Innovations actively shaping speech-language pathology evidence-based practice

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Correction to: Crowe et al., Innovations actively shaping speech-language pathology evidence-based practice

Evidence-based practice (EBP) is a central tenet of standard practice set out as a professional standard for speech-language pathologists (SLPs). The result of this professional focus on EBP is that speech-language pathology is an innovative profession that actively reflects on the outcomes of past practices and invests in our future practices to provide the best evidence-based care for our clients. Through challenging old assumptions and conventions, and striving for better evidence-based care, we ask ourselves, “Is this the best way?” and “Is there a better way to support this client?” The 2017 Speech Pathology Australia (SPA) National Conference theme, “Working and Investing in Future Innovations”, embodied the spirit of innovation borne out of a desire for EBP. The myriad of ways that embodies the spirit of innovation borne out of a desire for EBP. The myriad of ways that SLPs are reflecting, questioning, and innovating to improve evidence-based care are reflected in the papers presented in the current special issue.

The 2017 SPA National Conference theme attracted clinical and research workshops, presentations, and posters that demonstrated the strength of EBP and practice-based evidence. Fittingly, the conference was set in a new and innovative presentation space where participants were immersed in a melting pot of knowledge that seamlessly blended traditional conference procedures and protocols with new technologies (e.g. e-Posters) and methods of knowledge dissemination (e.g. trending #SPAconf social media hashtag). Conference papers evaluated novel ways that SLPs are applying well-known assessment (e.g. conversation and traumatic brain injury communities; Brunner, Hemsley, Togher, Dann, & Palmer 2017), intervention (e.g. telehealth and social communication therapy; Garnett, Davidson, & Eadie, 2017), and research (e.g. Language Environment Analysis; Choo, Dettman, Dowell, & Cowan, 2017) methods. Especially engaging were opportunities to hear first-hand about the experiences of clients and their families who had worked with SLPs (Kitchin et al., 2017). The 2017 conference highlighted SLPs’ engagement in self-evaluation of practice and that we stand together to share, learn, and grow the knowledge base of our profession. The papers that are presented in this special issue of the International Journal of Speech-Language reflect the diversity of topics, settings, and professionals who presented at this conference.

Eight articles appear in this special issue, with three of these representing the invited papers from the keynote speakers. In the Elizabeth Usher Memorial Lecture paper, Professor Tricia McCabe articulates principles from behavioural economics that inspire SLPs to practice what we preach; namely, to strive for evidence-based practice through understanding the tensions that exist in achieving this goal (McCabe, 2018). McCabe hypothesised that tensions and disconnect between evidence and practice can be managed more effectively when we take the time to analyse and recognise positive and negative behavioural patterns in our work. McCabe suggests that when we understand and embrace these behavioural patterns and challenges there is a collective advantage for our clients, colleagues and our profession as a whole.

Associate Professor Emily Plowman’s keynote address on neural plasticity and rehabilitation challenged traditional conventions and thus resonated with Professor McCabe’s call to view our existing practices in new ways. The paper in this issue, by Plowman and Humbert, extends Plowman’s keynote and brings in material covered during an associated workshop that she presented at the conference. It calls on us to examine our evidence and practices in terms of the concerns, challenges, and solutions for SLPs education in dysphagia rehabilitation (Plowman & Humbert, 2018). Drawing on their research with SLPs in the United States, Plowman and Humbert highlight potential barriers that may influence a clinician’s understanding of normal deglutition and ability to provide appropriate rehabilitative support for clients with dysphagia.

Professor Laura Justice’s keynote asked the question “What is optimum dose in paediatric language interventions?” While dose is a well-established concept within medical practice, the application of this concept to speech-language pathology intervention remains to be consistently defined. Justice argues that dose, and related concepts of dose intensity and duration, are complex phenomena which require careful attention to be understood and applied with maximal benefit for our paediatric clients. Justice challenges conventional thought that “more is always better”. Instead Justice proposes that optimal clinical outcomes must result from individualised intervention where calculation of optimum dose effectively incorporates personal and environmental facilitators and barriers to treatment (Justice, 2018).

Throughout the five papers from the concurrent sessions of the conference, we again see the rich diversity that exists in our profession in the topics, practices, and innovations that are addressed. Two papers explore evidence related to intervention. Sutherland, Trembath and Roberts (2018) describe a systematic search and review of the literature regarding the role and scope of telepractice in providing assessment and intervention for children and adolescents with autism spectrum disorder (ASD). The authors acknowledge that the rapid growth of telepractice requires careful examination before this service delivery method is accepted as best practice for clients with ASD. They provide a clear and objective overview of the existing evidence that highlights how telepractice provides an innovative method for working with children with ASD, engaging parents in therapy and education, and managing interdisciplinary, multi-site, work settings. Intervention practices are also considered by Brown, Westerveld, Trembath and Gillon (2018) who examine the evidence for story book reading to develop language and social communication in babies. In Brown et al. (2018) dose is considered, similarly to Justice (2018), to explore differences in the impact of an intervention delivered at a low intensity and a high intensity. This early book reading intervention, designed to stimulate language development and support carers’ book reading skills, draws evidence and practice together through operationalising many therapeutic techniques utilised by SLPs and clearly exploring the impact of dose.

In addition to papers that explore innovations in intervention, the current issue includes studies designed to explore innovations in assessment. Evidence and innovation in assessment practices are explored by van Doornik, Gerrits, McLeod, and Terband (2018) and Beales, Whitworth, Cartwright, Panegyres, and Kane (2018). The paper by van Doornik et al. (2018) examines how listener familiarity influences measures of speech intelligibility for children with and without speech sound disorders. The authors’ results challenge accepted practice that objective measures of speech production accuracy, such as percentage consonants correct, can adequately describe speech intelligibility when they do not account consonants correct, can adequately describe speech intelligibility when they do not account innovation towards more meaningful assessment of children’s communicative function in their daily lives. In contrast, a study by Beales et al. (2018) provides support for the suitability of using connected speech analysis for individuals with primary progressive aphasia and Alzheimer’s Disease. The generation of such evidence to support quality and confident assessment procedures is important to driving EBP in our profession.

Concluding this 2017 National Conference edition, Kelly, Cumming, Kenny, Smith-Merry and Bogaardt (2018) provide an overview of Australian SLPs medico-legal and ethical responsibilities with regards to comfort feeding practices in palliative dysphagia care. Kelly et al. (2018) highlight the importance of reflecting on practice in challenging cases.

Together, the papers in this edition of IJSLP present a picture of the rich diversity of Together, the papers in this edition of IJSLP present a picture of the rich diversity of together, the papers in this edition of IJSLP present a picture of the rich diversity of Speech Pathology Australia National Conference will centre around the theme of “Inspiring Practice Research and Engagement”. We hope that you enjoy reading the contents of this special issue of IJSLP as much as we have enjoyed bringing the issue together.

Declaration of interest

No potential conflict of interest was reported by the authors.