Developing treatment goals and hierarchies is fundamental to effective intervention. Despite this, interventions are often vaguely or ambiguously described, negatively impacting outcome measurement, client engagement, and team communication. THIMS (Target, Hierarchy, Ingredients, Measures, Success Criterion) is a novel intervention planning framework that aims to improve the specificity and measurability of treatment goals and hierarchies in speech–language pathology (SLP).
The objective of this pilot study was to determine if clinician training in the use of the THIMS Framework was feasible and effective at improving the specificity and measurability of SLP treatment goals and hierarchies.
We completed a within-group pre-post pilot study to determine the impact of training speech-language pathologists (SLPs) to use the THIMS Framework. We evaluated participant recruitment, task completion, and attrition, as well as the specificity and measurability of SLP goals and hierarchies submitted before and after training.
Twenty-three SLPs completed the study, with participants representing a broad range of years of experience and clinical practice areas. Results showed feasible recruitment and retention and significantly higher scores for treatment goals and hierarchies after completing THIMS training sessions.
Training in the use of the THIMS Framework was feasible for a small sample size and resulted in increased specificity and measurability of SLP treatment goals and hierarchies. This ‘one-size-fits-all’ framework has the potential to fill the current gap for a systematic but flexible goal and hierarchy writing system for SLPs.
Dysarthria, a motor speech disorder that has a significant impact on communication, requires precise assessment for accurate diagnosis and intervention. Although internationally recognised assessment tools exist, many are not culturally or linguistically adapted for Spanish-speaking populations. The objective of this study was to investigate how speech-language pathologists (SLPs) in Spain navigate the lack of appropriate dysarthria assessment tools and identify the additional resources and tools required to enhance evaluation practices.
This cross-sectional study surveyed 73 licensed SLPs in Spain using a 36-question online questionnaire, collecting data on a broad spectrum of topics, such as clinical experience, dysarthria assessment tools, tasks, and bilingual/multilingual practices. Descriptive statistical analysis was used to identify and highlight the key trends.
The findings revealed that participants commonly relied on informal tools for dysarthria assessment, with frequent use of linguistically dependent tasks, such as word repetition, loud reading, and sentence repetition, in addition to orofacial motricity. Participants also reported low use of patient-reported outcome measures (PROMs) and showed confusion regarding the validation status of the tools they used. Additionally, many expressed dissatisfaction with the current tools, highlighting the lack of comprehensive and culturally adapted instruments.
This study underscores the urgent need for validated, standardised, culturally and linguistically adapted tools for dysarthria assessment in Spain. The reliance on informal assessments and the combination of multiple tools highlights gaps in current resources. Future efforts should focus on developing comprehensive, adaptable tools that address the full range of dysarthria symptoms and raise awareness about the importance of tool validation to ensure consistent and effective care for Spain's diverse population.
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