Biomedical Engineering Reference
In-Depth Information
Start here
Develop client profile
Step 1: Develop and ask
meaningful EBP questions
Step 2: Collect personal
evidence and internal evidence
(Performance measurement)
Step 3: Collect external evidence
(Performance of other
individuals and research)
Previous performance
Evaluate
evidence
Other factors
(stakeholder input,
environmental
considerations, field
knowlodge, clinical
Step 4: Use evidence
to make therapy decisions
FIgUre 14.2
Four-step model for EBP. (Hill, K. and Romich, B.,
AAC Evidence-Based Clinical Practice: A Model for Sucess.
AAC
Institute Press. Pittsburgh, PA, 2003.)
In reality, the feature match process is extended by avoiding full characterization of the
individual (e.g., complete clinical and personal evidence). AT teams starting at the level of
matching the person with technology often find themselves in a “trial-and-error” process,
repeating trials and/or needing more time for additional AT trials. The wide range of
speech, language, and communication abilities and behavioral characteristics common
among children and adults diagnosed with autism spectrum disorder (ASD) demands
that SLPs collect and interpret quantitative clinical data regarding these domains at the
start of considering AT interventions. No two adults referred for an AT evaluation with
a diagnosis of aphasia present with the same residual abilities related to an oral-motor
speech or oral and written language disorder. AT teams cannot assume that the individ-
ual's current rehabilitation and educational records contain the diagnostic data needed to
proceed through the EBP and MPT processes. The SLP is a team member whose role may
be to review the records and suggest what additional testing, interviewing, and observa-
tions are needed to improve the assessment outcome.
The data gathered from all team members that characterize the individual supports the
team in formulating well-built, value-based questions. These meaningful questions lead
to locating the best external evidence or to identifying strategies to gather more authentic
clinical/educational and personal evidence (Hill 2006). The SLP may suggest posing two
types of questions: background and foreground (Sackett et al. 2000). The team may start by
