ClinicalForum

TreatmentDecisionsfor Children Disorders With Speech-Sound Alan G. lGmhi Universityof North Carolina-Greensboro

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l have a vivid mernory of a hnief corwelsation I had

professionin a hallway at a conferenceabout the latest beginning to infiltrate ihe profession' This thatwas bu.zrvord get individual scoffed at what he viewed as the latest attsrpt to treatrneff justify support ad to research use our profession to p-oi"o. He had been in the profession for more than 40 years *d hud rott t peatedatempts to make clinical practice mcneresearch

ABSTMCT:PurPce: ln thisarticle,lconsiderhol research' clientvalues,a clinician'stheoreticalperspeciive' clinicalexpertise, affuctthe decisionsthat and servkedeliveryconsiderations (SSD)' disorders cliniciansmaketo treatchildrenwith speech-sound treatrnent' phonological on research the reviewing After l{ethod: perspecliveinfluences how a clinician'sthe'oretical I cliscuss (a)normative; considered: are perspectives goalselection.Five (d)broad-based; (c) language*rased; skill; discrete bouorn-up. ib) efficiency The literaturcon treatrnent and (e)complexity-based. of servicedelivery followedby a discussion is thenconsidered, factors,clientvalues,and clinicianfacton' lmpl'rcathnr: I believe like M. Ylvisaker(2Cn4)that treatrnent decisionsareinfluencedthemo* by thechangesthatoccurin client behavion.Thesechangesnru$, however,be experimentally validated,which is not alwayseasyto do' M' YlvisakersuggesE thatvalidationcould takethe formof trial therapy'diagnostic but it may alsnbe importantto teaching,or dynamicassessrnent, shorythatthe treatrnentprovided,not sore othervariable'was for the behavioralchange(A' Tyler'personal primarilyresponsible communication, lanuary11,2tXl6)' treatment Kt\i WORDS:spcechdisorders,

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Senvtcss tN Scttoob,33' 23'l-253. Norrls, J. A., & Hoffurnr P. R. (2005). Goals and targets: Facilitating tlre self-organizing nat-ce of a neum-network. ln A Ka$hi & K- Pollock (Eds.\, Phonological disotders in childrcn: Clinical decicion making in assessmenland intervenlion (pp. 77-8?)' Baltimrc: Bmokes' ()fhr, lC (19?8). Infart vocalization ard the development ofspeech-,4llied Health and Behavior kience't, l, 523-549Olswang, L. (1990). Treatmert efficacy. The breadth ofresearch. ln L. Olswang C. Thomspso4 S. Wanan, & N. Minghstti (Eds.\, fieatment eflicacy rcsearch in communlcation disorden (pp. 99-103). Rockville' MD: American Speech-Lurguage-Hearing Association Foundation. Powel, T., Elberlr M.r Mlcch, A., Sdkc-Rousloc, C', & Brarseurr J. (lD8). Facilirating [s] productior in young children: An exp€rhrrntal evaluation ofmotoric and conceptual treatrnefit appmachcs" Clinical Linguittics & Phonetics, 12, 127-146. Rctncr, N. B. (2006). Evidence-based practice : An examination of its ramifications for the practice of speecblanguge pathology. Language, Speech,and Hearing Semicesin Schoohs,37,257-267Rmhrlg, S., Sulter, D., & Plercc, T. (2004, Novenber)- An examination of passiveoral motor %ercises. Post€f,prBsentedat the Annud Conv€trtion of th€ American Speectrlanguage'Hering Association, PhiladelPhia Rnrrk, J., & Moort, C. (1997). Coordination of lip muscle activity by 2-year-old children during speech and rnnspeech tasks. Journal of Speech and Hearing Research, 40, I3n-1385Seckett, D., Shrusr S.r Rkhardson, W., RocenberSt W.t & Heynes' R. (2O0O\.B,idence-hased medicine: How to practice and leach EBM i2nd ed.). New Yorkl ChLrch.ill Livingstone. Shrlberj, L,, & Kwiatkowskt J. (1994). Developmedal phonological