Science-based practice and the speech-language pathologist.

Evidence-based practice (EBP) is a well established concept in the field of speech-language pathology. However, evidence from research may not be the primary information that practitioners use to guide their treatment selection from the many potential options. There are various alternative therapy procedures that are strongly promoted, so clinicians must become skilled at identifying pseudoscience from science in order to determine if a treatment is legitimate or actually quackery. In order to advance the use of EBP, clinicians can gather practice-based evidence (PBE) by using the scientific method. By adhering to the principles of science, speech-language pathologists can incorporate science-based practice (SBP) into all aspects of their clinical work.

A survey of university professors teaching speech sound disorders: nonspeech oral motor exercises and other topics.

PURPOSE: The purpose of this article was to obtain and organize information from instructors who teach course work on the subject of children's speech sound disorders (SSD) regarding their use of teaching resources, involvement in students' clinical practica, and intervention approaches presented to students. Instructors also reported if they taught students to use nonspeech oral motor exercises (NSOMEs) to remediate children's SSD. METHOD: A questionnaire was mailed to 236 speech-language pathology preprofessional programs in the United States that are accredited by the Council of Academic Accreditation. RESULTS: Ninety-one questionnaires (39%) were returned. Participants reported that they provided their students with information on a variety of intervention approaches for SSD and typically used professional journals and textbooks for current information. Sixty-eight (75%) paticipants reported that they did not teach their students to use NSOMEs. Forty-seven (52%) of the instructors supervised students in clinical practicum serving children with SSD and perceived that academic course work and practicum experiences influenced their students' implementation of intervention for children with SSD. CONCLUSION: The instructors reported that they taught their students a variety of intervention techniques for children with SSD, although most did not teach the use of NSOMEs. These results contrast with previous research indicating that many speech-language pathologists use NSOMEs to improve children's speech (G.L. Lof & M.M. Watson, 2008).

Evidence-based systematic review: effects of nonspeech oral motor exercises on speech.

PURPOSE: The purpose of this systematic review was to examine the current evidence for the use of oral motor exercises (OMEs) on speech (i.e., speech physiology, speech production, and functional speech outcomes) as a means of supporting further research and clinicians' use of evidence-based practice. METHOD: The peer-reviewed literature from 1960 to 2007 was searched for articles examining the use of OMEs to affect speech physiology, production, or functional outcomes (i.e., intelligibility). Articles that met selection criteria were appraised by 2 reviewers and vetted by a 3rd for methodological quality, then characterized as efficacy or exploratory studies. RESULTS: Fifteen studies met inclusion criteria; of these, 8 included data relevant to the effects of OMEs on speech physiology, 8 on speech production, and 8 on functional speech outcomes. Considerable variation was noted in the participants, interventions, and treatment schedules. The critical appraisals identified significant weaknesses in almost all studies. CONCLUSIONS: Insufficient evidence to support or refute the use of OMEs to produce effects on speech was found in the research literature. Discussion is largely confined to a consideration of the need for more well-designed studies using well-described participant groups and alternative bases for evidence-based practice.

Epilogue: what we know about nonspeech oral motor exercises.

A great deal of information is available to help clinicians understand the principles of motor speech learning and control, and how to apply those principles to clinical practice. In addition, the results of many investigations have documented the differences between the motor movements for speech and nonspeech tasks. Finally, supporting evidence for using nonspeech tasks to improve speech is virtually nonexistent. All of that information, taken in concert, casts doubt on the use of nonspeech techniques for improving children's speaking skills. However, clinicians have available a variety of viable intervention techniques to help children improve speech productions. This article presents a summary of reasons not to use nonspeech remediation techniques along with suggestions clinicians should consider when choosing intervention procedures for children with speech sound errors.

A nationwide survey of nonspeech oral motor exercise use: implications for evidence-based practice.

PURPOSE: A nationwide survey was conducted to determine if speech-language pathologists (SLPs) use nonspeech oral motor exercises (NSOMEs) to address children's speech sound problems. For those SLPs who used NSOMEs, the survey also identified (a) the types of NSOMEs used by the SLPs, (b) the SLPs' underlying beliefs about why they use NSOMEs, (c) clinicians' training for these exercises, (d) the application of NSOMEs across various clinical populations, and (e) specific tasks/procedures/tools that are used for intervention. METHOD: A total of 2,000 surveys were mailed to a randomly selected subgroup of SLPs, obtained from the American Speech-Language-Hearing Association (ASHA) membership roster, who self-identified that they worked in various settings with children who have speech sound problems. The questions required answers that used both a forced choice and Likert-type scales. RESULTS: The response rate was 27.5% (537 out of 2,000). Of these respondents, 85% reported using NSOMEs to deal with children's speech sound production problems. Those SLPs reported that the research literature supports the use of NSOMEs, and that they learned to use these techniques from continuing education events. They also stated that NSOMEs can help improve the speech of children from disparate etiologies, and "warming up" and strengthening the articulators are important components of speech sound therapy. CONCLUSION: There are theoretical and research data that challenge both the use of NSOMEs and the efficacy of such exercises in resolving speech sound problems. SLPs need to follow the concepts of evidence-based practice in order to determine if these exercises are actually effective in bringing about changes in speech productions.

Speech-language pathologists' assessment practices for children with suspected speech sound disorders: results of a national survey.

PURPOSE: This study examined assessment procedures used by speech-language pathologists (SLPs) when assessing children suspected of having speech sound disorders (SSD). This national survey also determined the information participants obtained from clients' speech samples, evaluation of non-native English speakers, and time spent on assessment. METHOD: One thousand surveys were mailed to a randomly selected group of SLPs, self-identified as having worked with children with SSD. A total of 333 (33%) surveys were returned. RESULTS: The assessment tasks most frequently used included administering a commercial test, estimating intelligibility, assessing stimulability, and conducting a hearing screening. The amount of time dedicated to assessment activities (e.g., administering formal tests, contacting parents) varied across participants and was significantly related to years of experience but not caseload size. Most participants reported using informal assessment procedures, or English-only standardized tests, when evaluating non-native English speakers. CONCLUSIONS: Most participants provided assessments that met federal guidelines to qualify children for special education services; however, additional assessment may be needed to create comprehensive treatment plans for their clients. These results provide a unique perspective on the assessment of children suspected of having SSD and should be helpful to SLPs as they examine their own assessment practices.