Nicole Compty

Portfolio Artifact
Spring 2014

Summary
Hoffman et. al. (2013), created a survey for professionals working in the realm of Speech-
Language Pathology within public schools to inquire about their knowledge and experience with
Evidence-Based Practice (EBP). EBP is a three-pronged approach to best clinical practice; EBP
includes published research, integrated with professional expertise and client preferences. The
authors hypothesized that Speech-Language Pathologists (SLPs) have more informal than formal
training in EBP, have limited resources to support their search for published research, and have
minimal time to engage in EBP requirements. To test their hypothesis, an online survey was
distributed through professional networks. 2,762 individuals responding to the survey invitation.
Of the individuals who responded, 93% had a masters degree, 1% had a doctoral degree, and
6% had a bachelors degree. 85% of the participants had their ASHA Certificate of Clinical
Competence in Speech-Language Pathology. Although I did not agree with including individuals
without masters degrees in this study, I found the results of this study to be most interesting.
Although professionals early in their career reported more graduate level education on EBP, the
amount of articles read about assessment or intervention in one year were about the same for all
professionals, no matter how much experience they had in the field. I was also shocked that some
professional reported that they had not read any articles to support their assessment or
intervention practices. 91% of the participants responded to having no dedicated time at work to
conduct EBP activities. After those results were presented, I was relieved to read that 84% of
individuals were willing to participate in future EBP training and support.
Implications for Assessment
In the study by Hoffman et. al. (2013), 84% of respondents said they had read four or less
articles on the assessment in the field of Communication Sciences and Disorders within the last
year. Assessing childrens speech and language skills can be crucial in educational outcomes. In
my personal opinion, SLPs hold the skills and knowledge base of reading, writing, speaking,
listening, and many other crucial skills that affect a childs learning outcome. I believe that SLPs
can use EBP to increase their ability to successfully assess a childs abilities. EBP can be a step-
by-step process, using the PICO elements. Once the clinical questions are formulated and own
personal evidence is internalized, external research can be used to integrate and evaluate what
assessments can be most beneficial for an individual (Paul & Norbury, 2012). In the position
Nicole Compty
Portfolio Artifact
Spring 2014

statement on EBP, the American Speech-Language-Hearing Association (ASHA) state that SLPs
must evaluate the efficacy and effectiveness of what they are doing (2005). If an SLP gives an
assessment on language to a child just because it says it tests language, they could potentially be
putting the child in danger. The test could have a low reliability and validity. The SLP has to be
able to identify the difference between a low and high quality assessment. SLPs can do this by
using EBP. SLPs can research different published studies that have used the assessment. They can
research how the assessment gained its normative data. Does the assessment have normative data?
I believe that SLPs have to be able to use their own clinical common-sense along with their ability
to research questions to be able to provide best practice for their clients. Paul and Norbury (2012)
reiterate that it is critical for clinicians to be cautious about the quality of evidence they use to
guide decision-making.
Implications for Intervention
In the survey conducted by Hoffman et. al. (2013), 79% respondents created and
researched two or less EBP questions in the field of Communication Sciences and Disorders
within one year. I believe these respondents are not giving the best quality intervention to their
clients. These professionals are missing the third prong to EBP; they may be using their own
professional expertise along with the clients wants and needs, but they are lacking the hard
evidence behind what they are doing. EBP lays a huge implication for intervention. For best
practice, research has to be done to ensure that mode and method of intervention will be most
successful for the individual treated (Paul & Norbury, 2012). ASHA states that SLPs must
monitor and incorporate high quality research evidence into their clinical intervention (2005). I
met an SLP with years of experience. She had her own ways of doing things and in my personal
opinion she was stuck in her way. Nothing about her practice was innovative to me. Although I
do not know if she used any evidence in what she was doing, I know she would have benefited
from research on new techniques. I believe EBP is a system for which SLPs can continuously
learn about what they are doing and why they are doing what they are doing. Because one
intervention technique worked with one child, does not mean it will work with the next. EBP
allows SLPs to research new ways to intervene with a child, hopefully in the end increasing
success in childrens abilities.

Nicole Compty
Portfolio Artifact
Spring 2014

Implications for the Role of the SLP in School Based Intervention
The survey conducted by Hoffman et. al. (2012) revealed many implications that EBP
places on the SLP in school based intervention. The first is time constraints. Nearly all respondents
had no designated time to research for their practice, and it has been found that it takes three to
seven hours to define a question, conduct research, and find an answer. Brackenbury et.al. (2008),
revealed that ASHA knows that SLPs have minimal time to research for their practice. That is why
ASHA has begun providing more information on their website. ASHAs goal is to give access to
quality research to their members. Another constraint placed on SLPs in schools is the idea of lack
of applicability to their own clients characteristics. But, I believe that is why intangible resources
are crucial for research. Intangible resources are resources such as support structures and other
practitioners that create a support network for clinical decisions; intangible supports cannot be
purchased or printed (Hoffman et. al., 2008). I have reached out to one of my own intangible
resources, Casey OKeefe. She has given me the support in my practice when I felt I needed further
research and support in teaching literacy skills. Intangible resources should be more readily
available in school districts. 54% of the respondents reported that they had other SLPs that they
could contact to support them regarding EBP (Hoffman et. al., 2008). Making a professional
network for oneself can be critical in using EBP in ones own practice.
Question
From this article, I have realized how time constraints can really affect an SLP within a
school. From SLPs I have observed, they are literally running from the minute school begins to
the last bells of the day. One SLP I observed even had a working lunch in which she had to
meet with other faculty members. How can schools provide time for SLPs to conduct EBP
practices without reducing time with students and increasing costs on the district? Is that even
possible? ASHA (2005) states that SLPS must acquire and maintain the knowledge and skills
that are necessary to provide high quality professional serves, including knowledge and skills
related to evidence-based practice. The Department of Public Instruction states that Response to
Intervention (RtI) must have high quality instructional practice. How can SLPs provide high
quality instructional practice if they have no time to conduct EBP activities?

Nicole Compty
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Spring 2014

References
American Speech-Language-Hearing Association. (2005). Evidence-based practice in
communication disorders [Position Statement]. Available from www.asha.org/policy. -
See more at: http://www.asha.org/policy/PS2005-00221/#sthash.447u2mn4.dpuf
Brackenbury, T., Burroughs, E., & Hewitt, L. E. (2007). A qualitative examination of current
guidelines for evidence-based practice in child language intervention. Language, Speech,
and Hearing Services in Schools, 39(1), 78-88.
Hoffman, L. M., Ireland, M., Hall-Mills, S., & Flynn, P. (2013). Evidence-based speech-
language pathology practices in schools: findings from a national survey. Language,
Speech, and Hearing Services in Schools, 44(3), 266-280.
Paul, R., & Norbury, C. (2012). Language disorders from infancy through adolescence:
listening, speaking, reading, writing, and communicating (4th ed.). St. Louis, Mo.:
Elsevier.
WI's Vision for Response to Intervention (RTI). (n.d.). Wisconsin's Vision for Response to
Intervention. Retrieved March 27, 2014, from http://rti.dpi.wi.gov/