SPEECH DIFFICULTIES

Speech Difficulties

Speech Difficulties

Theoretical BackgroundRationale for the Topic

Evidence-based practice (EBP) has been espoused as a framework for guiding speech-language pathologists' (SLPs') management of speech sound disorders (SSDs) in children and is a term that has become part of most SLPs' workplace vernacular. EBP described as the integration of current best research evidence with clinical expertise and client values and preferences. It is a topic on which books have been written, workshops and seminars have been presented (Justice, 2010), particular issues in journals published, latest journals have been produced (EBP Briefs, Evidence-Based Communication Assessment and Intervention), curricula created.

Evidence is scarce regarding the clinical implementation of EBP for children with SSDs. According to O'Conner and Pettigrew(2009), the single most significant barrier reported preventing the implementation of EBP is the lack of time. SLPs regularly report there being insufficient time to search, read, and critique published research evidence (Baker, & Watts Pappas, 2010). Ironically, SLPs need time to develop and refine the searching skills required to efficiently search and find robust and relevant evidence. In a study examining the actual time to define a clinical question, search for evidence, read the evidence, and answer the question, Brackenbury et al. (2008) reported that it took from 3 to 7 hours.

In a study of SLPs' barriers to EBP, O'Conner and Pettigrew (2009) reported that half of their participants did not feel that research results were generalise to their personal settings. Dodd et al. (2008) echoed these sentiments, suggesting that intervention procedures in efficacy research need to be feasible for SLPs in regular clinical practice, or the results from such research run the risk of not applied. The inherent differences between intervention procedures in controlled research settings and the procedures achievable in clinical practice pose a threat to EBP becoming an everyday part of SLPs' clinical decision making. Although EBP may seem to be the panacea for guiding best practice management of SSDs in children, the conduct of EBP needs to be doable. How can EBP be made to work in clinical practice? Dollaghan (2007) proposed a modified framework of EBP, known as E3BP, in an attempt to refocus and better balance empirically controlled research evidence with individual client factors and the reality of what is achievable in clinical practice.

Consequently, the purpose of this paper is to provide both a tutorial and a clinical example of how SLPs can conduct EBP when working with children with SSDs. The current paper draws on and extends the comprehensive narrative review reported in the companion paper (Baker & McLeod, 2011), which summarises 134 phonological intervention studies for children with SSD.

Phenome awareness intervention

For beginning readers

Sing the ABC

Name recognition and letter sounds. You can also play the recognition by touch (put the letters in a bag or box and the child may reach in and take a recognized only by touch), especially when working with a new ABC as the printing lowercase.

Select a letter or syllable of drawings and follow some of which begin (or end) with that letter or syllable. The child must paint - make those drawings that follow the ...