Purpose In 2004, American Speech-Language-Hearing Association established its position statement on evidence-based practice (EBP). Since 2008, the Council on Academic Accreditation has required accredited graduate education programs in speech-language pathology to incorporate research methodology and EBP principles into their curricula and clinical practicums. Over the past 15 years, access to EBP resources and employer-led EBP training opportunities have increased. The purpose of this study is to provide an update of how increased exposure to EBP principles affects reported use of EBP and perceived barriers to providing EBP in clinical decision making. Method Three hundred seventeen speech-language pathologists completed an online questionnaire querying their perceptions about EBP, use of EBP in clinical practice, and perceived barriers to incorporating EBP. Participants' responses were analyzed using descriptive and inferential statistics. We used multiple linear regression to examine whether years of practice, degree, EBP exposure during graduate program and clinical fellowship (CF), EBP career training, and average barrier score predicted EBP use. Results Exposure to EBP in graduate school and during the CF, perception of barriers, and EBP career training significantly predicted the use of EBP in clinical practice. Speech-language pathologists identified the three major components of EBP: client preferences, external evidence, and clinical experience as the most frequently turned to sources of EBP. Inadequate time for research and workload/caseload size remain the most significant barriers to EBP implementation. Respondents who indicated time was a barrier were more likely to cite other barriers to implementing EBP. An increase in EBP career training was associated with a decrease in the perception of time as a barrier. Conclusions These findings suggest that explicit training in graduate school and during the CF lays a foundation for EBP principles that is shaped through continued learning opportunities. We documented positive attitudes toward EBP and consistent application of the three components of EBP in clinical practice. Nevertheless, long-standing barriers remain. We suggest that accessible, time-saving resources, a consistent process for posing and answering clinical questions, and on the job support and guidance from employers/organizations are essential to implementing clinical practices that are evidence based. The implications of our findings and suggestions for future research to bridge the research-to-practice gap are discussed.
Service delivery variables that may have an impact on the treatment outcomes of children with speech sound disorders include the number and duration of intervention sessions, distribution of the sessions over time, and the format (group intervention or individual intervention). In this article, we briefly review these variables and the recommendations for the most effective service delivery components for children with speech sound disorders. We then describe innovative, collaborative service delivery models for preschoolers and school-age children with speech sound disorder. The models include “Quick Articulation!” conducted in a local elementary school by clinical MS-SLP students from Purdue University, as well as Summer Speech and Literacy Laboratory, which takes place in the department of Speech, Language, and Hearing Sciences at Purdue and involves participation from clinical and research faculty, and graduate and undergraduate students. The article provides useful information to help guide clinicians and clinical supervisors in implementing components of these models into their practice with children with speech sound disorder.
Children with speech sound disorders (SSDs) represent a large proportion of clients served by school-based speech-language pathologists (SLPs). While considerable evidence is available regarding the identification of SSD in school-age children, there is a paucity of information regarding service delivery aspects of school-based speech therapy, such as frequency of sessions, number of trials, distribution of sessions over time, and format (individual or group intervention) that impacts the ability of SLPs to effectively treat SSD in the schools. School-age children with SSD are at risk for later literacy deficits, and strategically addressing their language and emerging literacy needs in addition to speech production accuracy may lead to increased intelligibility and better educational outcomes. In this article, we discuss the heterogeneity of school-age children with SSD with regard to weaknesses in phonological processing skills and language skills. We summarize the information currently available regarding the aspects of service delivery that contribute to gains in speech production accuracy. We conclude by sharing an example of how school-based SLPs could target speech production, phonological awareness, and morphological awareness in the same session with a child with SSD to maximize gains in speech and literacy skills.
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