Nelson, Nickola Wolf PhD, Editor; Butler, Katharine G. PhD, Editor Emerita
Procrustean methods are used to transform one set of data to represent another set of data as closely as possible. The name derives from the Greek myth where Procrustes invited passers-by in for a pleasant meal and a night's rest on a magical bed that would exactly fit any guest.1
The Greek myth of Procrustes' hospitality starts out friendly enough, but Procrustes was not a nice character. According to legend, Procrustes, son of Poseidon, had gone astray. He was a blacksmith who invited passersby on the mountain road to Athens to sleep on his magical iron bed. As the myth goes, Procrustes claimed the bed would fit any guest perfectly. When it proved to be either too long or too short, however (as it always did—there actually being two beds, which Procrustes exchanged strategically), he fulfilled his claim by hammering out his guests or cutting off their feet to make them fit. It was thus that Procrustes gave reshaping problems to fit a predefined solution a bad name.
Reshaping of data to make the results of separate studies comparable, however, holds value in the world of evidence-based practice. It is a critical step in performing meta-analyses, which can provide helpful evidence for making clinical decisions (Dollaghan, 2007). Improving the mythical character's reputation, statisticians of today apply the name “Procrustean” to the reshaping of data to fit a common frame of reference, preparatory to conducting further analyses (Gower & Dijksteruis, 2004). Making data comparable is a sensible thing to do, but only if the essence of the original data set is not lost in the process.
The challenge taken up by Teresa Ukrainetz, as editor of this fourth issue in Vol 29 of Topics in Language Disorders, and by the other authors of the articles in this issue, has been to adapt a framework in order to fit a variety of language intervention targets without maiming the body. Led by Ukrainetz, the authors responded to a call for evidence by Warren, Fey, and Yoder (2007) to describe treatment intensity in a manner that makes it possible to compare results across studies. The process involves defining intervention acts in terms of their “dosage” (i.e., frequency within sessions), dose form (i.e., method of delivery), frequency of delivery (i.e., number of sessions per unit time), total intervention duration (e.g., number of weeks or months over which sessions occur), and cumulative intervention intensity (computed as the product of components, such as by multiplying the number of doses/session × sessions/week × total weeks' duration). Taking this set of common terminology as their starting point, the authors tackled the challenge of making disparate language goal areas fit.
As Ukrainetz writes in her Foreword, “Intensity turns out to be as complicated as it is important.” It might be tempting to follow Procrustes' example and simply amputate pieces of complex, rich, and ecologically sound intervention approaches to make them fit a treatment protocol with preestablished dosage, but that is not the approach these authors take. Rather, they highlight the nature of the language features they are targeting and discuss options for shaping the bed slightly to fit the diversity of complex and interesting interventions they describe. In the process, the authors point out misfits where they occur rather than lopping off critical limbs to make the body fit. As the authors discuss the anatomy of a therapy session or language lesson in each of their domains, they make readers think more explicitly about all the choices to be made in any intervention, but especially in their domains of focus—for Kerry Proctor-Williams, it is morphosyntax; for James Baumann, it is vocabulary; for LaVae Hoffman, it is narratives; for Teresa Ukrainetz, it is phonemic awareness; and for Allison Breit-Smith, Laura Justice, Anita McGinty, and Joan Kaderavek, it is print referencing.
As the authors describe the fine-grained components of intervention approaches and intensity issues, they make readers think explicitly about the anatomy of a therapy session and importance of an extended course of treatment. With some of us (Editor and Editor Emerita included), they worry that a simplistic metaphor of premeasured doses delivered by an agent of intervention to a “patient” conjures up a level of preplanned control that may be unhealthy for the patient. The field of language disorders needs authors like these who take seriously the challenge to collect better evidence to undergird clinical choices while avoiding the temptation to reduce problems to forms that lose their essence. Examples are reminders for clinicians to be sensitive to, and to create, “teachable moments” that constitute heightened opportunities in which language learners are particularly primed to respond to an intervention dose (i.e., therapeutic act on the part of a clinician or teacher). The therapeutic process may be the most effective when clients are engaged actively in making new cognitive–linguistic connections and elaborating their systems of inner language knowledge, but that is hard to do when a clinician is consumed with the process of counting and delivering doses on schedule. A danger exists that language researchers will avoid gathering high-quality research evidence on complex interventions merely because they are complex. That problem is a central theme underlying this issue.
Our constant goal for Topics in Language Disorders is to provide a scholarly source of information that can further the work of researchers and clinicians alike for the benefit of people with language disorders. If researchers can think more like clinicians, and vice versa, we think this mission is more likely to be accomplished. We believe that this thought-provoking issue fits that mission well.
Nickola Wolf Nelson, PhD
Katharine G. Butler, PhD
Dollaghan, C. A. (2007). The handbook for evidence-based practice in communication disorders. Baltimore: Paul H. Brookes.
Gower, J. C., & Dijksteruis, G. B. (2004). Procrustes problems. New York: Oxford University Press.
Warren, S. F., Fey, M. E., & Yoder, P. J. (2007). Differential treatment intensity research: A missing link to creating optimally effective communication interventions. Mental Retardation and Developmental Disabilities Research Reviews, 13, 70–77.
1From the back cover of Procrustes Problems (Gower & Dijksteruis, 2004). Cited Here...