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Outcomes Framework

​NI Private Speech Therapy

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1. Purpose

This policy sets out how outcomes and progress are monitored and reviewed within NI Private Speech Therapy. It describes the use of clinician-rated outcome measures, patient-reported outcome measures, goal-based outcomes, and patient-reported experience measures to support high-quality, family-centred speech and language therapy.

This framework applies to children and young people aged 18 months to 18 years across a wide range of speech, language, and communication needs.

 

2. Regulatory and Professional Alignment

This outcomes framework aligns with:

  • HCPC Standards of Proficiency for Speech and Language Therapists, including requirements to evaluate the effectiveness of practice, involve service users, and use appropriate outcome measures

  • RCSLT guidance on person-centred, functional, and participation-focused outcomes, informed by the ICF framework

Outcome measures are used to support clinical judgement, not replace it.

 

3. Principles

Outcome measurement within the service is guided by the following principles:

  • Outcomes should reflect everyday communication, participation, and wellbeing

  • Children, young people, and families should be actively involved in goal-setting and review

  • Measures should be brief, meaningful, and proportionate

  • Tools should be accessible across a wide age range and range of communication needs

  • Language used should be neuro-affirming and non-pathologising

  • Data should inform clinical decision-making and service development

 

4. Outcome Measures Used

4.1 Clinician-rated outcomes: Therapy Outcome Measures (TOMs)

Therapy Outcome Measures (TOMs) are used by clinicians to record change across the following domains:

  • Impairment

  • Activity

  • Participation

  • Wellbeing

TOMs are completed:

  • at the start of an episode of intervention (baseline)

  • at review points where clinically indicated

  • at discharge or end of a block of intervention

 

4.2 Goal-Based Outcomes (GBOs)

Goal-Based Outcomes are used to capture person-centred, meaningful change.

  • Goals are agreed collaboratively with families and/or young people during therapy sessions

  • Goals are written in the family’s or young person’s own words

  • Up to three goals are recorded per episode of care

  • Progress is rated using a 1–5 scale with anchored descriptors

GBOs are reviewed:

  • during therapy at agreed review points

  • at the end of a block of intervention or discharge

 

4.3 Patient-Reported Outcome Measures (PROMs)

PROMs are used to capture the child or family perspective on communication in everyday life.

A brief, generic PROM set is used across all clinical areas to ensure consistency and accessibility. PROM items are informed by key ICF domains and focus on:

  • Participation
    My child can join in with family, play, or school activities using their communication.

  • Activity
    My child can communicate in ways that work for them (talking, gesture, AAC, play).

  • Wellbeing
    My child feels comfortable communicating with familiar people.

  • Environment
    I feel confident supporting my child’s communication in everyday routines.

  • ​

PROMs use a 1–5 rating scale and are completed by:

  • parents/carers (parent proxy), particularly in early years

  • children and young people where developmentally appropriate

 

PROMs are collected:

  • at the start of intervention (baseline)

  • at review or end of a block of intervention

 

4.4 Patient-Reported Experience Measures (PREMs)

PREMs are used to capture experience of the service, rather than outcomes.

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The Experience of Service Questionnaire (ESQ) is used to gather feedback on:

  • communication and information provided

  • involvement in decision-making

  • accessibility and delivery of the service

  • clarity around next steps

 

PREMs are collected:

  • once per episode of care

  • typically at the end of a block of intervention or at discharge

 

4.5 Use of assessment tools

Standardised and informal assessment tools may be used to support clinical decision-making, establish baseline profiles, and, where appropriate, contribute to the review of progress.

 

Assessments are selected based on the child or young person’s needs, age, and presenting profile, and may include formal, informal, observational, and play-based approaches.

 

Assessment findings are interpreted alongside:

  • clinical observation

  • Therapy Outcome Measures (TOMs)

  • Goal-Based Outcomes (GBOs)

  • Patient-Reported Outcome Measures (PROMs)

 

Standardised assessments are not used in isolation to determine outcomes, progress, or discharge decisions. Reassessment using formal tools is undertaken where clinically appropriate and when it is likely to provide meaningful information for intervention planning or review.

 

5. Timing of Outcome Collection

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Start of intervention - TOMs (baseline), PROMs (baseline), GBOs

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Review / end of block - PROMs (repeat), GBO review, TOMs (where indicated)

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Discharge - TOMs, PREMs (ESQ)

 

6. Use of Outcome Data

Outcome data are used to:

  • inform clinical decision-making and goal adjustment

  • support shared decision-making with families

  • guide continuation, modification, or discharge planning

  • support supervision and reflective practice

  • inform audit and service development

Outcome measures are not interpreted in isolation and do not replace clinical judgement.

 

7. Accessibility and Equity

Outcome tools are selected and worded to ensure:

  • suitability across a wide age range

  • accessibility for parent-proxy reporting

  • inclusion of AAC and alternative communication

  • neuro-affirming language

  • minimal burden on families

 

Reasonable adjustments are made where required.

 

8. Review of Policy

This policy will be reviewed periodically to ensure it remains appropriate, proportionate, and aligned with current professional standards and best practice in paediatric speech and language therapy.

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Last review: 13th January 2026
Policy owner: Suzanne Turner, BMedSci (Hons), MRCSLT, Reg HCPC

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