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Caroline Bowen, A.M., Ph.D.
Macquarie University, Sydney, Australia

EVIDENCE-BASED SPEECH-LANGUAGE PRACTICES

Good practice is based on scientific evidence. It is an agreement between (1), the needs of the child and family, (2), the expertise of the speech-language pathologist (SLP), and (3) the published, peer reviewed research evidence.

Conscientious parents everywhere pursue a gamut of approaches, procedures, and activities that are not evidence based. They are tempted for many reasons: The practice is ‘the fashion’, or ‘natural’ or ‘holistic’. It is new or tried-and-true. Someone they trust recommends it. Most of all, they are tempted because they will try almost anything to help their child. Sometimes even credentialed mainstream professionals become involved in delivering suspect treatments, honestly believing they are legitimate and necessary to children’s progress.

Here are some tips to help you avoid practices that lack evidence of effectiveness.

WHAT DOES ‘LACKING IN EVIDENCE’ MEAN?

Saying that an approach is lacking in evidence can mean:

  1. sufficient published scientific research has been done to show that the approach has no merit and should not be pursued or recommended. The approach is disproven.
  2. little or no scientific research has been done on the approach or the theory it is based on. Therefore, there is no way of knowing if it does work, or how it is supposed work. The approach is not proven or unproven.
  3. scientific studies have been done, but the results are so far either weak or mixed, so no firm conclusions can be drawn. The approach is unproven.

Your SLP should not use a practice that is disproven (#1 above). But what if the only options are unproven (#2 or #3 above)? That is where the SLP’s knowledge and experience kick in. They will use clinical judgement and reasoning to design an individualized treatment, and then carefully and objectively monitor how well (or not) your child responds.

Information literate consumers can choose wisely.
Hone your information literacy skills!

Helen Rippon: Image Copyright © 2017 J&R Press. Used with permission.

‘DIGGING DEEP’ AS A PARENT: A SAFETY CHECK

  1. If something—a treatment for example—seems too good to be true, it probably is.
  2. Be wary if a site’s link to research leads only to personal stories, unpublished in-house reports, blogs or magazine articles, ‘coming soon’, or a blank page. You want to see peer-reviewed scientific publications in scholarly journals.
  3. Be wary of hard-hitting marketing techniques, including free introductory offers, celebrity endorsement, and claims that their approach is like no other.
  4. Be wary of cure-all, quick fix, and magic bullet claims. Suspect deception if a treatment is purported to address many different conditions (ADHD, autism, CAS, DLD, dyslexia…).
  5. Be wary of slick websites, glossy brochures, flashing brain diagrams, and fancy infographics.
  6. Know that many approaches work a little bit, or for a little while.
  7. Use social media carefully.
  8. Use Google Scholar to access information from the peer-reviewed literature.

BE MINDFUL OF OPPORTUNITY COST

Sometimes you might think, ‘well, it won’t hurt so we might as well try it.’ That’s when it is important to consider opportunity cost. Opportunity cost is the time, effort, energy, emotion, hope, and money that might have been better invested elsewhere. As a busy parent, your resources are limited. Your child’s willingness to participate in a treatment is also limited. It must not be taken for granted or wasted.

A parent’s desire to do their best for their child can be infinite. They choose non-evidenced approaches because they believe in them, or because they think they hold more hope. They become caught up in pseudoscience with the best of motives, and mustn’t be made to feel embarrassed, foolish, guilty, or naïve for doing so. The slick marketing of many illegitimate treatments makes them appear authentic and the sell can be difficult to resist. We hope that the information shared here will help you to choose good treatments for your child.

REFERENCES

Bowen, C. & Snow, P. (2017). Making Sense of Interventions for Children with Developmental Disorders. J&R Press, pages 290-302.

Bowen, C. & Snow, P. (2023 in progress). The Developmental Disorders Roadmap. J&R Press.

Clark, H. M. (2003). Neuromuscular treatments for speech and swallowing: A tutorial. American Journal of Speech Language Pathology, 12(4), 400-415. https://doi.org/10.1044/1058-0360(2003/086)

READINGS

Ernst, E. (2015). A Scientist in Wonderland: A Memoir of Searching for Truth and Finding Trouble. Imprint Academic.

Foxx, R. M. & Mulick, J. A. (2016). Controversial Therapies for Autism and Intellectual Disabilities: Fad, Fashion, and Science in Professional Practice, 2nd edition. Routledge.

Gambrill, E. (2012). Propaganda and the Helping Professions. Oxford University Press, Inc.

Singer, M. T. & Lalich, J. (1996). ‘Crazy’ Therapies. Jossey-Bass Publishers.