ASHA2014: EBP or Pseudoscience?

I’m not attending ASHA 2014 this year (very much to my dismay). I wanted to go…I had planned to go…and then one thing after another conspired so that I couldn’t. But that doesn’t mean that it’s not on my mind .. a lot.

First, and foremost, I’m going to miss the #SLPeeps.  SLPeepsLogoWhiteThis will be the first ASHA I’ve missed since we became really active on twitter and I miss connecting with established friends and meeting new friends in real-life. Not to mention they have some really fun activities planned.

But… as fabulous as the #Slpeeps are, they’re not the only reason I have ASHA on my mind (and if you don’t know how fabulous we are, you should check us out on twitter).

One of the incredible things about ASHA is that there are vendors and speakers from nearly every corner of the earth (no mean feat on a sphere) discussing nearly every topic imaginable.

However, it’s important to remember that just because it was presented at ASHA and you’ve earned a CEU for attending the lecture, it does not mean that it is Evidence Based Practice. Nor does it mean that because you saw it in the exhibit hall and attended a learning lesson, is it research based (and boy could I point some fingers at exhibitors on this list…but I won’t because that would be unprofessional…but ask me about it sometime. There’s a list of vendors I’d LOVE to see banned from ASHA.). As far as presenters go, it means that the panel liked the abstract (I mean it…have you ever seen a proposal? The committees don’t have a lot of information to make these decisions on.) In the exhibit hall, it simply means the company paid the fees needed for a booth space. Not a lot of EBP needed there. (Please note: I am not dissing ASHA or the committees, or the exhibit hall people…I’m simply stating facts. As hard as ASHA tries to vet presenters, it’s impossible to do so 100% of the time.)

Regardless of where you are, it is still important to remember to think critically at all of the information. For instance:

1) Is there peer-reviewed research that is already published (or accepted for publication) on the subject?  This gets a bit tricky because many of the presenters at ASHA are students presenting thesis research (which is great, but not necessarily EBP) and researchers presenting on unpublished research (which is even greater once it goes through the peer review).

2) Are established theories being ignored? This gets a bit tricky because as we learn things, we need to adjust our theories a bit…but an adjustment is not abandonment.

3) Are you guilty of confirmation bias (you want it to be true – so it is)?   Oh come on! You know you’ve done it. I’ve done it. But when it comes to out clients, we owe them to really consider all aspects, not just the ones we like.

4) Are the terms and concepts measurable?    Somethings simply aren’t measurable…lip strength? Tongue strength needed for /r/? Just how would it be measured accurately – both the improvement AND the need? (wait…that wasn’t supposed to be a rant against NSOME)… But also other things – is the information qualitative or quantitative? Are they measuring “satisfaction” or “improvement?”

5) Is it anecdotal or a case study or is it true research?   Don’t get me wrong…I think case studies are important because sometimes we only have one client with the problem…or as a school-based clinician, we may not have 100s of people at our disposal (boy that sounds wrong!).  Case studies are good…BUT…they are not EBP. They’re better than nothing and a great first step…but don’t confuse case studies with other types of research…And speaking about other types of research look – I mean really LOOK at the research design. Is it faulty? Is the information represented correctly? Sometimes the research design is faulty, sometimes the results are misinterpreted…sometimes people make mistakes (even when they are presenting to thousands of people).

6) Are grandiose outcomes promised?    You know…This tool will correct ANY /r/ problem… Drink this juice to solve all language problems… Wear these inserts and your feet won’t hurt. Wait.. I bought that one! Think. THINK!  If it promises anything, it’s false. If it promises BIG things, it’s REALLY false. We are human. Our clients are human. And as such there are far too many variables to PROMISE anything. We can strive, we can hope, we can work hard…but we can’t PROMISE outcomes (heck! That’s even in the ASHA code of ethics). Don’t be a lemming…think.

I wrote a post way back in March about a speechpathology.com workshop I took from Dr. Greg Loff. (Disclaimer: I love Greg’s work…I think he’s great and I highly recommend you attend any of his seminars you can). You can read it here.  Essentially it was how to know the difference between science and pseudoscience.

Since I can’t go to ASHA, I’d love to hear which courses everyone is going to…and how you’ve employed “baloney detection” to determine whether or not what you heard was science based…or …

Until then…Adventure on!

Mary

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One thought on “ASHA2014: EBP or Pseudoscience?

  1. Mary, I’m so glad you’ve brought up all these points because I do think there is an assumption that inclusion at the conference means an endorsement. That said, I have deliberately popped in on a pseudoscience session to see what I’m up against, so to speak when teachers or families come to talk to me! Kim

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