Evidence Based Practice is an inter-disciplinary approach to clinical practice that has been gaining ground following its formal introduction in 1992. It started with medicine and has spread to other fields such as speech language pathology.
What is EBP?
It is a combination of,
1. Empirically supported treatments or best available clinical evidence from systematic research.
2. Family and individual preferences
3. Professional judgment and data based decision-making.
The popular speech therapy institutes will always believe in following EBP not as a matter of choice, rather a principle in its work style. Using only flash-cards and structured table top approaches and not play/toys, doing oral exercises without considering its speech and non speech distinctions, considering that children with Autism are always visual learners and many more such clichés or traditional views to name a few, indicate the lack of evidence based practice.
Let's see what EBP means in simpler terms. Let me illustrate an example of a 4 year old child with ASD who is not talking yet (non verbal) and the parents have approached a speech therapy institute for the first time in need of speech therapy services.
How do we start EBP?
1. Empirically supported treatments: At Magpie, we always look at current research practices. Picture Exchange Communication System (PECS) has sufficient research to support that it is a good choice of expressive communication for young children with Autism. Magpie therapists are trained in PECS so we will include PECS in our therapy plan.
2. Professional Judgment: Our clinical observation is that, a lot of young children with Autism who are completely at the sensory level of play (which means that they do not relate to objects/pictures) take longer to adapt to PECS and hence based on our professional knowledge we will work on improving this child’s play skills and only then introduce pictures or objects for PECS.
3. Family and Individual Preferences: Parents might be apprehensive about us using PECS with the child since they might fear that it will not encourage expressive speech (A myth! indeed). At Magpie, we share the research about PECS and /or make them meet other parents who use PECS. But at the same time accept their apprehension and along with educating them about PECS, offer them other research-supported methods like improving speech imitation skills using play and video modeling.
4. Professional Judgment and Data Based Decision-Making: We would at the same time inform the parents that we will try PECS for 3 months, keep track using our data sheets and meet the parents again at the end of 3 months to evaluate the progress made so that their decision about PECS can be built based on available data.
This is just an example of EBP at MAGPIE. In a nutshell, EBP demands that the SLP has completed his/her training in an institution recognized by the RCI so that the SLP has enough supervised clinical hours to their credit. It needs that the center or SLP constantly updates his/her knowledge about research in the field of speech language pathology even after completing the required formal bachelors or masters education. It is important that the SLP is sensitive to the family and client needs so that both of them are on the same page in terms of planning realistic goals. Also data based decision making is extremely important because only specific and measurable goals can lead us on to the true path to a holistic communication program for the child.
At MAGPIE, all our SLPs have completed their Master’s in Speech Language Pathology from RCI recognized colleges.
All our therapists have weekly meetings with me and monthly meetings with parents which helps us take informed decisions about the children and their therapy program. We constantly train ourselves with therapy tools that have been researched and proven in the field of Communication intervention. Tell Me, Show Me, Involve Me and i will still test it..... and only then believe it......... :)