Scientific Thinking in Speech and Language Therapy

Scientific Thinking in Speech and Language Therapy

Scientific Thinking in Speech and Language Therapy

Scientific Thinking in Speech and Language Therapy


Speech and language pathologists, like all professionals who claim to be scientific in their practice, make a public commitment to operate on the basis of knowledge derived in accordance with sound scientific standards. Yet students in communication disorders are given relatively little grounding in the fundamentals of science; indeed, they often receive implicit encouragement to rely on clinical wisdom. This pathbreaking text introduces the principles of critical scientific thinking as they relate to assessing communication problems, deciding about alternative approaches to intervention, and evaluating outcomes. The author provides many illustrative examples to help readers contextualize the ideas.

Her clear presentation will help not only undergraduate and graduate students but also established professionals reason more effectively about what they are doing and why. Though the examples come from speech and language pathology, this illuminating and readable book constitutes a valuable resource for all clinical practitioners.


Scientific and critical thinking do not come naturally. It takes training, experience and effort .... We must always work to suppress our need to be absolutely certain and in total control and our tendency to seek the simple and effortless solution to a problem. Now and then the solutions are simple but usually they are not.

—M. Shermer, Why People Believe Weird Things, 1997, p. 59

This book was originally motivated by events that influenced me almost 2 decades ago. It started during my first 4 years of clinical practice, when I realized that patients receiving rehabilitation therapy were not cured by therapy. Such naïvete belonged appropriately to a period in the history of the health professions when it was simply unthinkable for clinicians to question the efficacy of clinical practice. More years passed before I recognized and understood the factors that induced and maintained this type of thinking in clinical education and later, in professional practice. When what I knew failed to resolve my patients' problems, I could rationalize, for a while, a case for why the patient was not a suitable candidate for therapy. But when it became apparent that the practice of therapy in the field appeared to be guided mainly by intuition or personal preferences of clinicians, I felt unsettled for quite a time. It appeared to me that my education in a health science degree course did not equip me with knowledge or a framework by which it was possible to know or recognize a truth, if such a thing existed.

It has taken a couple decades that included learning and thinking outside the realm of speech and language therapy to understand this experience. During the same period, there has been an enormous change in the awareness and attitudes of the health professions. It has become increasingly acceptable to question the efficacy of interventions, and this is a truly liberating development in the field of speech and language therapy. Health professionals of all disciplines today speak more comfortably about whether interventions are effective, and students are slowly recognizing that it is becoming acceptable to question and challenge the status of the knowledge they are given during their training. However, the motivation of this new awareness appears driven more by changes in the political and economic climate of health care than by the need to simply understand the scientific basis of what we offer patients. Consequently, in speech and language therapy, we see the emergence of an awareness of therapy that is tied to pragmatic issues (e.g. . . .

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