Q: I am a SLP graduate student looking for some evidence-based practice to implement for a client diagnosed with childhood apraxia of speech. I watched the YouTube videos of your hand cues for placement, and I think they would work great. I was wondering if you had any research to support these cues, or if you obtained research elsewhere to support them.

A therapist doesn’t look for an evidence-based practice: A therapist creates one.

The EBP is formed when a therapist integrates information from three areas: (1) Laboratory research, (2) The therapist’s own clinical experiences, and (3) The needs of the client sitting across the table (see references below).

Do not get mislead by the incorrect idea that therapists only use methods that have been researched. Nothing could be further from the truth. Please see the references below, and search under “evidence based practice” on this Blog for more information on the real meaning of creating an EBP.

I have been a full-time clinician for 36 years, and I do not do the type of research on my methods that you are seeking. My cues were developed from working with hundreds of clients, an experience which often gives one far more information than that obtained from reading research.

Hard evidence about “cues” in general can be obtained by searching the ASHA journals online under the following key words: cue, cuing, gesture, tactile, and Blissymbolics. This is exactly what I am doing for my next book, which will have a chapter on the use of cues in articulation therapy. Also check the basic text you used in your articulation/phonology class. It should have a section on using cues in articulation and language therapy, and there should be references there.

References on the EBP

• American Speech-Language-Hearing Association. (2010) Evidence-Based Practice. www.asha.org.
• Dollaghan, C. A. (2007) The Handbook for Evidence-Based Practice in Communication Disorders. Baltimore: Paul H. Brooks.
• Friedland, D. J. et al (1998) Evidence-Based Medicine: A Framework for Clinical Practice. New York: McGraw-Hill.
• Justice, L. (2008) Evidence-based terminology. American Journal of Speech-Language Pathology, Vol 17, No 4, November. Pp x-x.
• Sackett, D.L., Rosenberg, W.M.C., Gray, J.A.M., & Richardson, W.S. (1996) Evidence-based medicine: What it is and what it isn’t. British Medical Journal, 312, 71-72.
• Sackett, D. L., & Richardson, W.S., & Rosenberg, W., & Haynes, R.B. (1997) Evidence-Based Medicine: How to Practice and Teach EBM. Edinburgh: Churchill Livingstone.
• Schooling, T. (2010) Systematic Review of Oral-Motor Exercise. The ASHA Leader, May 18, 2010, p. 12.