Clinical Forum  |   July 2008
The Application of Evidence-Based Practice to Nonspeech Oral Motor Treatments
 
Author Affiliations & Notes
  • Norman J. Lass
    West Virginia University, Morgantown
  • Mary Pannbacker
    Louisiana State University Health Sciences Center in Shreveport
  • Contact author: Norman J. Lass, Department of Speech Pathology and Audiology, P.O. Box 6122, West Virginia University, Morgantown, WV 26506-6122. E-mail: nlass@wvu.edu.
Article Information
Speech, Voice & Prosodic Disorders / Research Issues, Methods & Evidence-Based Practice / Speech, Voice & Prosody / Clinical Forum
Clinical Forum   |   July 2008
The Application of Evidence-Based Practice to Nonspeech Oral Motor Treatments
Language, Speech, and Hearing Services in Schools, July 2008, Vol. 39, 408-421. doi:10.1044/0161-1461(2008/038)
History: Received September 6, 2005 , Revised January 17, 2006 , Accepted March 7, 2007
 
Language, Speech, and Hearing Services in Schools, July 2008, Vol. 39, 408-421. doi:10.1044/0161-1461(2008/038)
History: Received September 6, 2005; Revised January 17, 2006; Accepted March 7, 2007
Web of Science® Times Cited: 13

Purpose: The purpose of this article is to help speech-language pathologists (SLPs) apply the principles of evidence-based practice (EBP) to nonspeech oral motor treatments (NSOMTs) in order to make valid, evidence-based decisions about NSOMTs and thus determine if they are viable treatment approaches for the management of communication disorders.

Method: A detailed description of EBP is provided, including levels of evidence for rating the quality of evidence. NSOMTs are described and a survey of the literature on NSOMTs is provided along with a determination of the level of evidence of each study reported. A systematic literature search was conducted using the electronic databases of MEDLINE and CINAHL (Cumulative Index to Nursing and Allied Health Literature) within an unrestricted time period. In addition, reference lists from identified articles were also reviewed. Ethical and fiscal issues related to EBP and NSOMTs, as well as clinical implications of EBP for the use of NSOMTs, are discussed.

Results: A total of 45 articles/reports were published between 1981 and 2006 in peer-reviewed and non-peer-reviewed journals. Most of the sources (25) relied on weak anecdotal evidence and opinions. Moreover, studies that employed stronger designs reported negative results for NSOMTs (i.e., evidence against the use of NSOMTs for modifying speech).

Conclusion: Despite their use for many years and their popularity among some SLPs for the treatment of a wide variety of speech problems in children and adults, NSOMTs are controversial because sufficient evidence does not exist to support their effectiveness in improving speech. Moreover, limited evidence exists for the use of NSOMTs to facilitate nonspeech activities. Therefore, the available evidence does not support the continued use of NSOMTs as a standard treatment and they should be excluded from use as a mainstream treatment until there are further data. SLPs should consider the principles of EBP in making decisions about NSOMTs.

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