This advice-column-style blog for SLPs was authored by Pam Marshalla from 2006 to 2015, the archives of which can be explored here. Use the extensive keywords list found in the right-hand column (on mobile: at the bottom of the page) to browse specific topics, or use the search feature to locate specific words or phrases throughout the entire blog.
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 your methods or not. If I try your methods, will I be considered a hero or a heretic by a jury of my SLP peers?
The main problem you are having is that you are falling into the trap that many others have. You believe that the term “Evidence-Based Practice” means that we can only do in therapy those things that have been proven. THIS IS NOT WHAT THE TERM MEANS! Please read my other blog posts about this topic so you can begin to understand what the term EBP really means.
Sacket et al (1997), the authors of the term EBP, the creators so to speak, wrote this about the EBP in their textbook:
“External clinical evidence [i.e., research] can inform, but can never replace, individual clinical expertise” (Sackett et al, 1997, p. 4).
Raymond Kent, professor extraordinaire, motor speech idol, wrote the following when asked about this EBP / OM dilemma:
“Lack of data does not mean that we should do nothing. Using the limited data that are available, along with an analysis of the motor tasks, we can assemble thoughtful paradigms for clinical application” (Kent, 2008).
By the way, why do you worry about what other people say about you? 🙂
References
- Sackett, D., & Richardson, W.S., & Rosenberg, W., & Haynes, R.B. (1997) Evidence-Based Medicine: How to Practice and Teach EBM
(p.4)
- Kent, R. (2008) Personal email correspondence. [Kent received ASHA’s Honors of the Association in 1994.]
Wow! I’ve come such a long way in my thinking since I wrote that question a while back. With the help of the OMI and Pam (Marshalla) and Diane (Bahr), I have such a better understanding of what EBP truly means, and the flaws in the whole “debate.” I still think the subject is hugely important, probably more so than most SLPs recognize. While the majority of SLPs do not have to deal with the issue of sensory motor-based speech disorders (or at least think they don’t!) on a daily basis, many that DO deal with them are unsure about what to do. Many thanks to Pam and Diane and others like them who help us sort through the questions to come up with answers!