EBP

Putting Evidence to Practice in Speech Sound Disorders

 Tonights Discussion
EBP: I remember something about that!
EBP is great...but I have no time.
Avoiding quackery, pseudoscience, & frivolous fads
Sifting through all of the medical lit to find gold
How can I apply this concept to my daily practice?
A quick & (relatively) painless quiz!
A quick refresher
PBE: EBP 2.0

ASHAs
Principles of
Ethics requires
SLPs to
monitor
treatment
effectiveness
 Before jumping to treat
SSDs consider the EBP

- Seven steps to effective EBP in an ideal world

- Barriers in the real world
- Networks & groups: making EBP manageable
- Following the evidence and Australias
example

Baker, E., & McLeod, S. (2011). Evidence-based practice for children with speech sound disorders:
Part 1 narrative review. Language, Speech, and Hearing Services in Schools, 42(2), 102-139.
 How to quit following the herd and
avoid the quacks
(or how to embrace your inner skeptic)

Lof, G. L. (2011). Science-based practice and the speech-language pathologist. International

journal of speech-language pathology, 13(3), 18996.
 If it quacks like a duck...
1.Quackery seldom looks crazy
2.Pseudoscientific jargon
3.Anecdotes & Testimonials
4.Claims that treatment works for
large range of unrelated problems
5. Despiration

Barrett, 1997
 How do we stay up to date with current
literature?

Straus, S. E., & Sackett, D. L. (1998). Using research findings in clinical practice. British Medical
Journal, 317, 339342.
 Guide to EBP
current, high-quality research evidence is integrated with
practitioner expertise and client preferences and values into the
clinical making decisions.

3 way
s
thoug to change
ht pro o
cess. ur
..

Guide to EBP: Linguisystem (2009)

 Clinical Integration
Whats working and what isnt:
-Thoughts based on your clinical experiences
thus far?
 Questions
1. According to Lof, one way we can avoid being quacked
is by being a skeptic. This means that we should:

a. Not believe anything unless seen with your own eyes and used in your own
practice.
b. Only try methods that other clinicians whom you trust have tried and
recommend.
c. Be willing to trust all claims--even very peculiar ones--and stringently
investigate all claims, even ones that sound legitimately scientific.
d. Avoid trusting and using newer methods; until a method has at least a
decade for clinicians to find problems and tweak it, its not trustworthy.
2. According to Baker and McLeod, how can
SLPs alleviate the time burden of EBP?

a. Form clubs or networks of clinicians to evaluate and discuss evidence

pertaining to specific clinical topics.
b. Only consider search results from the first page of results on electronic
search engines such as Google Scholar.
c. Decrease the amount of time spent evaluating evidence by reading just
the abstract and conclusion.
d. Phone an opinionated friend and ask what they think.
3. The first step in the EBP process is to develop a ___
____ ___ ___ question to help identify an answerable
clinical question.

a. PICO
b. CHIO
c. ICCO
d. IPCO
4. If there is no evidence for a particular method/type of
therapy, we should avoid using it. T/F?

a. False! We can use indirect evidence (ie look at studies with adults if
there is no info on kids) and transfer the evidence is applicable. If
there is limited research-PhD opportunity?
b. False! We should use every type of tx evidence we find, even if its
contradictory to ethical practice.
c. True! We should avoid tx if no one has researched it before.
d. True! We should refrain from researching any further and stop tx with
that client if we cant find evidence for a particular method of tx.
ASHA resources for EBP
guidelines and systematic reviews
http://www.asha.org/members/ebp/compendium/
systematic reviews grouped by year
http://www.asha.org/members/reviews.aspx
clinical practice guidelines grouped by year
http://www.asha.org/members/guidelines.aspx
 References:
Baker, E., & McLeod, S. (2011a). Evidence-based practice for children with speech sound disorders: Part 1 narrative
review. Language, Speech, and Hearing Services in Schools, 42(2), 102-139.

Baker, E., & McLeod, S. (2011b). Speech-language pathologists assessment and intervention practices for childhood
speech sound disorders [Powerpoint slides].

Guide to EBP: Linguisystem (2009)

Lof, G. L. (2011). Science-based practice and the speech-language pathologist. International journal of
speech-language pathology, 13(3), 18996. doi:10.3109/17549507.2011.528801

NSW Speech Pathology EBP Network (n.d.). Retrieved from: http://nswspeechpathologyebp.com

SpeechBITE (n.d.). Retrieved from: http://speechbite.com/ebp/links/

Straus, S. E., & Sackett, D. L. (1998). Using research findings in clinical practice. British Medical Journal, 317,
339342.