The Value of Asking “Why?”
Aha moments—sudden insights, clarity, and realizations—often hit when you least expect them. My SLP aha moment came when I was an assistant professor at (SUNY) Fredonia University, teaching undergrads how to carry out assessments and interventions.
We were discussing how to figure out clients’ language skills, as well as strengths and communication needs. As we were talking about treatment goals, a student asked, “Why aren’t there any references on your presentation slides?”
That was my pivotal moment. I realized I’d been writing goals a certain way simply because my supervisor and a governing body had instructed me to write goals that way. I had never questioned the process. Now I realized, with great clarity, the implications of not having scientific evidence to back up those goals.
My student had opened my eyes to a problem and I didn’t know what to do about it. But I knew that I had to take action.
I shared my story with colleagues, Dr. Anny Castilla-Earls, Ph.D., a professor at the University of Houston in the Communication Sciences and Disorders Department who was studying bilingual child language assessment, and Dr. Jeff Higginbotham, a professor in the Department of Communicative Disorders and Sciences at the University of Buffalo. We got so charged with the idea of using scientific evidence to back up goals that we developed a new series of studies and called it the EBP-Decisions (Evidence-based Practice Decisions) Project. We interviewed 40 speech-language pathologists across the United States and did qualitative analysis with a series of questions, primarily focusing on three areas:
What tools will you use to assess a child with a potential language disorder?
Why did you pick these tools?
How did you decide if that child has a language disorder?
Using a structured open interview approach, we gathered valuable data from school-based speech-language pathologists regarding their assessment practices for children with suspected language disorders. Together, we produced my first peer reviewed article, published by the National Institutes of Health: School-Based Speech-Language Pathologists’Perspectives on Diagnostic Decision Making.
Researching and writing that paper changed everything for me. I began to question all I was doing as a clinician. Why do I start with an interview when I'm doing an assessment, or getting a case history? Why do I ask certain specific questions? The more I examined my research results, the greater was my conclusion that evidence-based practice decisions are crucial to determining effective assessment plans.
That first paper felt monumental to me. It was the aha moment that propelled me into a career focused on understanding how speech-language pathologists really get their work done.
When your first article gets published in a respected journal in your field, it’s a very big deal.
For me, it was a critical reminder that we need to give speech-language pathologists a voice and we need to share that voice.
We need to learn from SLPs’ experiences, and gain wisdom from the whys and hows of their decision-making and observations. If we’re passionate about always giving our best quality assessments and treatments to our clients, we need to keep asking the questions.
