Paradigms, methods and the epistemology of speech pathology: some comments on Eastwood (1988).

Eastwood argues that speech pathology lacks core paradigms (British Journal of Disorders of Communication (1988) vol. 23, pp. 171-184). She suggests that a main reason for this failure is a reliance on conventional (experimental) scientific method, and that the use of qualitative methods may provide a more fruitful approach. The present paper contends that, whilst increased attention might usefully be paid to qualitative methods, the issue of method is secondary in the development of paradigms. Further, an analysis of the knowledge base of speech pathology shows that the discipline is an epistemological hybrid which, sui generis, resists conceptual unification and the development of a high paradigmatic consensus. Hence, the prospect of attaining core or over-arching paradigms for speech pathology is small. The present need is to develop a range of interesting and fruitful ideas and hypotheses for the several different facets of speech pathology, rather than to be too concerned about the development of over-arching paradigms and issues of method.

Health science, natural science, and clinical knowledge.

The epistemological status of health science, natural science, and clinical knowledge is explored. It is shown that 'health science', a term increasingly used in association with the clinical knowledge of the therapies, nursing, and other health occupations, is not fully a science in the sense of the natural sciences. It is rather a hybrid which relates applications of natural science, behavioral science, and the humanities to problems in health. The same may be said of clinical knowledge which entails, as essentials, humanistic considerations involving the personal concerns of the patient, in addition to the more evident external aspects of diagnosis and treatment. The recent introduction of the term 'health science' reflects scientism in its approach to health issues. It also reflects confusion about the nature of clinical knowledge.

Pure tone audiograms from hearing-impaired children. I. A statistical approach to summarizing audiogram information.

Principal component analyses of the better-ear pure-tone audiograms from 201 hearing-impaired children are reported. The analyses show that two components, one measuring degree of hearing loss, the other the slope of the audiogram, account for 86% of the total variability. Two indices are proposed which correspond to the two components, but which have numerically simple coefficients and which, unlike the raw components, are perfectly "clean" measures of the two variables. Since these indices, 11 and 12, still account for 84% of the total audiogram variability, it is suggested that they may provide a quantitative basis for summarizing pure tone audiograms for general use.

Stapedial reflex in neonates.

This paper considers the effect of behavioral responses on stapedial reflex data of neonates. Twenty clinically normal neonates were tested to determine whether repeated acoustic stimulation would habituate the behavioral response, leaving only the stapedial reflex for observation. The results failed to show systematic decline of behavioral response over trials. Stapedial reflex testing indicates a positive response for less than 5% of stimulus presentation. The results are discussed in terms of possible explanation for the apparently low incidence of stapedial reflex in a normal neonatal population.