Building research capacity in speech and language therapy – Part 3 (Resources for EBP)

I almost forgot I was going to do what I’m about to do as I was originally intending to include this information in Part 2.But as that got a bit too long it probably works out quite well as a post on its own.

I’ll also just preface the main point of this post with a pertinent account of a brief exchange I had with two students in my clinical education tutorial group today while we were waiting for the remaining members of the group to join us.We got to talking about despite it being the first day of term following the 4 week Easter vacation, Mondays just have this habit of making you feel like you’ve not had a break for ages – especially when you’ve just come out of a two-hour class on Research Methods (the students, not myself).This led one student to comment something along the lines of “and I’m not really sure what we’re ever going to use research methods for anyway” to which the other paused then replied something like “well probably for our dissertation but after that I don’t really know“. So, resisting the temptation to let my head drop to the table, as after all they are only in the second year of their four-year course (and they will get more modules which draw out aspects of this later on), I took the opportunity to suggest how such skills should be useful in carrying out Evidence Based Practice, which, is also what I am attempting to instill in them at this stage by asking them to develop therapy tasks based on evidence and citing this evidence in their written therapy plans. I don’t want to go into this in any more detail but I think it raises an interesting issue from a clinical education point of view in that we may be thinking we are instilling principles of evidence based practice but do students appreciate this at the time in that particular stage of their development in becoming SLTs?

And with that:

I’m just basically going to provide a list of resources that SLTs (and other Allied Health Professionals) may find helpful in their quest to implement Evidence Based Practice, or dare I say it, have a go at some research.Some will probably only be relevant/accessible by UK SLTs but most should be useful for others too.

If you are reading this and know of something else to add to the list, please feel free to add a comment so it can be shared with everyone :D

Building research capacity in speech and language therapy – Part 2

So as a Research Facilitator for SLT my remit was to increase research capacity in local NHS SLT services.The ultimate aim of this was to improve SLT services’ potential of taking part and leading large research projects which would be eligible for inclusion on the National Institute of Health Research’s Research Portfolio. This portfolio being a list of ‘high-quality’ clinical research within the UK which is funded directly through NHS funding streams or through streams that are open on a nationally competitive basis (i.e. where the researchers have applied for funding and where these applications have been judged alongside other competing bids). The long and short of this being that the more involvement in Portfolio research a particular NHS Trust has, the more money they will subsequently be alloted for research purposes in future cycles – so NHS Research and Development (R & D) offices are very keen on this!

However, not all SLTs have the personal desire to do such ‘high-quality research’ (which is fair enough) or the time allowed within their job description to do so even if it is an appealing proposition.Therefore, I saw my role as two-fold:1) to identify and support those who have the desire and committment to engage actively in research; and 2) to help develop core research skills with those, who while not considering research (at this stage), were still interested in developing their ability to conduct evidence based practice.

Building research capacity in speech and language therapy – Part 1

Research skills are integral to any working position as a speech and language therapist (SLT).This is because SLT is (or at least strives to be) an evidence based profession.This means that the things we do, as SLTs, when providing care to real people/patients/clients have been researched and shown to be effective.To make an analogy, if you are in the unfortunate position of needing to take medication or of undergoing a surgical procedure, your doctor should be giving you information on success rates of the intervention in question (e.g. “this drug/procedure has a 60% chance of success, there is a 20% chance of no effect, and a 20% chance of negative side-effects”).Such figures are not just plucked out of the air or based on the particular doctor’s prior experiences – these figures are generally based on the outcomes of thorough and controlled research which has been peer-reviewed and published.

As with all science and healthcare-based fields, knowledge is not stationary.Therefore, it is the speech and language therapist’s responsibility to keep up to date with new developments that are relevant to their working practices in order to ensure they are capable of providing the best possible care.

My thoughts on: Reading TherAppy from Tactus Therapy

Key details (taken from http://www.tactustherapy.com/reading.html)

Reading TherAppy – Phrase and Sentence-Level Reading Comprehension

From Tactus Therapy Solutions (website includes a video demonstration)

Cost:£10.49 / $14.99 (at time of writing) at the iTunes App store

Goal areas

Targets reading comprehension, attention, problem solving

For who?

Aphasia, Alexia, Alzheimer’s Disease, Dementia, Cognitive-Communication Impairment, Brain Injury, Early Language Learners, Language Learning Disability, Autism, English as a Second Language Learners

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Review

Giving a ‘big’ presentation on my research

So I’m in the process of sorting out my filing system on my computer and I came across some text that I had written for a previous blog that I was co-author on.As it still seems to be relevant I’ll post it here.Bear in mind that this was written approximately 18 months ago.It’s also makes a change to be posting about  something other than apps (but new post on this soon).

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Given that I’m now approaching the end of my third year of my PhD research in the area of speech and language therapy, I’ve reached the point where I actually have interesting and somewhat conclusive things to tell people. That’s why I was very excited when I had an abstract for a presentation accepted for a therapy symposium organised by the British Aphasiology Society which coincidentally was being held this year at Newcastle University.

Appraising apps in SLT/P (1) – Outcome measures and building the evidence base

I’ve resisted the cliché of calling this post “App”raisal / APPraisal / app-raisal

Well I’d probably over-estimated myself at the end of my last blog post when I suggested I’d present a structured approach to appraising apps. The more I thought about it, the more there seemed to be to think about and naturally there would always be things that I’d miss out on. So in the interests of getting a post up and making the topic of appraising apps more manageable and not restricting it to just a single blog post, I’m now proposing to present questions and things to think about, more or less as they occur to me. I’ll probably aim to introduce one or two into any one blog post. This means that I can always add to my list of thoughts later, and it also gives people the opportunity to comment and make suggestions (if they are so inclined).

So without any further excuses and delays I’ll go directly into some of my considerations on the issue. These will not necessarily be in any particular order as I’ll aim to make things more structured (i.e. so they could fit on a couple of sides of A4) as my list becomes more well-rounded and refined.

1) How can outcomes be measured?

Get with the times – Speech and Language Therapists need to be informed about apps!

Considering my previous post highlighting some of my thoughts on the availability of apps in SLT I thought I’d attempt to follow this up relatively quickly with some of my thoughts on the SLT’s responsibility in being aware of and appraising apps. Both of the comments on the previous post (at the time of writing this) alluded to the same point in one way or another: as SLTs we have to accept that parents/clients/family will not be passive when it comes to speech and language impairment. It is only natural to want to help when your child or partner has difficulties with communication. Therefore, in the current climate, an app may make for an obvious choice as a possible way to help. This may be especially the case when SLTs’ caseloads are growing and it may be a considerable amount of time before the client has the chance to receive ‘professional’ intervention.

Therefore, to ally my apprehensions, I do propose that it is the SLTs responsibility to:

1) accept that apps are going to be increasingly relevant in the field of SLT. Even if apps are not an individual SLT’s preferred method of delivering intervention, we still have a responsibility to have an awareness of apps because there will more than likely be a time when a new client says something along the lines of “I’m thinking about buying this app because it says it can help with X”.

When faced with such a statement, we are the expert so we should be able to offer an opinion, or at least we should know how we can find out more information.

Some positives and possible warnings about ‘apps’ in speech and language therapy

It appears as though apps are the future of speech and language therapy.In theory I do not have a problem with this as it does make sense to keep up with technology and exploit it wherever there is the potential for it to make our (speech and language therapists’) lives easier, and more importantly, to make a positive contribution to our clients’ development/recovery/rehabilitation.As an illustration of the increasing popularity of ‘apps’, I arrived home today to find the latest edition of the RCSLT’s Bulletin through my door and inside there was an article giving an overview of some of the apps that are currently available for adults with speech and/or language and/or swallowing needs.

From the SLT’s perspective, apps, or more generally tablet computers, would appear to be a sensible investment: they are small yet can store a huge number of different files and applications (i.e. therapy materials); they are touch screen, hence making it an interactive tool which is presumably engaging for clients; they are customisable; if clients see them as being useful, they may then purchase their own hardware and continue therapy independently (which may therefore give the SLT more time to see other clients/patients). Although the hardware itself may be a bit pricey, hard copies of published therapy materials aren’t exactly cheap, so in terms of budgeting, it may be a case or re-directing the flow of cash from buying expensive hard copies of materials which take up valuable shelf space to buying an expensive piece of hardware plus relatively cheap electronic materials which altogether would take up the same amount of space as a single book on a shelf (and a thin book at that).

Blast from the past – Mills (1904). Treatment of aphasia by training

“In testing him for powers of word-seeing, letter-seeing and number-seeing, it was evident that he recognised some letters and some words much better than others. This was especially true with regard to words.He could always pick out words which had evidently been unusually familiar to him before his seizure; for example, the words whisky, brandy and beer in the hospital diet list were at once recognised, although most other words he could not tell, except in a few cases with difficulty”

A look at: Mills, C. K. (1904). Treatment of aphasia by training. Journal of the American Medical Association, 43, 1940-1949.

Note/Promise to self

I’ll begin to use this blog to summarise some nice things I read related to aphasia and speech therapy.

Been inspired by excellent Research Digest blog by British Psychological Society. Not intending to be quite as productive and comprehensive as this but it will give me added motivation to write something when other ideas are thin on the ground.

I’ll keep up with other content as well but as I’m struggling to keep up with my plan of 1 blog post per week this will hopefully give me more inspiration.It’ll also encourage me to keep reading and appraising stuff rather than just re-tweeting links to articles and/or printing stuff out and adding them to my ever-growing pile of ‘things to read’.