A colleague of mine was asking for some references to support the notion that kids with severe learning difficulties can learn to use high frequency core words (such as want, stop, and get) because they were being told that what these kiddos really use (or need) are words like toy, cookie, and banana. I duly provided a quick sample of peer-reviewed articles and shared the information with other colleagues. And what the hell, I’ll share them with you, dear reader, in the References section at the end of this piece.

But another of my friends also commented that there are still those folks who respond with comment such as, “I don’t care what the research says, I don’t care who these kids are. These are not the kids I’m working with. The kids I’m working with just aren’t going to use these words.”

So what do you do about this? At what point does being “critical of the research” become “ignoring the research because I don’t believe it.”? In the world of Physics, it’s hard to say, “I don’t care what the research says, I’m still going to fly using my arms as wings.” Mathematicians don’t say, “I don’t care what the research says, 1 + 1 does equal 7.” And it’s a brave doctor who would say, “I don’t care what the research says, you go right ahead and smoke 40 cigarettes a day and you’ll be just fine.”

No-one would argue that Speech and Language Pathology as a profession will ever achieve the rigid, statistical certainties of physics and mathematics, but what does it say about our profession if we openly admit to ignoring “the research” because it doesn’t fit with our individual experience? There are certainly enough practices in Speech Pathology that are hotly debated (non-speech oral motor exercises, facilitated communication, sensory integration therapy) and yet still being used. But all of these are open to criticism and lend themselves to experimental testing, whereas an opinion based on personal experience is not. I could tell you that I have used facilitated communication successfully, but that is still personal testimony until I can provide you with some measurable, testable, and replicable evidence. This is one of the underlying notions of evidence-based practice in action.

However, it’s one thing to talk about using evidence-based practice but another to actual walk the walk. If the evidence suggests that something you are doing is, at best, ineffective (at worst, damaging), how willing are you to change your mind? If 50% of research articles say what you’re doing is wrong, how convinced are you? What about 60%? Or 90%? At what level of evidence do you decide to say, “OK, I was wrong” and make a change?

If there’s anything certain about “certainty” it’s that it’s uncertain! Am I certain that teaching the word get to a child with severe cognitive impairments is, in some sense, more “correct” or “right” than teaching teddy? No, I am not. But what I can do is look at as many published studies of what words kids typically use, at what ages, and with what frequency, and then feel more confident that get is used statistically more often across studies. This doesn’t mean teddy is “wrong,” nor does it preclude someone publishing an article tomorrow that shows the word teddy being learned 10x faster than the word get among 300 3-year-olds with severe learning problems.

But until then, the current evidence based on the research already done is, in fact, all we have. Anything else is speculation and guesswork, and no more accurate than tossing a couple of dice or throwing a dart at a word board.

Being wrong isn’t the problem. Unwillingness to change in the face of evidence is.

References

Banajee, M., DiCarlo, C., & Buras Stricklin, S. (2003). Core Vocabulary Determination for Toddlers. Augmentative and Alternative Communication, 19(2), 67-73.

Dada, S., & Alant, E. (2009). The effect of aided language stimulation on vocabulary acquisition in children with little or no functional speech. Am J Speech Lang Pathol, 18(1), 50-64.

Fried-Oken, M., & More, L. (1992). An initial vocabulary for nonspeaking preschool children based on developmental and environmental language sources. Augmentative and Alternative Communication, 8(1), 41-56.

Marvin, C.A., Beukelman, D.R. and Bilyeu, D. (1994). Vocabulary use patterns in preschool children: effects of context and time sampling. Augmentative and Alternative Communication, 10, 224-236.

Raban, B. (1987). The spoken vocabulary of five-year old children. Reading, England: The Reading and Language Information Centre.