A methodological framework toward developing clinical practice guidelines for cross-linguistic and cross-cultural (CLACC) early communication intervention

Speech-language pathologists are required to deliver services across multiple languages and cultures. This is particularly true for multicultural South Africa. Although the country does have speech-language pathology guidelines to support its culturally and linguistically diverse context, a framework for developing new guidelines (or updating them) has yet to be published. To fill said gap, this paper presents an eight-phase process as a methodological framework for developing clinical practice guidelines, following the core principles of the National Institute for Health and Care Excellence (NICE) guideline development framework, drawing on the authors’ experience developing a new guideline document, and using the Appraisal of Guidelines for Research and Evaluation II (AGREE II). A sequential mixed-methods design was employed, drawing on methodologies from four published papers: a scoping review, two hermeneutical studies, and a stakeholder review. The phases are to identify the topic, need, purpose and target audience and population of the guidelines; select the development group; collect and review evidence; grade the evidence; formulate the guidelines; conduct external appraisal; disseminate, peer-review and implement the guidelines; and update them. The framework provides a roadmap for developing culturally responsive guidelines. Evidence suggests that the framework can be effectively applied to develop high-quality guidelines. Moreover, it can serve as a training tool for undergraduate and postgraduate studies.