Evidence-Based Practice and D/HH Children

Throughout my years working as a speech-language pathologist (SLP) with deaf and hard of hearing (DHH) children, I have noticed that many clinicians do not seek evidence-based sources of knowledge to modify and improve their practice. Instead, they tend to rely on old sources of information without questioning their validity. Portney (2020) identifies three sources of knowledge that practitioners have typically relied on:

  1. Tradition - “That’s how we’ve always done it.”

  2. Authority - “That’s what the experts say.”

  3. Experience - “It’s worked for me before.”

This is highly relevant to SLPs and other professionals who work with DHH children. SLPs will often utilize non-evidence-based approaches with DHH children because of tradition. For example, auditory-verbal therapy methods and concepts such as the Ling 6 sound check and the auditory hierarchy are the way that we’ve always treated DHH children and we inherit that knowledge and accept it as evidence without attempting to validate it. SLPs may also utilize non-evidence-based approaches because of authority. Organizations like the Alexander Graham Bell Association (AGBell) or the Moog Center will support or back a therapy method and clinicians will rely on that information blindly, without seeking out if knowledge has changed. Lastly, SLPs often utilize non-evidence-based approaches with DHH children because of experience. Perhaps they worked with one or two DHH students in the past for whom these methods worked. Therefore, they continue to utilize them for all of their DHH students without attempting to change or modify their practice.

However, the problem with relying on these three sources of knowledge rather than objective research and evidence is that they stagnate our practice as clinicians and hinder our skill growth. As Portney (2020) states, “over time, these are likely to result in a lack of progress, limited understanding of current knowledge, or resistance to change even in the face of evidence” (p. 54). When working with DHH children, it is vital for SLPs to think critically, keep an open mind, seek new evidence, and change their practice to better serve the child.

References

Portney, L. G. (2020). Foundations of clinical research: Applications to evidence-based practice. F. A. Davis Company.