By Pam Marshalla
Q: I am confused over the term NS-OME (Non Speech Oral Motor Exercises). Some people are saying that we cannot use things like toothettes, bite sticks, whistles, or straws in therapy. I use many things like this in therapy. Shouldn’t we do whatever we can to help our clients learn to make speech sounds? Your question is a good one. Yes, we are supposed to use whatever we can to help our clients learn to produce speech sounds. Van Riper…
By Pam Marshalla
This opinion paper was originally posted as a downloadable PDF on my website, authored in mid- 2011. Download the original PDF here. *** What Evidence-Based Practice (EBP) Really Means Q: It is surprising to me that you find it reasonable to pass on non-evidence based ideas. I don’t think this meets a best practice standard at all. I’m curious to know how you demonstrate efficacy this way. The term “Evidence-Based Practice” has been bandied about and distorted. EBP does not mean that we only…
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…
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…
By Pam Marshalla
Q: I am a CFY and my supervisor will not let me attend your seminars because she says that you teach oral-motor techniques for which there is no proof. I need help with the lateral lisp and the distorted R. What can I tell her to convince her to let me go? First of all, what right does your supervisor have to determine which continuing education seminars you can and cannot attend? Why are you giving her this power over…
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…
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…
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….
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…
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…
