Scientific Method is Everything
Why is evidence-based decision making so important for the speech-language pathologist? That’s the question that kept coming up for me throughout my PhD studies and university teaching posts. The research was continually turning up examples of how evidence-based decisions could make a difference, but I wasn’t seeing evidence of how it did make a difference.
Speech-language pathologists learn quickly that employment settings can often be quite constrained. For decades, school administrators have relied on standardized and norm reference testing and the result has been mandated school district policies for SLP school-based assessments. When a child has a speech or language concern, a professional speech-language pathologist will be asked to complete an assessment. Unfortunately, the people who develop special education policies and make the decisions regarding who's eligible for recommended services, aren’t typically experts in our field.
Our challenge as SLPs is that while we have knowledge and experience with speech and language disorders, we are often constrained by environments that are loaded with outdated, restrictive policies. It seems that every day I hear from a speech-language pathologist who’s been cut out of relevant discussions and decisions that have long-range implications for clients.
As effective SLPs we need to trust our experiences and inclinations based on clinical expertise and scientific evidence and that can sometimes lead us outside of norm reference testing that seldom takes cultural and linguistic diversity into account.
Misdiagnosing leads to huge ramifications for children, their families, and educational systems that are already overloaded. My focus at The Big Picture SLP is to include clinicians as relevant stakeholders from the beginning.
Research has brought me to understand the tremendous value of evidence-based practice that rests on three pillars: internal/external scientific evidence, clinical expertise, and patient and family values.
As lifelong learners, we lean on these pillars to help us think critically about our processes when providing client care. As scientists, we need to remember that when developing assessments and treatment plans, what works for one individual or group in a specific setting might not work for another.
Consider this: the demographic population of “norms” used to develop assessments were primarily based on a sample group of white children from the Midwest. Why would it make sense for children at risk for speech development in the Bronx to use the same assessment protocol? When we make the shift into evidence-based practice, it quickly becomes clear that clients living in different environments, including cultural, socio-economic, educational, environmental, and family all benefit from individualized assessments and treatments.
It wasn’t until I started digging into research methods that I realized we are all scientific practitioners. We are involved in the scientific process every time we meet a client, collect data, make and test a hypothesis, and collect more data as we learn what works.
Instead of following formulas, we’re training speech-language pathologists to ask relevant questions and learn what works for their current client base. We’re providing clinicians with vetted research and resources they can trust.
We’re training SLPs to make evidence-based decisions. We’re learning how to write our own goals instead of using goals written by others, for others.
Each client we meet has their own way of thinking and their own way of solving problems. The Big Picture is guiding SLPs in how to work through problems with the understanding that research and clinical experience go hand in hand.
Approaching this profession as a scientist continues to inspire me as we build and mentor an evolving community of learners. When we use science to help remove obstacles for our clients, we all succeed.
