What is Evidence-Based Practice?
What kind of evidence should there be? What is meant by Evidence-Based Practice (EBP)? EBP refers to the process of clinical decision-making that integrates clinical expertise and client needs and preferences with external research evidence. This last piece (external research evidence), with respect to treatment, refers to findings from careful studies in which the effect of a treatment is systematically examined under controlled circumstances – typically by comparing treatment to absence of treatment or another treatment.
When a new therapy protocol is developed, it is usually tried with a few children initially. This type of research is just the beginning of building evidence. If the results are positive, then more evidence must be obtained by replication and more controlled studies. Replication is important, because if something happens only once or twice, it could be a fluke or coincidence, but if the effect can be shown over and over again, it is more and more likely that it can be generalized to a larger population. Other types of studies might include groups of children, with randomized control studies (RCTs), where children are randomly assigned to treatment groups, which are considered the strongest evidence. See the glossary of terms for more detailed discussion of types of studies.
When reading about a program or product, if there is evidence like given above, the website or brochure should give the details of that research. Or at least give information for where the evidence can be found. If it is not listed, then it may still be under development or does not exist. Then consumers are relying on less stringent information and clinical judgement to make decisions about the appropriateness of a program or product.
We are fortunate to have some evidence based research to help guide us in diagnosis and treatment of CAS which shows that the best treatment for improving speech is intensive therapy that focuses on the motor movement sequences of speech, follows the principles of motor learning, and uses multisensory cues. However, even approaches for which there is controlled and replicated evidence may look different for different children, as each child is an individual and many children with CAS have additional areas of concerns. In accordance with the description of EBP above, it is up to the child’s team (which includes the parents/families) to make sound decisions based on the evidence available as to what treatments would be beneficial. Before making decisions, parents are advised to seek out appropriate professionals (speech language pathologists, doctors, other healthcare providers) to help determine if a specific program or therapy is appropriate for their child.
Click here to learn how to judge evidence for yourself.
Click here to learn about which program could be good for your child.
Evidence Brief on Childhood Apraxia of Speech
There are a multitude of different treatment approaches available for CAS. Tricia McCabe, Elizabeth Murray and Donna Thomas from the University of Sydney have graciously enabled us to share with you an Evidence Brief on childhood apraxia of speech.
This Evidence Brief reflects the past and current research from Australia in collaboration with researchers and clinicians across the world. The CAS Treatment Project Log includes research that covers many aspects of childhood apraxia of speech. We thank these excellent researchers not only for their contributions to our understanding of CAS but also for their generosity in sharing their vital information with others.