Evidence-Based Practice for Children With Speech Sound Disorders: Part 2 Application to Clinical Practice
Conclusion: SLPs need to use their clinical expertise to integrate research findings with the constraints and complexities of everyday clinical practice and client factors, values, and preferences in their management of SSDs in children.
The World Wide Web (WWW) was 20 years old last year. Enormous amounts of information about stuttering are now available to anyone who can access the Internet. Compared to 20 years ago, people who stutter and their families can now make more informed choices about speech-language interventions, from a distance. Blogs and chat rooms provide opportunities for people who stutter to share their experiences from a distance and to support one another. New technologies are also being adopted into speech-language pathology practice and service delivery. Telehealth is an exciting development as it means that treatment can now be made available to many rural and remotely located people who previously did not have access to it. Possible future technological developments for speech-language pathology practice include Internet based treatments and the use of Virtual Reality. Having speech and CBT treatments for stuttering available on the Internet would greatly increase their accessibility. Second Life also has exciting possibilities for people who stutter.
Conclusion: Treatment fidelity is a neglected construct in the EBP literature; however, fidelity is a crucial construct for documenting intervention effectiveness and engaging in EBP.
Qualitative study of the therapeutic relationship in speech and language therapy: perspectives of adults with acquired communication and swallowing disorders
Background: Considerations of the negotiated therapeutic relationship in speech and language therapy are somewhat scarce, with specific therapeutic factors generally framed from psycholinguistic, behavioural, or neurological perspectives.
Aims: To explore the therapeutic relationship in speech and language therapy, focusing on the personal meanings and experiences of adult clients with acquired communication and swallowing disorders.
Methods & Procedures: The study was qualitative, using methods from Grounded theory to analyse eleven interviews with adults who had acquired disorders of communication or swallowing, as they described their perceptions of speech and language therapy and therapists. Five males and six females with a mean age of 62 years, ranging from 25 to 87 years, with varied communication disorders, were interviewed.
Outcomes & Results: A preliminary theoretical framework explains how speech and language therapists supported alienated, demoralized or confused clients with therapeutic qualities, such as Being Understanding, Being Gracious, Being Erudite and Being Inspiring; and with therapeutic actions, such as Being Confident, Being Soothing, Being Practical and Being Empowering. These categories provided a basis for the researcher to construct a substantive theory of restorative poise which characterized the attitudinal and behavioural characteristics of an ideal speech and language therapist from the perspective of the client.
Conclusions & Implications: Participants were aware of the components of a therapeutic relationship and valued these as essential to their own personal understanding of positive outcomes in speech and language therapy. Therefore, specific types of attitudes and actions that constitute the speech and language therapist’s contributions to the therapeutic relationship seemed to provide catalytic conditions for successful working together in therapy; and consequently, may have a bearing on effective practice and treatment efficacy.
The World Health Organization’s international classification of functioning, disability and health: implications for clinical and research practice in the field of augmentative and alternative communication
In 2001, the World Health Organization (WHO) ratified and published a new classification system, the International Classification of Functioning, Disability and Health (ICF). There has been a varying amount of discussion and debate across the health and disability fields about what the ICF means and what it has to offer. However, there has been little discussion of its use and value in the field of augmentative and alternative communication (AAC). This article describes the earlier International Classification of Impairments, Disabilities, and Handicaps (ICIDH), upon which the current ICF was based; and outlines the ICF and the preliminary, derived Child and Youth version of the ICF (ICF-CY). The article also proposes what the ICF has to offer the AAC field, from both a clinical and research perspective; and concludes with a discussion of the advantages and challenges of using the ICF.