To identify children in need of extra help. Then the question becomes to what extent the child experiences difficulties with language function in everyday life; this may depend not only on the nature, number and severity of P144 Peptide molecular weight impairments in language and other systems, but also on the environment and any adjustments made to counteract the impairment. The World Health Organization’s International Classification of Functioning, Disability and Health–Children and Youth (ICF-CY) framework [20] is consistent with such an approach. In an effort to improve consensus in this area we adopted the Delphi technique [21], taking as our initial model the approach used by Greenhalgh and colleagues [22]. We decided to undertake two Delphi exercises; the first to consider the criteria that would be used to identify children in need of extra specialist help, and the second to address terminological issues. This paper reports on the first of these. The Delphi is a consensus-building order Bay 41-4109 method that has key features that distinguish it from the other main approach that has been used, which is to gather experts together to discuss issues, either at a conference, or in a series of meetings: 1. The process goes through a series of cycles. In each cycle, a panel of experts is presented with a set of statements to rate, and feedback is then given that shows how each individual’s ratings compare with whole distribution. Items can then be dropped or modified in relation to the feedback, before the next cycle. This process is repeated until either consensus is obtained, or it is clear no consensus is possible. 2. As well a quantitative ratings, open ended comments can be included at the rating stage and fed back to all panel members. This way, panel members can attempt to influence the consensus by giving justification for their ratings. 3. The process is anonymised. This means everyone gets a chance to have their views taken into account, without senior individuals or forceful personalities dominating. 4. The Delphi can be run online. It does not require that everyone is in the same place at the same time; this facilitates international collaboration and gives people time to respond as they find convenient. Note that, although quantitative ratings are used in the Delphi process, it is not equivalent to a simple voting system, because it incorporates interaction and engagement between panel members. It necessarily involves judgement, particularly at the stage between cycles when decisions are made to modify or drop items. The basis for doing this is to improve the likelihood of agreement in the subsequent round.PLOS ONE | DOI:10.1371/journal.pone.0158753 July 8,3 /Identifying Language Impairments in ChildrenMaterials and Methods Identification of panel membersSelection of an expert panel is a key part of any Delphi exercise, and has been a topic of some debate in the literature [23]. It is important to have panel members who are committed to the project, have credibility, and are heterogeneous enough to represent the range of stakeholders who have an interest in results. In determining panel membership, key questions arose as to the scope of the exercise: in terms of what we aimed to achieve, and whether our focus would be national, multinational or multilingual. In terms of the goal of the exercise, our focus was on those children who would traditionally be regarded as having specific language impairment (SLI), i.e. those with severe and persistent language difficultie.To identify children in need of extra help. Then the question becomes to what extent the child experiences difficulties with language function in everyday life; this may depend not only on the nature, number and severity of impairments in language and other systems, but also on the environment and any adjustments made to counteract the impairment. The World Health Organization’s International Classification of Functioning, Disability and Health–Children and Youth (ICF-CY) framework [20] is consistent with such an approach. In an effort to improve consensus in this area we adopted the Delphi technique [21], taking as our initial model the approach used by Greenhalgh and colleagues [22]. We decided to undertake two Delphi exercises; the first to consider the criteria that would be used to identify children in need of extra specialist help, and the second to address terminological issues. This paper reports on the first of these. The Delphi is a consensus-building method that has key features that distinguish it from the other main approach that has been used, which is to gather experts together to discuss issues, either at a conference, or in a series of meetings: 1. The process goes through a series of cycles. In each cycle, a panel of experts is presented with a set of statements to rate, and feedback is then given that shows how each individual’s ratings compare with whole distribution. Items can then be dropped or modified in relation to the feedback, before the next cycle. This process is repeated until either consensus is obtained, or it is clear no consensus is possible. 2. As well a quantitative ratings, open ended comments can be included at the rating stage and fed back to all panel members. This way, panel members can attempt to influence the consensus by giving justification for their ratings. 3. The process is anonymised. This means everyone gets a chance to have their views taken into account, without senior individuals or forceful personalities dominating. 4. The Delphi can be run online. It does not require that everyone is in the same place at the same time; this facilitates international collaboration and gives people time to respond as they find convenient. Note that, although quantitative ratings are used in the Delphi process, it is not equivalent to a simple voting system, because it incorporates interaction and engagement between panel members. It necessarily involves judgement, particularly at the stage between cycles when decisions are made to modify or drop items. The basis for doing this is to improve the likelihood of agreement in the subsequent round.PLOS ONE | DOI:10.1371/journal.pone.0158753 July 8,3 /Identifying Language Impairments in ChildrenMaterials and Methods Identification of panel membersSelection of an expert panel is a key part of any Delphi exercise, and has been a topic of some debate in the literature [23]. It is important to have panel members who are committed to the project, have credibility, and are heterogeneous enough to represent the range of stakeholders who have an interest in results. In determining panel membership, key questions arose as to the scope of the exercise: in terms of what we aimed to achieve, and whether our focus would be national, multinational or multilingual. In terms of the goal of the exercise, our focus was on those children who would traditionally be regarded as having specific language impairment (SLI), i.e. those with severe and persistent language difficultie.
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