ecent systematic review by ). These authors concluded that the inclusion of peers was one of the most promising strategies for intervention and resulted in positive impacts on social communication. An important aspect of peer-mediated interventions concerns the peers chosen to interact with focal children. These peers can provide appropriate language models and also an opportunity for children with SCI to practice newly acquired skills. In general, it has been reported that teachers children who are popular, prosocial, and self-confident as peer partners for interventions . Locke et al.’s longitudinal study  did not report any adverse outcomes for typically developing children as a result of participating in a peer-mediated intervention. An important feasibility question will concern recruitment of these children and willingness of parents to allow participation. Schools will send participant information sheets to parents of the peer partner children, one written for parents and one written in simpler terms for the child to share with their parent (as above for children with social communication impairment), as well as a consent form for parents to sign.
Parents of the children with SCI who will complete post-test measures for health economics.
Parents will be asked to consent to completion of these forms at the same time as they will be asked to provide consent on behalf of their children (b) above.
Whilst research assistants will pass on information sheets to participants via schools and request the return of consent forms, all participants will be given the option to contact the Chief Investigator in the event of additional questions. All participants will be free to withdraw at any time from the protocol treatment without giving reasons and without affecting their usual standard of care. The Chief Investigator will preserve the confidentiality of participants taking part in the study and is registered under the Data Protection Act.
Randomisation and allocation process
Participating children with SCI will be cluster-randomised at the level of the SLTs. SLTs will be randomised 1:1 to receive either immediate briefing from the research team together with the manual on the E-PLAYS intervention or at to receive this at the end of the trial. Randomisation will take place after SLTs have consented to participate in the study, and have identified and recruited children on their caseloads to participate in the trial but before they receive briefing. Allocation will be via minimisation to ensure balance across the two groups based on the borough of the SLT (there are five boroughs within the district covered by NELFT, each served by a different SLT team) and number of children recruited (dichotomised around the median number of children recruited to form a two level factor). All SLTs will be randomised together as opposed to having a rolling recruitment/randomisation period. The minimisation will be implemented by the trial statistician at the York Trials Unit using MinimPy version 0.3. Once the allocations have been generated, they will be communicated to members of the research team responsible for training the SLTs, while ensuring that the outcome assessors (research assistants) remain blind to these allocations.
Parent- and teacher-completed measures cannot be blinded; however, measures collected by research assistants (RAs) will be blinded. Teachers and teaching assistants at the schools will be reminded not to reveal allocations to the research assistants at every visit. For the qualitative data collection (Fun Tool Kit, open-ended training questionnaires, observations and focus groups) in which blinding is not possible, research assistants will not collect data from the same schools in which they are collecting quantitative data in order to preserve blinding.
The SLTs in the intervention group will receive training from the research team and will then, in turn, train teaching assistants in schools to deliver the E-PLAYS intervention to the children. Training for SLTs will be kept to the minimum as the aim of this feasib