What is Evidence-Based Practice?
Today’s blog post focuses on Evidence-Based Practice (i.e. EVB). Below, are some key points to consider to help ensure that the AAC evaluation procedures and/or intervention decisions being considered will result in the best possible outcome for the AAC user and his or her family.
Best Available Clinical Evidence
(a) Framing the Clinical Question
- The framework of a clinical question includes the population, the intervention being considered, the comparison intervention (if appropriate) and the outcome desire.
- Example: Compared to single-switch auditory scanning, is two switch auditory scanning an effective means to an AAC system for functional communication for an 11 year-old with spastic cerebral palsy and visual impairments?3
- Example: Compared to the Picture Exchange Communication System (PECS), is an iPad (used as a speech generated device) a preferred means of communication for school-age children with autism spectrum disorder?
(b) Finding the Best Available Evidence
- Selecting information from sources that have high levels of evidence for clinical application, as opposed to using/trialing anecdotal information (individual successes of one’s individual modalities discussed on social media platforms); the product is only a solution when it matches the student’s abilities, needs, and goals.
- Peer reviewed, refereed journals provide a higher standard of clinical evidence as the likelihood of negative findings being published is reduced.
- Published research studies with well-designed randomized controlled trials and meta- analysis/ systematic reviews of multiple well-designed controlled studies provide trustworthy evidence for treatment decisions.
- Individual studies found on databases such as MEDLINE and CINAHL may also be sources of evidence when systematic reviews are not available.
(c) Assessing the Evidence
- Critical appraisal of the evidence found by examining the quality of evidence, treatment integrity, social validity, and external validity.
- Evaluating the application of the evidence by assessing the research design and outcome measures.
(d) Making the Clinical Decision
- Applying the evidence in the clinical setting and/or real world setting with the client.
Patient Abilities, Expectations & Perspectives
- Determining the individual’s needs and abilities.
- Identifying the demands versus capacities of the patient related to educational, vocational, and social environments.
- Knowing what your patient, family, and/or school district expect and knowing it will vary from person to person.
Individual Clinical Expertise
- Clinical expertise refers to the experience, education, and skills of the treating clinician and/or clinical expert.
- Providing efficacious treatment to the client and/or student.
- Being a life long learner no matter what role you play; parent, student, clinician.
When each key component of EBP aligns the results are
IMPROVED PATIENT OUTCOMES!
So what does it mean when we use evidence-based practice?
- Accurate assessment of the users abilities
- Appropriate selection of AAC devices
- Increased use of device to communicate
- Improved receptive language & expressive language
- Enhanced quality of life for the AAC user and family
The Benefits of “ACC News for Newbies”
- Inform all “Newbies” on Evidence- based practice methods by providing quality content that can be applied in therapy and in daily routines.
- Explain the fundamentals of augmentative communication in a concise manner.
- Help YOU help severely speech impaired children and adults with autism and developmental disabilities, children with; apraxia, cerebral palsy, and traumatic brain injury; and teens and adults with advanced communication skills.