensus exercises; these might reach different conclusions related to different structures for education, insurance, health care and intervention. Our goal was to ensure our process kept us aware of any major discrepancies in approach from one discipline or country to another, so that we could, as far as possible, increase the likelihood that our guidelines would be acceptable beyond the narrow confines of one profession or nationality. There is no agreement about the optimal size of a Delphi panel, with many including under 20 people [24],[25],[26]. The advantage of a larger panel is more representative coverage of experts, but a corresponding disadvantage is that the group discussion that is an inherent part of the process gets harder to achieve when more than 40 or 50 participants are involved [27]. We aimed to strike a compromise order RG7666 between coverage of a range of disciplines and geographical regions, and encouraging development of a cohesive group for discussion. To form the Delphi panel we started with the individuals who had been asked to write commentaries for the IJLCD special issue, and all co-authors of the target articles, excluding BishopPLOS ONE | DOI:10.1371/journal.pone.0158753 July 8,4 /Identifying Language Impairments in ChildrenTable 1. Professional group and nationality of panel members. Profession Speech-Language Therapist/Pathologist Joint SLT/SLP.S who are at risk of educational and social problems even if taught by teachers who are skilled at supporting children’s communication. These are the children who need additional help beyond targeted help in the classroom and who should be referred to a SLT/ SLP for more detailed evaluation and intervention tailored to their specific needs. Given this focus, we deemed it appropriate to have predominant representation of SLT/ SLPs, as this is the professional group that has particular expertise in children’s speech and language difficulties. However, we thought it was important also to include representation of different professions involved with these children, including those from education, psychology, audiology and medicine, so that a variety of views could be aired and discussed. Our goal was to have a mix of individuals who had strong research credentials in this field and those who had extensive clinical experience, with some panel members combining both of these. In addition, we included representatives from charities whose primary focus is on supporting families affected by language impairments in children. We restricted consideration to English-speaking countries. The issues we focused on are equally challenging in other countries, but manifestations of language difficulty, and terminology used to describe these, differ across languages [21]. Given that there are an estimated 6500 languages in the world, it would be unfeasible to cover all of them. Rather than encompassing all languages, we aimed to produce a study that might form a model for future studies in other languages. Nevertheless, we note that in many of the countries we included, significant proportions of the population speak more than one language, and we included items relevant to multilingual contexts. Our focus was predominantly on the United Kingdom, but we aimed to include on the panel representatives of the other large English-speaking countries, i.e., Australia, Canada, Ireland, New Zealand and USA. Our rationale was that we were aware that experts in other countries planned to conduct their own consensus exercises; these might reach different conclusions related to different structures for education, insurance, health care and intervention. Our goal was to ensure our process kept us aware of any major discrepancies in approach from one discipline or country to another, so that we could, as far as possible, increase the likelihood that our guidelines would be acceptable beyond the narrow confines of one profession or nationality. There is no agreement about the optimal size of a Delphi panel, with many including under 20 people [24],[25],[26]. The advantage of a larger panel is more representative coverage of experts, but a corresponding disadvantage is that the group discussion that is an inherent part of the process gets harder to achieve when more than 40 or 50 participants are involved [27]. We aimed to strike a compromise between coverage of a range of disciplines and geographical regions, and encouraging development of a cohesive group for discussion. To form the Delphi panel we started with the individuals who had been asked to write commentaries for the IJLCD special issue, and all co-authors of the target articles, excluding BishopPLOS ONE | DOI:10.1371/journal.pone.0158753 July 8,4 /Identifying Language Impairments in ChildrenTable 1. Professional group and nationality of panel members. Profession Speech-Language Therapist/Pathologist Joint SLT/SLP.
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