Category: Evidence-Based Practice

Uncertainty About Evidence

By Pam Marshalla

Q: I still am uncertain about evidence in therapy. According to you, laboratory research is not the only place from which evidence comes. How can this be? I am confused. This is not what I was taught. The originators of the term “evidence-based practice” wrote their whole book to say that health practitioners need evidence to support what they do; however, evidence could not come exclusively from laboratory research. They wrote: “External clinical evidence [i.e., laboratory research] can inform, but…

Oral-Motor and Evidence-Based-Practice Misinformation

By Pam Marshalla

Q: I am now so thoroughly frustrated with the field of speech pathology, I’m tempted to throw in the towel… Or should I say throw in the bite blocks? I think the whole question of oral-motor therapy has gotten totally out of hand, and I no longer know what to believe. In this age, from every corner, we are encouraged to follow the evidence-based practice. In the absence of any hard evidence, I don’t know whether I ought to try…

The OM Controversy (again…)

By Pam Marshalla

Q: I am a special education advocate and I would like to discuss oral motor exercises with someone. An SLP at a district I’m working with stated, “There is no evidence that oral motor exercises are helpful for speech.” Is that true? This area is a mess. Professionals who bash oral-motor generally can be accused of the following: They don’t know what the term “evidence-based practice” really means. They are confusing the concepts of “evidence-based practice” with the concept of…

Sharing Ideas and Evidence-Based Practice (EBP)

By Pam Marshalla

Q: I received the email you sent regarding collecting suggestions for carryover that you intend to compile in a book. It is surprising to me that you find it reasonable to pass on non-evidence based ideas submitted by therapists. I don’t think this meets a best practice standards at all. Will you measure the merit of these ideas? I’m curious to know how you propose to demonstrate efficacy. What you seem to propose is to collect and disseminate ideas that…

What is Evidence-Based Practice (EBP)?

By Pam Marshalla

The term Evidence-Based Practice (EBP) has been giving practicing SLP’s a lot of trouble recently. This is because some professionals have mistakenly assumed that an evidence-based practice requires that practicing therapists restrict their methods to only those that have been researched in a laboratory. This is a false interpretation of the EBP. The EBP actually integrates information from three sources: LAB, CLINIC, and CLIENT. Let’s review four references that explain this: 1. According to Carol Dollaghan (The handbook for evidence-based…

“Believing” in “Oral Motor” – Lighten up!

By Pam Marshalla

Q: My supervisor will not let me use oral-motor techniques. She says there is no research to support them. What are your thoughts? First I say, “Ho-hum!” Aren’t we tired of this argument yet? Isn’t it time to get past this ridiculous war of words? Let’s lighten up! To by-pass “the oral-motor war,” I have been using the term “mouth movement” lately, as in: If you don’t believe in “oral-motor techniques,” fine. That’s okay. It’s not a religion any way….

Evidence-Based Practice and Controversy Over My Work

By Pam Marshalla

Q: The lead SLP at my agency will not allow me to attend Pam Marshalla’s workshop on R therapy. She feels that Pam’s book suggests an oral motor approach that is not evidence-based. I think there is some confusion in our profession about the difference between placement techniques and oral motor exercises as a isolated activity. I work for a progressive educational agency that seems to be running scared of any controversial terms. Honestly, the amount of misunderstanding about oral…

Evidence Based Practice – Chopping Down Trees To Save The Forest

By Pam Marshalla

Q: I have heard you say that you have a real problem with Evidence-Based Practice (EBP). Why would you be opposed to something that so clearly will help and protect our clients? I am not against using EBP. I am for EBP. However, I am concerned about several recent results of the EBP philosophy. I am especially opposed to three new ideas: I am against throwing out everything we have learned through a century of trial-and-error speech-language therapy just because we…