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Issue Editor Foreword

Applying Evidence-Based Practices in School-Based Speech and Language Therapy

Editor(s): Farquharson, Kelly PhD, Issue Editor

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doi: 10.1097/TLD.0000000000000234
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This issue of Topics in Language Disorders includes six articles focused on evidence-based practices, with a particular application to school-based settings. Why the focus on a specific setting, instead of a specific population, disorder, theory, or problem? School-based settings are unique in several important ways: (a) more than half of American Speech Language Hearing Association (ASHA) members report working in an educational facility (ASHA, 2019); (b) caseloads are quite variable in their size, age, and population composition (Katz et al., 2010); (c) legislation that governs school-based services varies substantially within and between countries and states (Farquharson & Boldini, 2018); and (d) there remains a dearth of field-based empirical data to guide clinical decision-making within constraints of school-based speech and language therapy. Within the extant literature, there are, indeed, potential assessment and intervention tools and strategies to use with school-aged children who have speech and language impairments. However, the extent to which the effectiveness of these tools and strategies is ecologically valid in school-based settings remains largely unknown. Specifically, school-based speech–language pathologists (SLPs) must make decisions concerning service delivery factors that may differ from those in laboratory-based research studies. Thus, this issue was curated for school-based SLPs who are looking for specific research that is directly applicable to their caseloads.

In my reading of these works, several themes emerged, including the importance of collaborative practices between SLPs and educators, tailoring interventions to students' individual profiles, and SLPs' critical and unique roles in supporting literacy. As I think about the complexities of being a school-based SLP and reflect on my own experience in that role, I am reminded of one of my favorite Maya Angelou quotes: “Do the best you can until you know better. Then when you know better, do better.” We know clinicians are all doing the best that they can. It is my hope that with the information in this issue, clinicians also find opportunities to expand their practice and to implement some new ideas and tools.

I am honored to share the lineup of authors who have generously given their time to writing these pieces. To begin, Cabbage and DeVeney (this issue) call attention to the need to individualize therapy approaches for children with speech sound disorders (SSDs). If clinicians find themselves tending to treat all SSDs the same way, this article may provide a fresh perspective. The authors introduce three hypothetical cases, each representing common profiles seen in school-based settings. Next, the authors review several popular speech sound treatment approaches within the dichotomy of motor-based approaches compared with cognitive-linguistic approaches. Table 2 then shows how an appropriate treatment approach is matched with each of the three cases. The authors' review of these varied treatment approaches is comprehensive, yet concise and relatable for school-based practice. I recommend readers pick one of the approaches with which they are less familiar and determine whether it might work with a child on their caseload. Considering the prevalence and variability of SSDs, this article is bound to be a favorite among clinicians. Reading it will empower clinicians with the available evidence to make an individualized treatment plan for the kids on their caseload.

The article by Ireland and colleagues (this issue) is available for free access. This article presents an important response to a call to action from school-based SLPs. In 2018, McLeod and Crowe published an award-winning article reviewing consonant acquisition data spanning 27 languages. Although this 2018 article did not present new data on speech sound norms, the article has colloquially become known as the “new norms.” Shortly after its publication, there was a flurry of panic and overwhelm, particularly from school-based SLPs in the United States. Fear of caseloads expanding beyond their already unmanageable sizes was rightfully felt far and wide. In this article, the authors contextualize the “new norms” within the federal, state, and local requirements and guidance that school-based SLPs are required to follow. This article includes several case examples used to help school-based SLPs determine the influence of SSDs on educational performance.

In the next article, Tambyraja and Schmitt (this issue) highlight critical barriers to implementing literacy-based treatments within the context of schools. These authors review the federal and professional mandates that support SLPs' role in literacy, the research that connects poor oral language skills to literacy deficits, and the reading outcomes of this population of children. They call attention to the fact that children with language impairments experience reading difficulties at more than twice the rate of typically developing children and then review the efficacy of literacy interventions. Table 1 alone is a powerful resource for obtaining free evidence-based curricular materials. Through several concrete clinical suggestions, the authors provide actionable steps for school-based SLPs to support literacy. Importantly, the authors encourage SLPs to rely on their robust training in oral language to help make connections between language and literacy.

Gillon et al. (this issue) then take the reins and provide exactly what Tambyraja and Schmitt (this issue) asked for—the results of a collaborative model of classroom-based literacy intervention. Their study, available as open access, focused on outcomes for children with low language skills with and without comorbid speech issues. This article stands out because it showcases a real-world example of an ecologically valid intervention—the data collection took place directly in schools. The authors found that children who received services earlier in the year did better than those who got the same intervention, but later in the year. In addition, children with comorbid impairments performed poorer overall. Both results speak to the importance of early identification and earlier intervening service provision.

Koutsoftas et al. (this issue) present a clever investigation of the importance of spelling skills to help middle school children during the process of revising their own written work. Couched within triple word form theory, the authors dig into the linguistic underpinnings of spelling skills to include phonological, orthographic, and morphological-semantic knowledge. This study established feasibility for a bespoke spelling coding rubric to help SLPs and other educators better classify spelling errors and understand which language constructs may need explicit instruction. Importantly, this work addresses a learning standard from the Common Core State Standards.

When considering the skills that are crucial for classroom success, narrative abilities are near the top of the list. How do we build those skills in children? Petersen et al. (this issue, online only) have the answer. These authors present work that has a real “boots on the ground” feel by employing a commonly used curriculum and a district writing assessment that is administered and scored by teachers. This research examines how oral narrative instruction impacts reading comprehension. Specifically, the intervention was delivered in a tiered manner and the researchers report gains on both proximal and distal measures in second-grade students. These included narrative language, reading comprehension, and writing. The authors generously provide a clear outline of their 8-week program in an appendix, which will make lesson planning for you, the reader, a breeze.

Taken together, this collection of empirical and clinical research articles draws attention to important issues in school-based practice, provides clear evidence of tangible steps for SLPs, engages in action research using curriculum-based assessment and treatment materials, and explores new and collaborative approaches to helping children with speech and language impairments achieve classroom success. School-based SLPs are on the front lines of this work but do not often have a clear map to guide their role in improving educational performance. Reviewing research articles and attempting to apply laboratory results to real-world school settings create an exhausting barrier to evidence-based practice. It is my sincere hope that our school-based SLP colleagues receive this issue and feel our support for their daily efforts. With this issue, the field is one step closer to closing the research-to-practice gap. Thank you for reading.

—Kelly Farquharson, PhD
Issue Editor

REFERENCES

American Speech Language Hearing Association (ASHA). (2019). 2019 benefits and programs survey. CCC-SLP survey summary report: Number and type of responses. www.asha.org
Farquharson K., Boldini L. (2018). Variability in interpreting “educational performance” for children with speech sound disorders. Language, Speech, and Hearing Services in Schools, 49, 938–949.
Katz L. A., Maag A., Fallon K. A., Blenkarn K., Smith M. K. (2010). What makes a caseload (un)manageable? School-based speech-language pathologists speak. Language, Speech, and Hearing Services in Schools, 41, 139–151.
McLeod S., Crowe K. (2018). Children's consonant acquisition in 27 languages: A cross-linguistic review. American Journal of Speech-Language Pathology, 27(4), 1546–1571.
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