Evidence Based Practice

Question 1

Name the 3 factors evidence based practice combines.

Answer 1

clinical judgement
patient values and expectations
research evidence

Question 2

What are practice guidelines?

Answer 2

Explicit statements to assist clinical decisions- delivery therapy in the most appropriate, effective and cost-effective way.

Question 3

What are some good guidlines?

Answer 3

The RCSLT guidelines for stroke-dysarthria

Parkinson’s UK SLT Guidelines and Standards

Question 4

Summarise these guidelines

Answer 4

• Should be assessed for dysarthria
• Explain and inform family and person about dysarthria
• Use different approaches suited to their diagnosis and individual needs
• Ensure effective means of communication e.g. Use AAC
• Support communication with conversation partner
• Review and Manage

Question 5

Whats the problem with evidence?

Answer 5

Not enough evidence, need RCT’s to demonstrate most effective form of SLT to treat dysarthria.
People are individuals e.g. have different environment, personality, different causes of dysarthria and different types of dysarthria etc. so it’s really hard to control

Question 6

Speech Supplementation Techniques for Dysarthria 2004

Answer 6

Intelligibility increased regardless of strategy used.
More generalization e.g. communication function in natural setting, the better the benefit.
Select strategies based on individual.
Conversation partner plays a big role in ensuring successful use of strategies- training them is an important of intervention.

Question 7

What is there great debate about?

Answer 7

Non-speech oro-motor exercises. e.g. moving tongue side to side.

Question 8

What’s the purpose of doing non-speech oro-motor exercises if there is mixed evidence and no guarantee it will work?

Answer 8

• easy for patient to practice
• gives them feeling they are working on their speech
• might increase awareness of articulators
• focus on postures for speech sounds then built up to CV, CVC etc.
• clinical experience shows success on some occasions.

Question 9

When doing non-speech oro-motor exercises, what’s important to explain to the patient?

Answer 9

No guarantee it will wrk but could give them a try.

Question 10

On occassion non speech tasks may have their place- but what is more appropriate?

Answer 10

Speech tasks :)